Transcultural Health Care: A Culturally Competent Approach, 4th Edition
French Canadian Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ More than 2.2 million people of French Canadian descent
reside in the United States.
▪ Nowadays, French speaking Canadians, unlike those of the
19th century living in the USA, may have been raised within
the French culture but descended from a variety of
ethnicities.
▪ The Multiculturalism Canada Act of 1988 provides guidelines
for implementing policies regarding multicultural diversity.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ Before the latter half of the 18th century, most
French immigrating to Canada were Catholics.
▪ French Protestants tended to come directly to the
United States.
▪ After the French Revolution, more Catholics sought
shelter in the US, most coming via Canada settled in
the New England states and later dispersed
throughout the United States.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ The Métis, descendants of Native Americans and
Europeans, are mainly, though not entirely, Frenchspeaking.
▪ Another major portion of Canada’s French-speaking
population are the Acadians who are the
descendants of the early French colonists.
▪ Canadians whose first language is French are called
Francophones.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ Canada has become an increasingly diverse
society composed of various ethnocultural
groups with more than 100 different
languages as mother tongue.
▪ Much like that of the US, interethnic marriage
patterns have dramatically changed from a
multiethnic society to multiethnic individuals.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Canada has two official languages, French and
English.
▪ In many homes in the US and in Canada English
and French may be used equally.
▪ The French-speaking population may lack
sufficient knowledge of the English language to
access the workforce and other material.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Among French Canadians, a conversation may be
conducted with high voice crescendos, which do
not necessarily mean anger or violence.
▪ Volume can increase with the importance and the
emotional charge invested in the content of the
message.
▪ French Canadians encourage sharing thoughts and
feelings.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Using hand gestures for emphasis when
speaking is common.
▪ Facial expressions for men and women of all
ages are a part of communication, often
replacing words.
▪ Spatial distancing for differs among family
members, close friends, and the public.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ When in the intimacy zone, people may touch
frequently and converse in close physical
space; however, they tend to avoid physical
contact in public.
▪ When greeting another person, men usually
shake hands.
▪ Close female friends and family members
may greet each other with an embrace.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Maintaining eye contact is an important
French Canadian value.
▪ Most French-speaking Canadians have a past,
present, and future orientation in their
worldview.
▪ More traditional people, and many from rural
backgrounds, attach primary importance to
living in the present.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Until the late 1970s, women and children took the
father’s surname.
▪ Today, under Quebec law, a woman keeps her
maiden name throughout her lifetime, although in
other parts of Canada this practice is decided
between the spouses.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communication
▪ Québécois family of two spouses and two children may
well include four different surname combinations: one
child may have the father’s surname or the mother’s
surname alone or a hyphenated or non-hyphenated
surname composed of those of the father and mother.
For a second child, the surnames are the same, but in
reverse order.
▪ The decision for using surnames rests entirely with the
parents.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
The Métis in Canada are
a. Mostly English Speaking.
b. Mostly speak an indigenous dialect.
c. Descendants of Native Americans and
Europeans.
d. Descendents of French and Arabic.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: C
a. Descendants of Native Americans and
Europeans.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Many older people with a strong religious
background maintain a future worldview
regarding life after death.
▪ Many of the younger generation reject past
traditions and attempt to maintain a balance by
enjoying the present, working, and planning for
their future.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Traditionally, in French-speaking Canadian
families, the man was seen as the moral
authority and responsible for material wellbeing, such as economic provider and purveyor
of affection and security.
▪ The woman served as the family mediator and
social director as well as being responsible for
household activities, child care, and health care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ With more women working, family roles are
becoming more egalitarian.
▪ French Canadians have always attributed great
value to family relationships and obligations.
▪ Research reports that Francophones are less
committed than Anglophones to with respect to
marriage, sexual activity, and non-married
parenthood.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ The greatest source of pride for French
Canadian families is to see their children well
established with a good education.
▪ The French Canadian family is more nuclear
and autonomous than its counterpart in France.
