Expert Answer:Discussion 12


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Week 12 Discussion Questions
Florida National University
Nursing Department
BSN Program
NUR 3655
March 25, 2019
Prof. Cassandre Milien, MSN, RN
A nurse or any other healthcare service provider should have an explicit recognition and
understanding of the unique impact culture has on a patient’s preferences, behaviors and attitude
around healthcare.
The countries that make up the Baltic states are Estonia, Latvia and Lithuania, running
from north to south. These countries are considered Baltic states because they all have coastlines
along the eastern coast of the Baltic Sea (“What Countries Make up the Baltic States?”). Almost
immediately after independence, the three Baltic countries began a radical reform of their
healthcare, dismantling the old polyclinic system and aiming at a system of Western European
type based on primary care. In this process they received support from many countries, including
the Nordic states (Håkansson, Ovhed, Jurgutis, Kalda, & Ticmane). Baltics believe in being
physically active. This makes them to spend most of their leisure time doing physical exercise,
for not less than four days a week, which boosts their health status greatly, and has enabled them
to be active in their day to day activities and prevent chronic diseases like blood pressure and
diabetics by burning more calories (Yakhlef & Basic, 2015).
Baltics make use of healthy eating. Most of the men and women eat fresh fruits and
vegetables for not less than three days a week. This has boosted their life span and reduced
infection of different diseases like malnutrition by making their immune system strong due to
eating a balanced diet (Dooris & Heritage, 2013).
Latvians, one of the Baltic people has more men and a small number of women who
smoke daily and drink strong alcohol, but the number decreases every year. The number of
people who do not consume alcohol is also increasing. This has increased their health status
because of low exposure to diseases such as cancer of the liver, which is brought by alcohol
(Yakhlef & Basic, 2015).
The reports show that 16% of Estonian men and women practice physical exercise during
their leisure time. The Lithuanians are also reported to be active physically in the Baltics. 71% of
both men and women are reported to eat fresh fruits, and most women of Latvian and Lithuanian
origin eat fresh vegetables. The survey also indicates that men and women consuming alcohol
few times a month has decreased in Estonia and Latvia. It is also shown by the decrease in the
number of people being admitted in hospitals since the diseases is not too serious and does not
require close medical attention (Dooris & Heritage, 2013).
Brazilians believe that health is the absence of disease, pain and suffering. They also
believe that health is a blessing. Most of Brazilians do not seek medical health to prevent, but to
treat an illness, which they believe is brought by fate. The sick people cannot make decisions and
they cannot be informed about the illness. First, the family is informed to make decisions and
suggest a remedy for the illness, especially for serious illness. Brazilians strongly believe in
herbal and medicinal teas, which can be shared by family members as, prescribed (Dooris &
Heritage, 2013). Brazilians generally do not like to talk about pain, however, once the emotional
barrier is removed, they feel relieved to be able to discuss their discomfort.
Brazilians also believe that most childhood illness is caused by spiritual origin, such as an
evil eye or exposure to wind or air. Negative strong emotions like worry can cause diseases.
Some diseases such as mental problems are believed to be God’s will. Events such as accidents
during pregnancy is believed to be attributed by defective sperms, excessive use of alcohol or the
will of God (Dooris & Heritage, 2013).
Research states that a portion of Brazilian people do not accept hospital care due to their
strong belief in traditional medicine rather than hospital medicine. Brazilians always travel along
with their drugs or have them sent from Brazil since they believe that it can help them than
pharmaceutical treatment. Most of them do accept hospitalization but prefer home care for the
seriously sick people. It was also found that they only seek higher medical attention when the
illness worsens and the sick is at the point of death (Yakhlef & Basic, 2015).
People of Baltic and Brazilian heritage have a positive view towards health and disease,
and a high value for good health. People of both heritages accept modern medical treatments and
readily use the health-care system available to them. Also, Baltics and Brazilians take an active
interest in healthy lifestyles, exercise, and nutrition. One similarity between the heritages studied
this week is that family usually cares for individuals at home, and if they need to be treated at
hospitals, the family will be present. Baltic descendants and better-educated Brazilians accept
blood transfusions, organ donation, and transplantation. Brazilian and Baltics in the United
States tend to respect and follow the orders and prescriptions of physicians and nurses.
Dooris, M., & Heritage, Z. (2013). Healthy Cities: facilitating the active participation and
empowerment of local people. Journal of Urban Health, 90(1), 74-91.
Håkansson, A., Ovhed, I., Jurgutis, A., Kalda, R., & Ticmane, G. (n.d.). Family medicine in the
Baltic countries. Retrieved from
What Countries Make up the Baltic States? (n.d.). Retrieved from
Yakhlef, S., & Basic, G. (2015). Policing Borders through Cooperation in the Baltic Sea Area. In
ESA 2015, 12th Conference of the European Sociological Association, Prague, August
25-28, 2015. (pp. 1548-1549).
Week 12 Discussion – People of Baltic and Brazilian Heritage
David Alvarez
Florida National University
BSN Program
NUR 3655
March 26, 2019
Prof. Cassandre Milien, MSN, RN
Week 12 Discussion – People of Baltic and Brazilian Heritage
Estonia, Latvia, and Lithuania are known as the Baltic countries. They are known
by that name because each of them is located in Europe on the Baltic Sea. Historical,
cultural, religious, and language differences prevent the group from being one cultural
