Putting a damp cloth on the forehead for a headache

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Irish American Culture

Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage

  • The Republic of Ireland, also known as Eire and the Emerald Isle, covers most of the island bearing its name.
  • The remainder of the island, Northern Ireland, is part of Great Britain.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage

  • During the potato famine between 1846 and 1848, thousands of Irish died from malnutrition, typhus, dysentery, and scurvy; millions immigrated to America.
  • Over 38 million people of Irish descent live in the United States.

 

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview/Heritage

  • Most Irish immigrants initially settled in industrial areas in the northeastern United States along the Atlantic coast.
  • The Irish attained success in America because they spoke the same language, had the same physical appearance as other European Americans, and mastered the political system.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • The major languages spoken in Ireland are English and Irish (Gaelic); the latter is the official language and is spoken primarily in West Ireland.
  • The Irish enjoy puns, riddles, limericks, and storytelling.
  • This Irish accent has a nasal quality, spoken with a strong inflection on the first syllable of a word, resulting in a loss of weak syllables.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • When one becomes accustomed to hearing the Irish-accented English used by newer immigrants, there is little difficulty in understanding the speaker.
  • Irish is low-context English, using many words to express a thought.

 

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

 

  • Some common Gaelic words and their meanings are shamrock for “emblem,” limer for “folklore character,” colleen or lassie for “girl,” sonsie or sonsy for “handsome,” cess for “luck,” brogue for “shoe,” dudeen for “pipe tobacco,” and paddy for “Irishman.”

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • Even though most Irish delight in telling long stories, when discussing personal matters, they are much less expressive unless they are talking with close friends and family.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • Humility and emotional reserve are considered virtues.
  • Displays of emotion and affection in public are avoided and are often difficult in private.
  • Even then, many are still reluctant to express their innermost thoughts and feelings.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • To many, caring actions are more important than verbal expressions.
  • Direct eye contact when speaking with each other.
  • Not maintaining eye contact may be interpreted as a sign of disrespect, guilt, or evidence that the other person cannot be trusted.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • Personal space is important to the Irish, who may require greater distance in spatial relationships than other ethnocultural groups.
  • Although the Irish may be less physically expressive with hand and body gesturing, facial expressions are readily displayed, with frequent smiling even during times of adversity.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • The Irish in America, with their strong sense of tradition, are typically past-oriented.
  • They have an allegiance to the past, their ancestors, and their history.
  • While respecting the past, they balance “being” with “doing,” and they plan for the future by investing in education and saving money.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Communication

  • Many Irish see time as being elastic and flexible.
  • Mac before a family name means “son of,” whereas the letter O in front of a name means “descended from.”
  • Women usually take the name of their husband when they marry. Some keep their last name and other use both their surname and that of her husband.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles and Organization

  • The traditional Irish family is nuclear with parents and children living in the same household.
  • Irish families emphasize independence and self-reliance in children.
  • Boys are allowed and expected to be more aggressive than girls, who are raised to be respectable, responsible, and resilient.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles and Organization

  • Children are expected to have self-restraint and self-discipline and to be respectful and obedient to their parents, elders, church, and community figures.
  • Adolescent years are a time for experiencing emotional autonomy, independence, and attachment outside the family while remaining loyal to the family and maintaining the traditional Irish belief in the importance of family.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles and Organization

  • Provisions are made in Irish homes for care of elderly family members, a task that becomes increasingly difficult when both parents work outside the home.
  • Irish respect the experience of elderly people and seek their counsel for decision-making.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles and Organization

  • The Irish value physical strength, endurance, work, the ability to perform work, children, and the ability to provide their children with the needed education to attain respectable socioeconomic status and accomplishments.
  • Same-sex relationships continue to carry a stigma for some.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Workforce Issues

  • Because cultural differences between Ireland and the United States are minimal, Irish assimilate into the American workforce easily.
  • When change is necessary to improve the status quo, the Irish readily relinquish traditional beliefs and adjust to the workforce.
  • Even though the Irish are typical of past-oriented groups in other ways, they tended to question the status quo of the American workforce.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Workforce Issues

  • The low contextual use of language, where most of the message is in an explicit mode rather than an implicit mode, enhances pragmatic communications in the workforce.
  • Personal space is important to the Irish, who may require greater distance in spatial relationships than other ethnocultural groups.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

The Irish are noted for their low-context English. Low contexted language means

Few words are used to express a thought.

