Question

PUERTO RICAN CASE STUDY #2 Carmen Medina, aged 39, lives with her husband, Raúl, aged 43, who works as a mechanic in a small auto shop. Mr. Medina has worked in the same place since he and his wife came to the United States from Puerto Rico 15 years ago. The Medinas have a 4- year-old son, José; a 16-year-old daughter, Rosa; and an 18-year-old son, Miguel. The Medinas both attended vocational school after completing high school. Mrs. Medina is employed 4 hours a day at a garden shop. She stopped working her full-time job to care for her ill mother and aged father, who do not speak English and depend on government assistance. The family income last year was $28,500. The family has health insurance through Mr. Medina’s job. They live in a threebedroom apartment in a low-income Illinois community. Miguel works in a fast-food store a few hours a week. Because Rosa has responsibilities at home, the Medina’s do not allow her to work outside the home. She is very close to her grandmother but avoids talking with her parents. Both Rosa and Miguel are having difficulties in school. Rosa is pregnant and the family does not know. She is planning to drop out of school, get a job in a beauty shop, and leave home without telling the family. Miguel frequently comes home late and, on occasion, sleeps out of the home. He is beginning college next semester and has plans to move out of the house during the summer. The family is having difficulty dealing with Rosa’s and Miguel’s developmental and behavioral challenges. Although Mrs. Medina is outspoken about these concerns, Mr. Medina is quiet and not actively involved in the discussion. He is more preoccupied with the family’s financial situation. Mrs. Medina’s parents are encouraging them to return to Puerto Rico. Mr. Medina was diagnosed with hypertension 2 months ago, when he went to the emergency room for a respiratory infection. He smokes cigarettes and drinks two to three beers every evening after work. He has not followed up on his blood pressure treatment. Miguel is beginning to smoke, but not at home. José has had frequent colds and sinus allergies. He has been to the emergency room three times during the past year for respiratory infections. Mrs. Medina’s last physical examination was after she had José. She is experiencing insomnia, tiredness, headaches, and gastrointestinal problems. She is very concerned about Rosa and Miguel, her parents, and the family’s finances. Mrs. Medina is Catholic and recently has been visiting her church more often.

9. If the Medina family chose to visit a folk healer, which one(s) do you think they might visit? Why?

10. If Mrs. Medina’s parents visit a health-care provider, what might they expect?

11. Identify culturally congruent interventions to ensure compliance with Western health prescriptions for Mr. Medina.

12. Discuss the importance of respeto and familism in the Medina family.

Answer 1

9.Puerto Ricans are culturally very much bonded and believes illness is a evil or a sin.They hardly believe the scientific medicine given by patients nor their treatment.They follow Puerto Rican folk medicine . They might visit a Curandero who is a healer ,providing remedy with the use of herbs,religious or spiritual powered or holy water.This is because of their beliefs and practices generation after generation .

10.Medina's parents can expect the following from a health care provider

• A culturally competent care
• Get the proper and complete benefits of financial assistance from government
• They can be introduced with the social support group ,virtual assistance to get help
• Oldage care assistance can be provided by informing to support group.

11.The culturally congruent interventions are

• Explaining the line of treatment and their preferences, this can create a clarity and a sense of trust on healthcare professionals. This is a way of showing respect and giving them priority. (Respeto is highly valued)
• Suggesting the complementary medicines like herbal medicine, sidhaa,ayurveda ,etc., to treat their illness along with allopathic treatment. This can ,make them more comfortable and cooperative because this js widely followed by them
• Encourage to quit drinking with help of medication and by spiritual practices
• Encourage to take responsibility upon family because in Puerto Rican, the male dominancy is highly prevalent

12.The importance of respeto and familism can benefit the family in the following way

• Can reduce the stress of Mrs.Medina
• Can make Mr.Medina to take responsibility of each action in home . He can correct his son and provide steady financial assistance. Can be a role model to his son.Can work along with his wife to find a solution of sexual promiscuity in her daughter and get medical help.
• It can prevent the expected incidence of family distortion (Son and daughter's idea to leave the family)
• To pay attention to the health of their youngest son who is with low immunity to infection
• Familism can reduce almost all problems in the family.