NU580 Unit 8 Discussion

NU580 Unit 8 Discussion

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Purdue University Global

NU580 FNP II – Primary Care of Children and Adolescents’ Health

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NU580 Unit 8 Discussion

Native Hawaiian and Pacific Islander (NHPI) culture views health as a balance between physical, mental, spiritual, family, community, and environmental well-being. Effective healthcare for NHPI patients requires cultural awareness, respect for family-centered decision-making, and recognition of historical experiences that influence trust in healthcare systems. Incorporating culturally responsive communication, patient education, and shared decision-making can improve healthcare engagement, treatment adherence, and preventive care outcomes.

Native Hawaiian and Pacific Islander Perspectives on Health Promotion and Disease Prevention

Native Hawaiian and Pacific Islander communities often understand health through a holistic framework that emphasizes harmony among the individual, family, community, environment, and spiritual connections. Rather than viewing health as only the absence of disease, NHPI traditions often define wellness as achieving balance among multiple aspects of life.

The Native Hawaiian concept of Lokahi, meaning balance or harmony, reflects this perspective. Health is maintained when physical, mental, and spiritual aspects of life are aligned. The individual is viewed as connected to their surroundings, ancestors, family, and spiritual beliefs, meaning that illness affects not only the individual but also their wider support system.

Health promotion and disease prevention efforts are often more effective when they acknowledge these cultural values. Research suggests that healthcare programs designed around NHPI cultural priorities, family involvement, and community relationships are more acceptable and may improve participation in preventive care.

Examples of culturally appropriate health promotion approaches include:

• Including family members in discussions about preventive care and treatment decisions.

• Recognizing traditional healing practices alongside evidence-based medicine.

• Providing education in a way that respects cultural values and community relationships.

• Building trust by acknowledging historical experiences with healthcare systems.

NU580 Unit 8 Discussion

Immunization views among NHPI communities are influenced by both cultural values and historical experiences. While many NHPI individuals support preventive healthcare, some communities experience distrust due to historical trauma, colonization, and previous injustices involving outside institutions.

For example, Native Hawaiian communities experienced significant population loss after exposure to introduced diseases such as measles, smallpox, and cholera. Other Pacific Island communities have experienced historical events that contributed to healthcare mistrust, including colonization and environmental harms such as nuclear testing in the Marshall Islands.

However, personal experiences and community-based healthcare relationships demonstrate that many NHPI families actively support vaccination when they receive respectful communication and culturally appropriate education. Preventive care decisions are often strengthened when healthcare providers involve families and explain recommendations within the context of overall wellness.

The Role of Spiritual Beliefs in NHPI Health

Spiritual beliefs are deeply connected to NHPI concepts of health. Many Native Hawaiian and Pacific Islander communities view wellness as a relationship between the person, family, land, ancestors, and spiritual forces.

The four major relationships influencing health include:

• Family (ʻohana): Family involvement is central to healthcare decisions, and illness is often viewed as affecting the entire family unit.

• Community: Social connections and community support contribute to emotional and physical well-being.

• Land and environment: Connection to the natural world is an important part of cultural identity and health.

• Spiritual relationships: Faith, prayer, and spiritual practices may influence coping, healing, and health decisions.

Because spirituality is closely tied to health beliefs, healthcare providers should avoid separating physical treatment from emotional, cultural, and spiritual needs. Understanding a patient’s beliefs allows providers to create treatment plans that respect both medical recommendations and personal values.

Traditional healing practices among NHPI communities may include:

• Prayer and spiritual practices.

• Plant-based or herbal remedies.

• Massage and bodywork.

• Cultural practices focused on restoring harmony and relationships.

Respecting these practices and discussing them openly can help create trust between patients and healthcare providers.

Impact of NHPI Culture on Patient Care

Cultural awareness directly influences how healthcare providers communicate, educate patients, and develop treatment plans. Without culturally appropriate care, patients may experience misunderstanding, reduced trust, and decreased engagement with healthcare services.