▪ French-speaking Canadian family is known for
its closeness, and some families are a “closed”
family system.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ Traditionally, the Catholic Church dictated the
parameters of sexual behavior for French
Canadians.
▪ There is a growing trend for couples to live
together without marrying.
▪ Many young couples answer that they cannot
financially afford to get married.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles and Organization
▪ In 1996, the Canadian government extended
health, relocation, and other job benefits to
same-sex partners of federal employees.
▪ The Ontario Court of Appeals ruled that samesex couples must be treated as common-law
couples under the Family Leave Act.
▪ Canada is one of the few countries in the world
where same-sex marriage is legalized.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Workforce Issues
▪ Opportunities for Francophone nurses to function
successfully outside Quebec and in the US are
limited if they have not mastered the English
language.
▪ Because Francophone culture is more collevistic
than individualistic, some may initially have
difficulty adapting to an environment where
autonomous decision-making is required.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Canadians of French descent are white or
Caucasian; however, Francophones, as a
linguistic group, represent a mosaic of
ethnocultural characteristics, including racial
differences prompted by acculturation, adoption,
and the children of mixed marriages.
▪ Assess individuals for biological risks according
to their racial and cultural heritage.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Higher incidences of prostate and breast and
ovarian cancers have been seen among
Francophones.
▪ A high rate of suicide and suicidal ideation,
particularly among Francophone adolescents
and young adult males, is seen in Canada. It is
unknown if this extends in the US.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Genetic and hereditary diseases include spastic
ataxia Charlevoix-Saguenay type, cystic fibrosis,
tyrosinaemia, cytochrome lipase deficiency,
familial chylomicronemia resulting from the
lipoprotein lipase (LPL) deficiency,
hyperlipoproteinemia type I which has been
traced to migrants from the Perche region of
France.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ An increased incidence of cystic fibrosis and
muscular dystrophy occurs among Frenchspeaking Canadians.
▪ Sickle cell anemia is also higher among
Francophones than the general population.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
High-Risk Health Behaviors
▪ Misuse of alcohol, tobacco, marijuana, and
psychotropic drugs are major health problems.
▪ Tobacco and alcohol use is highest among
French-speaking males and is associated with
masculine sex roles, higher self-esteem, and an
external locus of control.
▪ The rate of individuals who do not exercise on a
regular basis has increased over the last decade.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ For French Canadians, food is associated with
hospitality and warmth. Food is part of all
meetings and celebrations.
▪ Common vegetables enjoyed by French
Canadians include potatoes, turnips, carrots,
asparagus, cabbage, lettuce, cucumbers, and
tomatoes.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Meat choices are mainly beef, pork, and poultry.
Lately, however, lamb has gained popularity.
▪ In Acadia, due to the proximity of the coastal
areas, fresh fish and seafood are part of the
diet.
▪ Common foods include fricot (stew made with a
special spice called summer savory).
▪ French Canadians do not escape the overall
trend toward being overweight.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Until the middle of the 20th century, French
Canadians maintained high fertility rates, which is
uncommon for a population living in an
industrialized country.
▪ This phenomenon, called the “revenge of the
cradles,” has never been explained.
▪ The number of children per family has been
declining since the mid-1960s.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Effective contraception and family planning
methods such as the pill, intrauterine devices, and
tubal ligation have become available to all women.
▪ The pill remains the primary reversible method for
birth control.
▪ On the basis of relative frequency, tubal ligation
and vasectomy follow the pill as nonreversible
methods of fertility control.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Diaphragms, foams, and creams are not
commonly used for birth control, partially
because perceptions imply that women are not
supposed to, or do not like to, touch their
genitals.
▪ The beliefs that condoms reduce the level of
sexual feeling during intercourse, or that
contraception is not a man’s responsibility, are
inversely proportionate to the age of men.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ Few French Canadians practice natural
childbirth.
▪ Men are welcomed and encouraged to be in the
delivery room with their wives.
▪ Breastfeeding has regained importance after
years of bottle feeding.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ In Canada, maternity and paternity leaves are
available with pay for a period ranging from 6 to
20 weeks.