May words are used to express a thought.

Nonverbal communication is common.

Nonverbal communication is rare.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: B

Low contexted English means that the majority of the message is verbal and many words are used to express a thought.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

  • Most Irish have dark hair and fair skin or red hair, ruddy cheeks, and fair skin; however, other variations exist in hair and skin color.
  • The fair complexion of the Irish places them at risk for skin cancer.
  • The Irish are taller and broader in stature than average European Americans, Asians, or Pacific Islanders.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

  • Because mining is an important economic activity in Ireland, miners are at increased risk for respiratory diseases.
  • The cool maritime climate of Ireland increases susceptibility to respiratory diseases.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Biocultural Ecology

  • Commonly occurring health conditions for Irish Americans are coronary heart disease, phenylketonuria, osteoporosis, alcoholism, and skin cancer.
  • The major cause of infant mortality in Ireland is congenital abnormalities.
  • Other conditions with a high incidence among Irish newborns are phenylketonuria (PKU), neural tube defects, and fetal alcohol syndrome.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

High-Risk Health Behaviors

  • Smoking has been identified as a major risk factor causing premature mortality from cancer in Ireland and among the Irish in America.
  • The use of alcohol and intravenous drugs are major health problems among Irish Americans.
  • Alcohol problems in Ireland are among the highest internationally.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

High-Risk Health Behaviors

  • Alcoholism researchers generally agree that Irish ancestry puts individuals at risk for developing drinking problems.
  • Irish pubs are popular establishments that have become synonymous with alcohol intake, lively music, and a vivacious time.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Irish food is unpretentious and wholesome if eaten in recommended proportions.
  • Food is an important part of health maintenance and celebrations.
  • Vitamins are commonly used as a dietary supplement.
  • Meat, potatoes, and vegetables are dietary staples.
  • Lamb, mutton, pork, and poultry are common meats.
  • Seafood includes salmon, mussels, mackerel, oysters, and scallops.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Popular Irish dishes include Irish stew made with lamb, potatoes, and onions.
  • Potatoes are used in a variety of ways. Colcannon is made with hot potatoes, mashed with cabbage, butter, and milk, and seasoned with nutmeg. This dish may be served at Halloween.
  • Champ is a popular dish made with mashed potatoes and scallions.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Potato cakes, made with mashed potatoes, flour, salt, and butter, are shaped into patties and fried in bacon grease.
  • Potato cakes are served hot or cold with butter and sometimes with molasses or maple syrup.
  • Another popular dish is Dublin coddle, made with bacon, pork sausage, potatoes, and onions.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Oatmeal is popular in Ireland.
  • Soda bread, another popular food, is made with flour, baking soda, salt, sugar, cream of tartar, and sour milk.
  • Mealtimes are important occasions for Irish families to socialize and discuss family concerns.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • Meals are eaten three times a day with a large breakfast in rural areas, lunch around noon, and a late dinner.
  • Some Irish Americans continue the afternoon tradition of “tea,” a light sandwich or biscuit with hot tea.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

Health conditions with a high prevalence among Irish and Irish Americans include all of the following except

a. Alcohol misuse.

b. PKU

c. Skin cancer

d. Aortic anyerisms

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: D

No documentation exists that indicate Irish and Irish American have an increased risk for Aortic aneurysms.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Pregnancy and Childbearing Practices

  • Not eating a well-balanced diet or not eating the right kinds of food may cause the baby to be deformed.
  • A belief common to many other ethnic groups is that the mother should not reach over her head during pregnancy because the baby’s cord may wrap around its neck.
  • A taboo behavior in the past, which some women still respect, is that if the pregnant woman sees or experiences a tragedy during pregnancy, a congenital anomaly may occur.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Pregnancy and Childbearing Practices