Communication With NHPI Patients

Communication is one of the most important components of culturally competent healthcare. NHPI patients may have concerns related to historical experiences, discrimination, or lack of understanding from healthcare providers.

Healthcare professionals can improve communication by:

• Asking patients about their cultural beliefs and healthcare preferences.

• Using respectful and nonjudgmental language.

• Including family members when appropriate.

• Allowing time for questions and discussion.

• Recognizing that healthcare decisions may involve collective family input.

Trust is especially important because historical trauma may influence how some patients perceive healthcare recommendations. Providers who demonstrate cultural humility are more likely to establish positive relationships with NHPI patients.

Patient Education and Anticipatory Guidance

Patient education should be adapted to the patient’s cultural context. For NHPI families, education is often most effective when it includes family members and connects recommendations to protecting the health of the entire household.

Healthcare providers should:

• Provide verbal education using clear, respectful explanations.

• Offer written materials that are culturally appropriate and easy to understand.

• Encourage questions and shared decision-making.

• Connect preventive care recommendations to family and community wellness.

Anticipatory guidance for children and families should consider the importance of ʻohana involvement. Parents and caregivers may appreciate healthcare discussions that recognize family roles and cultural responsibilities.

Treatment Planning and Medication Management

Treatment plans for NHPI patients should incorporate cultural preferences while maintaining evidence-based medical care. Shared decision-making allows patients, families, and providers to work together to determine the best approach.

Healthcare providers should consider:

• Whether traditional practices are being used alongside medical treatments.

• Patient and family preferences regarding medications.

• Barriers such as cost, transportation, and healthcare access.

• The importance of explaining the purpose and benefits of treatments.

Culturally responsive care can improve adherence because patients are more likely to follow recommendations when they feel respected and understood.

Healthcare Challenges Affecting NHPI Communities

Although NHPI communities include diverse populations with unique traditions, many face significant health disparities. Research shows that NHPI populations experience higher rates of certain chronic conditions, including obesity, diabetes, and cardiovascular disease.

Healthcare challenges include:

• Limited access to culturally appropriate healthcare services.

• Socioeconomic barriers.

• Healthcare costs.

• Historical mistrust of medical institutions.

• Lack of representation in health research.

NHPI populations are often grouped together with Asian American populations in research, which can hide important differences in health outcomes. Separating NHPI data from broader categories helps identify specific healthcare needs and develop better interventions.

Conclusion

Providing culturally appropriate care for Native Hawaiian and Pacific Islander patients requires understanding that health extends beyond physical symptoms. NHPI perspectives emphasize balance, family relationships, community connections, spirituality, and respect for cultural traditions. Healthcare providers can improve outcomes by practicing culturally sensitive communication, involving families, providing meaningful education, and creating treatment plans that honor patients’ values while supporting evidence-based care.

References

Kaholokula, J. K., Okamoto, S. K., & Yee, B. W. K. (2019). Special issue introduction: Advancing Native Hawaiian and other Pacific Islander health. Asian American Journal of Psychology. https://psycnet.apa.org/fulltext/2019-54603-001.html

Makau, N., DeLeon, P. H., Kaholokula, J. K., Soares, S., Tsark, J. U., & Haia, C. (2016). Challenges and promise of health equity for Native Hawaiians. National Academy of Medicine. https://nam.edu/challenges-and-promise-of-health-equity-for-native-hawaiians/

NU580 Unit 8 Discussion

Stanford School of Medicine. (2021). Culturally appropriate care: Native Hawaiian and Pacific Islander health. Stanford Ethnogeriatrics. https://geriatrics.stanford.edu/ethnomed/hawaiian_pacific_islander/fund.html

Masters, P. (2018). Evaluating socially determined health in rural Appalachia: Use of the social quality theory. East Tennessee State University. https://dc.etsu.edu/cgi/viewcontent.cgi?article=4832&context=etd