School of Nursing

Chestnut Hill, MA 02167

Spring 2000

Course Number: NU 301

Course Title: Culture and Health Care

Credits/Level: 3/Level Three

Placement in Curriculum: Elective

Faculty: Rachel E. Spector, Ph.D., R.N., C.T.N., F.A.A.N.

Prerequisites: Upper division undergraduate or graduate student

Course Description:

This course is designed to bring the upper division undergraduate and graduate student into a direct interface between the American Health Care Delivery System and Health Care Consumers of diverse socio-cultural backgrounds.

Topics covered include lectures and discussions in the perception of health, health and illness among health care providers and consumers; the cultural and institutional factors that affect the consumers' access to and use of health and health care resources; heritage consistency and its relationship to health and health / illness beliefs and practices; specific health/health and illness beliefs and practices of selected populations; and specific issues related to the safe and effective delivery of health care, such as poverty and the right to health care.

Course Objectives:

At the end of NU 301 the student will be able to:

1. deepen his/her understanding of the perceptions and meaning of " health," "health," and "illness" - to both themselves and the consumer;

2. enter into dialogue with people who have experienced problems in dealing with the American Health Care System;

3. understand the conflicts between the consumer and the American Health Care System and the impact on nursing practice and action;

4. develop plans as to what nursing practice can do to intervene in these conflicts and diminish them; and

5. understand the multiple issues relating to health from a multicultural perspective.

Course Content:

I. Perceptions of Health, health, and Illness

II. Illness Perceptions

III. Poverty and Health Care Delivery

IV. Culture-Heritage Consistency and Health Care

V. Familial Beliefs

VI. Complimentary health Care and Healing

VII. Health, health, and Illness in Selected Populations

VIII. Multicultural Health and health Issues

IX. Policy Implications

Teaching and Learning Methods:

lectures debates

reading assignments seminars

discussion films

academic project/paper field trips

Required Texts:

Fadiman, A.(1977) The spirit catches you and you fall down. NY: Farrar, Straus, Giroux.

Spector, R. (2000). Cultural Diversity in Health and Illness (5th.ed.). Upper Saddle River, NJ: Prentice Hall Health

Spector, R. (2000) CulturalCare: Guides to Heritage Assessment and health Traditions, (2nd Ed.) Upper Saddle River, NJ: Prentice Hall Health

Suggested Texts:

Dresser, N. (1993). Our Own Stories White Plains, NY: Longman

Kraut, Alan (1994). Silent Travellers. New York: Basic Books

Starr, Paul (1984). The Social Transformation of American Medicine New York: Basic Books

Other readings will be required from books and journals.

Course Requirements and Evaluation Methods:

A. This course places considerable emphasis on clarification of students' beliefs and values about the multicultural issues confronting professional nurses. Clarification of professional beliefs and values cannot be accomplished by reading content or reviewing lecture notes alone. Without informed interaction in class, such learning does not occur. Because of this, the course has three (3) requirements:

1. students will attend ALL classes;

2. students will actively participate in ALL classes; and

3. students will complete assigned readings related to class topics prior to class.

B. Course Grading:

Weight Due Dates

1. Mid-term (Take Home) 30% 2/28/00

2. Weekly Readings, Attendance and Class Participation 20%

3. Two Papers:

a. A 4-Week "HEALTH" Diary 10% 2/14/00

b. Health/ health Interview with Maternal Grandmother, 10% 2/21/00

Aunt or Mother

4. Term Paper and Project 30% 5/1 or 5/8/00

This is a written, well-documented report of your portion

in the group project for the health Fair

Evaluation Methods:

reading & discussion term paper & project health diaries

class participation class presentations term project

health interviews examination--mid-term

Faculty Information:

Dr. Rachel E. Spector, R.N., C.T.N.

Associate Professor

Cushing Hall 336L 552-8819

Course Content:


1/24 Introduction "Health, " health," & "Illness" Spector, Chapter 1

1/31 Health Care Delivery System Spector, Chapter 3

2/7 Delivery Issues: Poverty, Access, Financing Spector, Chapter 7

2/14 Heritage Consistency Spector, Chapter 4

2/21 Familial Traditions Spector, Chapter 2

2/28 Healing vs. Curing Spector, Chapters 5 & 6

3/6 ** Spring Break **

3/13 health Traditions in the American Indian Communities Spector, Chapter 8

3/20 health Traditions in the Asian Communities Spector, Chapter 9

3/27 health Traditions in the Black Communities Spector, Chapter 10

4/3 health Traditions in the Hispanic Communities Spector, Chapter 11

4/10 health Traditions in the European Communities Spector, Chapter 12

4/17 **HOLIDAY **

4/24 Managing Diversity

5/1 health Fair

5/8 health fair

Films related to Culture and Health Care


El Norte Angelo, My Love Fried Green Tomatoes New Jack City

Dances With Wolves Avalon Boys in the Hood The Sorceress

The Pawnbroker Like Water for Chocolate The House of the Spirits

Write a review of the film and include an overview of the plot, the ways in which the traditions of the cultural group are portrayed, and how this background can help in understanding a snap-shot of a point of view of a given person's experience as a member of that community


Course and faculty teaching methodologies are evaluated each semester and this is accomplished through the university course evaluation tool that is distributed to the students at the end of the semester.