▪ Although the movement used in washing a floor
resembles that of an exercise aimed at
strengthening the perineal muscles, this activity
in the past was associated with the onset of
labor and early or preterm deliveries.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Pregnancy and Childbearing Practices
▪ French Canadians do not differ from Canadians
and others of European origins on issues
related to death and death rituals. Expectations
are closely related to Christian religious
practices, in particular, those of the Roman
Catholic Church.
▪ Whether one is an active church-goer or not,
religious funerals are the norm.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
▪ Cremation is an acceptable practice.
▪ Supports for those who have lost a family
member include openly acknowledging the
family’s right to express grief, being physically
present, making referrals to appropriate religious
leaders, and encouraging interpersonal
relationships.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
▪ While most French Canadians identify
themselves as Roman Catholic and are baptized
at birth, they may or may not remain active
church members.
▪ Older adults are more inclined to use prayers for
finding strength and adapting to difficult physical,
psychological, and social health problems.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
▪ In times of illness and tragedy, French-speaking
Canadians use prayer to help recovery.
▪ Many of the younger generation are not strongly
influenced by religious values, beliefs, and faith
practices.
▪ The younger generations turn towards
spirituality rather than religion.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ Canada’s ensures free, universal health
coverage at any point of entry into the system.
▪ Many people in the upper socioeconomic classes
call on their family physicians instead of the local
community service centers.
▪ Many lower socioeconomic individuals many do
not seek health care until their health becomes a
crisis situation.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ French-speaking Canadians have joined the
current trend toward over-the-counter drug use.
▪ Language differences may be a barrier to
accessing health care.
▪ French-speaking subjects rate acute pain as
more intense than chronic pain, and more
affectively laden than the English-speaking
subjects.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
▪ On issues of death and dying, which religion
most influences French Canadian’s decision
making?
▪ Baptist
▪ Methodist
▪ Catholic
▪ Islamic
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: C
The Catholic religion has the most influence on
decision making for death and dying issues for
French Canadians.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practices
▪ As a cultural group, French Canadians have no
official proscriptions against receiving blood or
blood products.
▪ The decision to donate or receive an organ is
an individual decision without cultural influence
for French Canadians.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Health-care Practitioners
▪ Health-care providers hold a favorable status in
the eyes of French Canadians, especially among
older people.
▪ The universal health insurance system in Canada
makes the folk practitioners less appealing.
▪ Professionals throughout Canada are vigilant in
trying to avoid exploitation by traditional and folk
healers, who are viewed as practicing outside the
law.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German American Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German American Overview/Heritage
▪ Over 50 million Americans are of Germans heritage.
▪ The first wave of German immigrants came to the USA
for religious freedom.
▪ The second wave arrived between 1840 and 1860 and
was fleeing political persecution, poverty, and
starvation.
▪ Many worked as indentured servants.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German American
Overview/Heritage
▪ The 1930s and 1940s saw a third wave because of
the rise of fascism in Germany.
▪ Germans receive a stronger education than
Americans.
▪ The German undergraduate degree is equal to the
American master’s degree, except for nursing which
is at a lower level than that of the USA.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ German is the official language of Germany.
▪ German is a low-contextual language, with a
greater emphasis on verbal than nonverbal
communication.
▪ A high degree of social approval is shown to
people whose verbal skill in expressing ideas and
feelings is precise, explicit, and straightforward.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ For traditional Germans, sharing one’s
feelings with others often creates a sense of
vulnerability or is looked on as evidence of
weakness.
▪ Expressing fear, concern, happiness, or
sorrow allows others a view of the personal
and private self, creating a sense of
discomfort and uneasiness.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ “Being in control” includes harnessing one’s
emotions and not revealing them to others.
▪ Newer generations are more demonstrative in
sharing their thoughts, ideas, and feelings with
others.
▪ In families where the father plays a dominant role,
little touching occurs between the father and
children.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ Affection between a mother and her children is more
evident.
▪ Germans generally are careful not to touch people
who are not family or close friends.
▪ Most individuals place a high value on privacy.
