Cultural Paper Outline: Exploring Orthodox Jews in Healthcare

This paper, intended for a nursing course, explores the cultural perspectives of Orthodox Jews in healthcare, focusing on a 50-year-old male patient with H1 diabetes. It begins with an introduction to Orthodox Judaism, its denominations, and practices, highlighting the importance of adhering to Jewish law (halacha). The paper examines the patient's behaviors, values, attitudes, dietary restrictions (kosher food), and mental health considerations, including the role of rabbinical guidance in healthcare decisions. It delves into Jewish values and beliefs, including the significance of the Land of Israel, the Ashkenazi heritage of the patient, and the belief in divine providence. The patient's communication preferences, family structure, social customs, and religious practices are also discussed. The paper then applies the Giger and Davidhizar Transcultural Assessment Model to analyze the patient's cultural beliefs and practices, focusing on time, environmental control, and biological variations. The conclusion emphasizes the importance of understanding the patient's illness, cultural preferences, and willingness to cooperate with medical treatment, using evidence-based research to support its claims. The paper underscores the need for healthcare providers to be culturally competent when caring for Orthodox Jewish patients.

Running head: CULTURAL PAPER OUTLINE 1
Orthodox Jews
Gideon Nnabuike
Regis College
Young School of Nursing
NU 716: Cultural Perspectives in Healthcare
January 26, 2020

CULTURAL PAPER OUTLINE 2
Introduction
About Orthodox Jews
Orthodox Judaism basically refers to a combined term for the traditionalist divisions
of present-day Judaism. Orthodox Jews comprise 10% of the overall U.S. Jewish population.
Orthodox Judaism is considered one denomination of the three major denominational
movements of the Jewish religion. Orthodox Jews may have different degrees of observance,
from Modern Orthodox to Ultra-Orthodox. Orthodox Jewry, usually adhere to Jewish law
(halacha).
Purpose of the paper
Taking the above discussion into consideration this particular paper attempts to
explore the Orthodox Jews as a group/population; their behaviors, values, attitudes, foods,
mental health and beliefs of the cultural family system. All members of the same cultural
group share the patterns that are present in every culture. These include communication,
mean of economic and physical survival, family systems, social customs and mores, and
religious systems. The research particularly revolves around a 50 years male orthodox Jews
patient suffering from H1 diabetes.
Exploring Orthodox Jews
Behavior
Some Jews who do not consider themselves Orthodox are nevertheless observant of
some or all Orthodox Jewish practices. Ultra-Orthodox Jews are divided into Chassidic and
non-Chassidic sects. Orthodox Jews consider education to be an important endeavour.
Orthodox Judaism places great importance on religious higher education. The 50 years male

CULTURAL PAPER OUTLINE 3
orthodox Jews patient suffering from H1 diabetes considered for this research pursued higher
secular education and lives in urban area of the major U.S. cities. His beliefs and practices
may be considered both cultural and religious. Apart from receiving medical care, patient
along with his family might look for spiritual means of maintaining, protecting and restoring
health by obtaining blessings from righteous men as well as women, using amulets,
consuming particular food items and performing specific rituals.
Values and Beliefs
Judaism is both a religion and a culture. In the Old Testament, God promised the
Land of Israel (the “Promised Land”) to the biblical forefather Abraham. Jews have lived
continuously in the Land of Israel for more than 3,700 years. The Land of Israel is the Jewish
homeland and central to Jewish life. After the destruction of the First and Second Temples (in
586 BCE and 70 AD, respectively), for those Jews expelled from Israel their area of
destination and local culture influenced them. In the United States, the largest Jewish ethnic
groups are the Ashkenazim and the Sephardim. Jews whose ancestors lived in European
countries (for example, France, Germany, Eastern Europe) are known as Ashkenazi Jews.
Jews whose ancestors lived in the Middle East, North Africa, Spain, or Portugal are known as
Sephardic Jews (Edot Mizrach). Ashkenazi and Sephardic Jews observe the same Jewish
laws, but some of their customs and practices may differ. The patient considered is
Ashkenazim with ancestors from Germany.
Attitudes
The patient believes that the God is the ultimate healer. He believes in divine
providence (that is, the universe is controlled by God). Also, he has many people visiting him
and highly values it. Many Orthodox Jews do not feel comfortable socializing in situations in
which both males and females are present. Household and child-rearing tasks are individually

CULTURAL PAPER OUTLINE 4
decided by the couple. Many Orthodox Jewish families seek rabbinical advice regarding
health care decisions.
Food
The patient strictly eats only strictly kosher food. Thus, the patient will be strictly
provided with kosher food. The kosher food would be double-wrapped and the patient or
family would only open the food packaging. The patient also does not prefer eating meat and
dairy products together. The patient would also be asked the how soon dairy foods could be
offered after meat has been consumed.
Mental health
He and his family require rabbinical guidance for the purpose of forming health care
decision. The conception ionof pikuach nefesh implies towards the fact that health
emergencies take precedence over observance of the Sabbath or Jewish holidays. The
Sabbath and Jewish holidays are observed in maximum cases. Apart from receiving medical
care, patient along with his family might look for spiritual means of maintaining, protecting
and restoring health by obtaining blessings from righteous men as well as women, using
amulets, consuming particular food items and performing specific rituals.
Orthodox Jews Cultural Group
Communication
The native language of the patient is English and he grew up in English-speaking
home. Hebrew is the common language of the Jewish people. It must be remembered that in
Orthodox Jewish practice, physical contact with a member of the opposite gender is
prohibited unless it involves direct family members or unless it is required for health care.