Course Grade:

1. health Diary - 10 points

Maintain a 3 week diary of your daily health status: mental, physical, and spiritual. Note eating, sleeping and exercise patterns. Evaluateyour health activities at the end of 4 weeks. Written reflection is vital. Due 2/14/00

2. Health Interview - forms attached - 10 points

3. Take home midterm

4. Term Project - Class Presentation with small group of 2 or 3 students. A brief oral presentation and a poster presentation will be presented. Include the following data as applicable:

(a) history of ethnic group or substance in United States

(b) group's perception of health, health and illness

(c) traditional healing methods

(d) current health care problems


(a) bibliography

(b) interviews with people within given community

(c) observation

(d) United States history

5. Term Paper - Predicated on your share of the group project; must be typed and documented in APA style; individual grade

15 points Due: Day of Presentation

Course Policies:

A. Academic Integrity

The Boston College School of Nursing has adopted the following policy on academic integrity:

Nursing students are expected to have high standards of integrity in both the academic and clinical settings. Students who misrepresent their work in papers, examinations or clinical experience, at a minimum will receive no credit for the course requirement involved; in addition, a written statement of the incident will be placed in their file, and they will be subject to dismissal from the School of Nursing

It is expected that students will attend all classes.

B. All papers must be handed in on time. They will be marked down 0.5 points for each late day.

Rachel E. Spector, PhD, RN, CTN, FAAN

Cushing Hall 336L (Office hours posted on door and available by appointment)



In preparation for the class on 2/21/00 I am asking each of you to interview your Maternal Grandmother, Mother or a Maternal Aunt. Please ask her for the following information:

1. Begin with the Heritage Assessment in the CulturalCare Guide, pg. 4 and score yourself and your grandmother or mother.

2. Ethnic background

Country of Origin


3. What does she do to maintain health /health? Also, if she can remember, what did her mother do?

4. What does she do to protecthealth/health? Also, if she can remember?, what did her mother do?

5. What "home remedies" does she use to treat illness? Also, if she can remember, what did her mother do?

6. How do her religious/spiritual beliefs define birth? What rituals accompany this event?

7. How do her religious/spiritual beliefs define illness? What rituals accompany this event?

8. How do her religious/spiritual beliefs define healing? What rituals accompany this event?

9. How do her religious/spiritual beliefs define death? What rituals accompany this event?

(This is a paper that you may want to save - please make 2 copies)

NU 301 Culture and Health Care


NAME ________________________________________________

1. The World Health Organization's definition of Health is accurate. a b c

2. Santeria is a concept and practice I understand. a b c

3. Health care is a right for all people. a b c

4. Patients must be allowed to wear bracelets, charms or amulets to the

operating room. a b c

5. I consider a patient who fails to take a medication a "non-complier." a b c

6. If a patient does not return for a clinic appointment, I believe he or she

has "eloped." a b c

7. A given person is either well or ill. a b c

8. The first person that a "sick" person should consult is a doctor. a b c

9. "Mal Ojo" can be prevented if a nurse touches a baby's hand. a b c

10. A Nurse ought to avoid the placement of her fingers on an

Hispanic infant's head when the mother is watching. a b c

11. Mrs. Garcia's husband explains that Mrs. Garcia has attaque. He

has consulted an Espiratista. This is an acceptable resource. a b c

12. Patients must be on time for clinical appointments. It is accept-

able, however, for them to wait several hours for the doctor. a b c

13. The Bureau of Indian Affairs provides health care resources

for all Native Americans. a b c

14. Alcoholism in Native Americans may be treated by the Medicine

Man and a favorable outcome is expected. a b c

15. Chinese patients have a high pain threshold. a b c

16. Mrs. Garcia, 3 days post partum, refuses to eat her chicken

dinner. This is an unexpected behavior as her appetite is good. a b c

17. It is O.K. to write down the client responses when you interview a

Native American. a b c

18. The "Jay Treaty" is a respected law. a b c

19. The Chinese believe that man is healthy if body and mind are

in harmony. a b c

20. The Black Muslim patient who refuses to eat Jello must be encouraged

to do so if he or she is on a liquid diet. a b c

a. agree b. disagree c. don't know