People may live side by side in a neighborhood and
never develop a close friendship.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ Germans would never consider dropping in on
another German neighbor because this
behavior is incongruent with their sense of
order.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ Even looking into a room from the outside is
considered a visual intrusion.
▪ Eye contact is maintained during conversations, but
staring at strangers is considered rude.
▪ A closed door requires a knock and an invitation to
enter, regardless of whether the door is encountered
in the home, business, or in-patient facility.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ To focus on the present is to ensure the
future.
▪ The past, however, is equally important, and
Germans often begin their discussions with
background information.
▪ There are rarely good excuses for tardiness,
delays, or incompetence that disturbs the
“schedule” of events.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Communication
▪ Those in authority, older people, and
subordinates are always addressed formally.
▪ Younger generations or the more
acculturated may be less formal in their
interactions.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and Organization
▪ Traditional families view the father as head of the
household.
▪ In the USA, the husband and wife are more likely
to make decisions mutually and share household
duties.
▪ Older people are sought for their advice and
counsel, although the advice may not always be
followed.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and
Organization
▪ Helping parents or grandparents to remain in
their own home is important to families.
▪ Prescriptive behaviors for children include using
good table manners, being polite, doing what
they are told, respecting their elders, sharing,
paying attention in school, and doing their
chores.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and Organization
▪ Prescriptive behaviors for adolescents include
staying away from bad influences, obeying the
rules of the home, sitting like a lady, and
wearing a robe over pajamas.
▪ Restrictive and taboo behaviors for children
include talking back to adults, talking to
strangers, touching another person’s
possessions, and getting into trouble.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and Organization
▪ Restrictive and taboo behaviors for adolescents
include smoking, using drugs, chewing gum in
public, having guests when parents are not at
home, going without a slip (girls), and having
run-ins with the law.
▪ One’s family reputation is considered part of a
person’s identity and serves to preserve one’s
social position.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and
Organization
▪ Because families are concerned about their
reputations in the community, an unwed mother
taints their reputation and may result in the
family being ostracized by others. If marriage
follows the pregnancy, less sanctioning occurs.
▪ The fact that pregnancy existed before marriage
creates a stigma for the woman, and sometimes
for the child, that may last the rest of their lives.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Family Roles and
Organization
▪ Many older gays and lesbians may fear
exposure because of the extreme discrimination
homosexuals experienced in Nazi Germany.
▪ Younger generations of gays and lesbians are
less likely to fear exposure of their sexuality.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Workforce Issues
▪ For Germans being on time is important.
▪ Business communication should remain formal:
shaking hands daily, using the person’s title with
the last name, and keeping niceties to a
minimum.
▪ Employees are not addressed by their first
names.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Common German cultural individualist is values
include
a. Timeliness and sharing emotions.
b. Timeliness and direct communication.
c. Smooth inexact communication and readily
sharing emotions.
d. Readily sharing emotions and present
orientation.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: B
German and German Americans value direct
communication and timeliness in work and in
social engagements.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Biocultural Ecology
▪ Germans range from tall, blond, and blue-eyed to
short, stocky, dark-haired, and brown-eyed.
▪ Common health conditions for German
Americans include cardiovascular disease,
stomach cancer, muscular dystrophy, hereditary
hemochromatosis, sarcoidosis, Dupuytren’s
disease, peyronie’s disease, cystic fibrosis,
hemophilia, and cholelithiasis.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German High-Risk Health Behaviors
▪ Smoking and excessive alcohol consumption
remain high-risk behaviors for most Germans.
▪ Most individuals enjoy the outdoors, fresh air,
and exercise.
▪ Sports are played for exercise and the pleasure
of participating in group activities.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Nutrition
▪ Food is a symbol of celebration for Germans and
is often equated with love.
▪ Children are rewarded for good behavior with
food.
▪ Real cream and butter are used.
▪ Gravies, sauces, fried foods, rich pastries, and
sausages are only a few of the culinary favorites
that are high in fat content.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Nutrition
▪ Foods are also fried in butter, bacon fat, lard, or
margarine.