entity. These countries represent three distinct ethnic groups and are treated as such.
However, people of Baltic heritage adapt readily to America values of timeliness in the
workplace. Most have no difficulty maintaining their sense of autonomy and readily
assume work roles and responsibility for decision making.
Individuals of Baltic descent adhere to modern medical regimens and readily use
the health-care system available to them. Because they consider health and well-being
important, they take an active interest in healthy lifestyles, nutrition, and exercise.
Natural foods such as rye and whole-grain breads, fruits, and vegetables are preferred.
Fresh air is considered important, and walking, especially in natural settings such as
parks, is enjoyed by all ages.
Americans of Baltic heritage are health conscious and believe that a wellbalanced lifestyle maintains health and well-being. For example, well-being among
Lithuanian Americans is typically described as a holistic concept, composed of a state
of being in which the person’s physical, spiritual, psychological, and social health are in
balance. Moderation is perceived as desirable for living a healthy life. Natural foods are
preferred, and whenever possible, vegetables and fruits are homegrown.
Western medicine practices are used among people of Baltic descent. They are
likely to obtain early prenatal medical care and are likely to be receptive to health
teaching for prenatal and postnatal care. Because they prefer natural processes, some
women and families prefer natural childbirth and breastfeeding.
Week 12 Discussion – People of Baltic and Brazilian Heritage
Individuals of Baltic descent use less folk medicine than they did in the past.
Older Americans of Baltic descent are more likely to use more-current healing practices.
Chamomile and linden blossom teas may be used for fevers and colds honey is used
for colds and sore throats. The nurse or health-care provider should ask about teas or
folk remedies that may have been used before the client sought medical help. Younger
people prefer to use over-the-counter cold remedies and analgesics. The use of natural
substances for healing purposes is not customary among this generation.
Brazilians are a mixture of Portuguese, French, Dutch, German, Italian,
Japanese, Chinese, African, Arab, and native Brazilian Indians. Information about
Brazilian culture is unidentifiable in the professional health-care literature, which tends
to incorporate Brazilians into aggregate data on Hispanics. Most Brazilians in the United
States are concentrated in communities around Boston, New York, Newark, New
Jersey, and Miami. Portuguese is the official language of Brazil and continues to
dominate the Brazilian communities in the United States. Brazilians, in general, are not
punctual, arriving late—from minutes to hours—especially for social occasions.
However, those in professional circles are punctual. Health-care providers may need to
carefully explain the necessity of showing up on time for health appointments.
People of Brazilian heritage usually do not talk about their illnesses unless these
are very serious. Generally, illness is discussed only within the family. Many Brazilians
feel that talking about an illness such as cancer negatively influences their condition.
Because many Brazilians tend to shun hospitals, when they are hospitalized, their
families accompany them and stay around the clock. Brazilian families are eager to
Week 12 Discussion – People of Baltic and Brazilian Heritage
participate in patient care and, thus, can be taught various procedures and care
The Brazilian culture is rich in folk practices that depend on geographic region,
ethnic background, socioeconomic factors, and generation. Traditional and
homeopathic pharmacies are supplemented by remedios populares (folk medicines)
and remedios caseiros (home medicines). Health-care providers need to specifically ask
about their use. Brazilians generally do not like to talk about pain. However, once the
emotional barrier is removed, they feel relieved to be able to discuss their discomfort.
Many pain-relieving medicines are available without a prescription in Brazil. Frequently,
a person requiring these on a regular basis will request that friends bring a supply from
Health-seeking behaviors among Brazilians living in the United States are
increasing. Information about safe sex is frequently sought to prevent sexually
transmitted infections. A paradigm shift from acute care to preventive care is evident
among Brazilians in Brazil and in the United States.
When comparing the Baltic and Brazilian heritage health care beliefs we see
many differences. People of Baltic heritage and descent are more open about their
health care needs than those of Brazilian heritage, they seek medical assistance when
necessary and implement Western medicine practices. People of Brazilian heritage are
reluctant when it comes to illnesses, they don’t seek medical attention and don’t like to
talk about it because they think doing so will aggravate their condition. Furthermore,
Brazilians are big on folk medicine practices unlike those of Baltic descent.
Week 12 Discussion – People of Baltic and Brazilian Heritage
As future nurses it is important to understand and respect these cultures and
their religious and health care beliefs, as they influence all aspects of their care. By
getting to know them better, we can provide a better healing environment and make
them feel more comfortable while going through a difficult time in their lives.
Week 12 Discussion – People of Baltic and Brazilian Heritage

Brazil. (n.d.). Retrieved from

Chapter 26 Power Point

Chapter 27 Power Point

Health in the Baltic Countries 2015 – Tervise Arengu Instituut. (n.d.). Retrieved
from in the
Baltic Countries.pdf

Håkansson, A., Ovhed, I., Jurgutis, A., Kalda, R., & Ticmane, G. (2008). Family
medicine in the Baltic countries. Retrieved from

Lima, N. T. (2007, July). Public health and social ideas in modern Brazil.
Retrieved from

Purnell, L. D. (2013). Transcultural health care: A culturally competent approach.
Philadelphia: F.A. Davis.

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