  • Eating a well-balanced diet after delivery continues to be a prescriptive practice for ensuring a healthy baby and maintaining the mother’s health.
  • Plenty of rest, fresh air, and sunshine are also important for maintaining the mother’s health.
  • Going to bed with wet hair or wet feet causes illness in the mother.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals

  • The Irish are fatalists and acknowledge the inevitability of death.
  • The American emphasis on technology and dying in the hospital may be incongruent with the Irish American belief that family members should stay with the dying person.
  • Whereas men are expected to be more stoical in their bereavement, women are more expressive.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals

  • A wake continues as an important phenomenon in contemporary Irish families and is a time of melancholy, rejoicing, pain, and hopefulness. The occasion is a celebration of the person’s life.
  • Cremation is an individual choice, and there are no proscriptions against autopsy, if required.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • The predominant religion of most Irish is Catholicism, and the church is a source of strength and solace.
  • Other religions common among Irish in America include various Protestant denominations, such as the Church of Ireland, Presbyterian, Quaker, and Episcopalian.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • In times of illness, Irish Catholics receive the Sacrament of the Sick, which includes anointing, communion, and a blessing by the priest.
  • The Eucharist, a small wafer made from flour and water, is given to the sick as the food of healing and health.
  • Family members can participate if they wish.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • Attending Mass daily is a common practice among many traditional and devout Irish Catholic families.
  • Prayer is an individual and private matter.
  • In times of illness, the clergy may offer prayers with the sick as well as with the family.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • For Catholics, holy day worship begins at 4 PM the evening preceding the holy day of obligation; all Sundays are considered holy days.
  • The obligation to fast and abstain from meat on specified days is relinquished during times of illness.
  • Some Irish may wear religious medals to maintain health.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

  • Many Irish use denial as a way of coping with physical and psychological problems.
  • The Irish view of life is illustrated in the belief that life is black with long suffering, and the less said about it, the better.
  • Many Irish ignore symptoms and delay seeking medical attention until symptoms interfere with the ability to carry out activities of daily living.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

  • Irish Americans limit and understate problems and handle problems by using denial.
  • Because Irish people may not be very descriptive about their symptoms, treatment may be more difficult.
  • Illness or injury may be linked to guilt and considered to be the result of having done something morally wrong.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

  • Most Irish believe one is obligated to use ordinary means to preserve life.
  • Extraordinary means may be withheld to allow the person to die a natural death.
  • The sick person and family define extraordinary means; finances, quality of life, and effects on the family usually influence the decision.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

  • In most Irish families, nuclear family members are consulted first about health problems.
  • Mothers and older women are usually sought for their knowledge of folk practices to alleviate common problems, such as colds.
  • Having a strong religious faith, keeping one’s feet warm and dry, dressing warmly, eating a balanced diet, getting enough sleep, and exercising are important for staying healthy.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

 

Irish practices include—

  • Wearing religious medals to prevent illness
  • Using cough syrup made from honey and whiskey
  • Taking honey and lemon for a sore throat
  • Drinking hot tea with whiskey and eating toast for a cold
  • Drinking hot tea for nausea
  • Putting a damp cloth on the forehead for a headache.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practices

  • The behavioral response of the Irish to pain is stoic, usually ignoring or minimizing it.
  • One explanation for high rates of mental illness may be associated with the Irish having difficulty describing emotions and expressing feelings.
  • Blood transfusions are acceptable to most Irish Americans.
  • Many participate in organ donation and indicate their willingness to do so on their driver’s licenses.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health-care Practitioners

  • The Irish respect all health-care professionals.
  • Although the Irish are not noted for being overly modest, some may prefer to receive intimate care from someone of the same gender.
  • In general, men and women may care for each other in health-care settings as long as privacy and sensitivity are maintained.

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