▪ Traditional food preparation methods use highfat ingredients that add to nutritional risks.
▪ Garlic and onions are eaten daily to prevent
heart disease.
▪ Those who are ill receive egg custards, ginger
ale, or tomato soup (without cream) to settle
their stomach.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Nutrition
▪ Ginger ale or 7-Up relieves indigestion and
settles an upset stomach.
▪ After gastrointestinal illnesses, a recuperative
diet is administered to the sick family member
beginning with sips of ginger ale over ice.
▪ Coddled eggs, a variation of scrambled eggs
prepared with margarine and a little milk, is
used for recuperation.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Pregnancy and Childbearing
Practices
▪ Heterologous artificial insemination, use of
contraceptive pills, and unnatural contraception
are forbidden among strict Catholic Germans.
▪ Therapeutic or direct abortion is forbidden as the
unjust taking of innocent life.
▪ Prescriptive practices during pregnancy include
getting plenty of exercise and increasing the
quantity of food to provide for the fetus.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Pregnancy and Childbearing
Practices
▪ Restrictive practices during pregnancy include
not stretching and not raising the arms above
the head to minimize the risk of the cord
wrapping around the baby’s neck.
▪ Prescriptive practices for the postpartum period
include getting plenty of exercise and fresh air
for the baby.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Death Rituals
▪ Death is a transition to life with God.
▪ Because illness is sometimes perceived as a
punishment, the duration and intensity of the
dying process may be seen as a result of the
quality of the life led by the person.
▪ Careful selection of the clothes to be worn by the
deceased and the flowers that represent the
immediate family is important.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Death Rituals
▪ The body of the deceased is prepared and “laid
out” in the home where support from family and
friends is readily available
▪ A short service is held in the home before the
body is taken to the church, where family and
friends can attend a funeral service. After the
church services, the body is taken to the
cemetery for burial.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Death Rituals
▪ After a short graveside service, the minister
invites everyone at the graveside service to go
to the home of the deceased for food.
▪ The viewing provides an opportunity for family,
friends, and acquaintances to view the body.
▪ Crying in public is permissible among some
families, but in others the display of grief is
private.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Death Rituals
▪ A tradition of wearing black or dark clothing when
attending a viewing or a funeral may be expected
of both family and friends.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Spirituality
▪ Major religions among Germans include Roman
Catholicism, Methodism, and Lutheranism.
▪ Other religions, such as Judaism, Islam, and
Buddhism, have substantial membership.
▪ Prayers are often recited at the bedside with all
who are present joining hands, bowing their
heads, and receiving the blessing from the
clergy.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Spirituality
▪ Family and other loved ones are also sources
of support in difficult times.
▪ Home, family, friends, work, church, and
education provide meaning in life for individuals
of German heritage.
▪ Family loyalty, duty, and honor to the family are
strong values.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Health-care Practices
▪ In traditional families, the mother usually ensures
that children receive check-ups, get
immunizations, and take vitamins.
▪ Women in the family often administer folk/home
remedies and treatments.
▪ German Americans use a variety of over-thecounter drugs, believing that individuals are
responsible for their own health.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Health-care Practices
▪ Common, natural folk medicines include roots,
herbs, soups, poultices, and medicinal agents
such as camphor, peppermint, and spirits of
ammonia.
▪ Folk medicine includes “powwowing,” use of
special words, and wearing charms.
▪ Many value being stoic when experiencing pain.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Health-care Practices
▪ Mental illness may be viewed as a flaw, resulting
in this group being slow to seek help because of
the lack of acceptance and the stigma attached
to needing help.
▪ Physical disabilities caused by injury are more
acceptable than those caused by genetic
problems.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Health-Care Practices
▪ Blood transfusions, organ donation, and organ
trans-plants are acceptable medical interventions
unless a religious choice contradicts them.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
German Health-care Practitioners
▪ Health-care providers hold a relatively high status
among Germans.
▪ This admiration stems from the love of education
and respect for authority.
▪ Most individuals accept care from either gender.
Some younger and older, more traditional
women prefer intimate care from a same-sex
health-care provider.
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