Defense Date

7-9-2008

Graduation Date

2008

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Joan Such Lockhart

Committee Member

Rick Zoucha

Committee Member

Lauren Clark

Keywords

Puerto Rican women, health beliefs and practices, focused ethnography, acculturation, home remedies, cultural competency

Abstract

The purpose of this focused ethnography was to discover the culturally based health care beliefs and practices of the Puerto Rican population in urban Southeastern Pennsylvania as related by Puerto Rican women. The study also sought to discern the influence of acculturation on the health beliefs and practices of this population. The study used a qualitative methodology to elicit the emic viewpoint of the informants through semi-structured interviews, participant observation, fieldnotes and memos. A quantitative measurement scale was used to measure psychological acculturation; most informants were bicultural although all self-identified Puerto Rico as home. A purposive sampling strategy with snowballing was used to identify 37 informants. Informants provided detailed data on home remedy use. Four themes were abstracted from the data analysis including (a) between two worlds: staying connected to our roots; (b) gardens as symbols of the motherland: creating the environment; (c) the holistic nature of health; (d) surviving the system: healthcare perspectives in Puerto Rico and Philadelphia. Findings have implications for health professions education and practice in the areas of safe integrative healthcare and health disparities. Policy implications include the need for interdisciplinary education of health professions students in social policy and health disparities and corresponding clinical practice in health disparities areas. Policy implications for third-party health insurers include the need to re-examine current primary care service mandates to reflect client input and needs. Further research is needed in the areas of safety and integrative medicine, health policy and health disparities, creation of healthcare delivery models that are culturally-based and focus on improving health outcomes, and the relationship of acculturation to health beliefs and practices, and ultimately to health outcomes.

Format

PDF

Language

English

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