CULTURAL PAPER OUTLINE 5
Family systems
The patient’s family includes father, mother, wife and one kid. He married at younger ages
than the average age of marriage in the United States. Childbearing is a biblical
commandment. Orthodox Jewish couples typically have large families. Women are
considered to have equally important but different roles within the family and religious life
than men. Because of the importance of the woman's role in childbearing and child-rearing,
women are exempt from certain religious commandments. He does not feel comfortable
socializing in situations in which both males and females are present. Household and child-
rearing tasks are individually decided by the couple.
Social customs
He traditionally wears modest clothing. For women, pants are not traditionally worn.
Clothes may cover elbows and knees. Married women traditionally cover their hair with a
head covering or wig. It must be remembered that in Orthodox Jewish practice, physical
contact with a member of the opposite gender is prohibited unless it involves direct family
members or unless it is required for health care.
Religious systems
He prays three times per day (morning, afternoon, and evening). Women are exempt
from praying three times per day but may prefer to do so. Women are exempt from certain
religious commandments, and other commandments are specific to women. Men and women
sit separately during traditional prayer services.
Nursing Cultural Model (Giger and Davidhizar)

CULTURAL PAPER OUTLINE 6
Transcultural nursing is considered as being a vital factor of healthcare in the present
day. Transcultural nursing was devised as a result of the requirement of offering care to
individuals from extensively different cultures. Transcultural nursing models offer a sound
guide to the nurses for being informed about the cultural framework of the community and in
examining it. The Transcultural Assessment Model proposed by Giger and Davidhizars
(2002) is an approach devised for assessing cultural beliefs of the patients regarding health as
well as disease behaviors along with their impacts. Moreover, the framework includes six
cultural areas i.e. Communication, Social Organizations, Space, Time, Environmental
Control and lastly, Biological Variations. Based upon the Transcultural Assessment Model
proposed by Giger and Davidhizars (2002), the group assessment has been presented as a
case study. This particular framework offers the chance for comprehending a person’s
cultural heritage, attitudes, beliefs and conduct. Within Giger and Davidhizars’ model, every
person is considered as being exceptional and evaluated with respect to six cultural aspects
taking in Communication, Space, Social Organizations, Time, Environmental Control, and
Biological Variation.
Time
In order to comprehend individualistic opinions about culture, nurses need to evaluate
patient’s outlooks related to passage of time, duration of time and points in time (Eisenberg,
2017). Several nations as well as cultures are directed with an emphasis upon the past. Such
cultures give importance to tradition and performing tasks like their predecessors have
performed (Giger & Davidhizar, 2002). This could result in unwillingness to accept new
treatments or technology. Few cultures focus upon the present and might appear reasonably
undisturbed about the future. Such people might contempt preventative measures and might
be late or miss appointments (Feldman et al., 2014).

CULTURAL PAPER OUTLINE 7
Environment group
Environmental control could be highlighted in the patient’s capability, in his/her
cultural system, for planning practices, which control their atmosphere and their insight about
personal control over forces within the surroundings (Giger & Davidhizar, 2002). In such a
situation nurses must comprehend that such issues perform a highly essential part in the
manner patients describe wellness and illness, use health care resources and react to health
related experiences.
Biological
At the time when evaluating a patient’s cultural reinforcements, biological variations
must be examined prudently for avoiding discrimination and stereotypes. Such forces take in
race, genetic variations, body structure, nutritional preferences and lastly, psychological traits
(Davidhizar, & Giger, 2002). Additionally, nursing examples take in diseases associated with
particular ethnic groups along with rural vs. urban wellness. Nurses need to remember the
individuality of people and that an individual’s relation with any ethnic group doesn’t imply
that the patient would follow the communally acknowledged meaning of his/her biological
basis (Vandenberg & Kalischuk, 2014)
Application of Evidence-based Cultural Research
Time
In order to comprehend individualistic opinions about culture, nurses need to evaluate
patient outlooks related to passage of time, duration of time and points in time (Eisenberg,
2017).
Environment group

CULTURAL PAPER OUTLINE 8
In such a situation nurses must comprehend that such issues perform a highly
essential part in the manner patients describe wellness and illness, use health care resources
and react to health related experiences.
Biological
Nurses need to remember the individuality of people and that an individual’s relation
with any ethnic group doesn’t imply that the patient would follow the communally
acknowledged meaning of his/her biological basis (Candelaria et al., 2019).
Conclusion
The above discussion clearly highlights the case of an orthodox Jews patient suffering
from H1 diabetes. It can be stated that the patient holds sound knowledge about his illness
and has preference for curing it. The food he is consuming is reasonably not responsible for
his illness. As evident from the case history the patient’s father is major diabetic so it is
possible that the illness is genetic. The patient easily understands and communicates about his
illness. He is also ready and willing to take up appropriate medication to control the disease.

CULTURAL PAPER OUTLINE 9
References
Bressler, T., & Popp, B. (2018). Ethical challenges when caring for Orthodox Jewish patients
at the end of life. Journal of Palliative Nursing, 20(1), 36–44.
Candelaria, L., et al. (2019). Breastfeeding guidance for Orthodox Jewish families when
Clayton, T. (2017). Ethical issues with genetic testing for Tay-Sachs. Journal of
Christian Nursing, 34(4), 246–249.
Eisenberg, D. (2017). Maintaining compassion for the suffering terminal patient while
preserving life: An Orthodox Jewish approach. Perspectives in Biology and Medicine,
60(2), 233–246.
Feldman, G. L., et al. (2014). Results of the College of American Pathology/American
College of Medical Genetics and Genomics external proficiency testing from 2006 to
2013 for three conditions prevalent in the Ashkenazi Jewish population. Genetics in
Medicine, 16, 695–702.
Giger, J. N. & Davidizhar, R. (2002). The Giger and Davidizhar Transcultural Assessment
Model, Journal of Transcultural Nursing, 13(3), 185-188. Retrieved from
http://knorozov.be/public/185.full.pdf.