Full Answer Section

• Spanish Language: Mrs. Hernandez’s primary language is Spanish. It’s vital to ensure clear communication by using a qualified interpreter if needed, or by providing written materials in Spanish. Avoid relying on family members to translate medical information, as this can lead to inaccuracies and misunderstandings.
• Personalismo: Cubans often value personal connections. Taking the time to engage in friendly conversation and showing genuine interest in Mrs. Hernandez’s life and family can build trust and rapport.

2. Assisting Mrs. Hernandez with Diet and Exercise:

• Culturally Appropriate Diet: Work with a registered dietitian or nutritionist who is familiar with Cuban cuisine to develop a 1500-calorie meal plan that incorporates traditional Cuban dishes in a healthy way. Focus on portion control and modifications to recipes rather than completely eliminating familiar foods. For example, suggest healthier cooking methods (baking instead of frying) and emphasize the importance of fruits, vegetables, and lean protein.
• Family Involvement: Involve Mariana in the dietary plan, as she is responsible for preparing the meals. Educate the entire family about healthy eating habits to support Mrs. Hernandez’s efforts.
• Gradual Changes: Suggest gradual changes to Mrs. Hernandez’s diet and exercise routine, rather than making drastic changes all at once. This approach is more likely to be successful in the long term.
• Accessible Exercise: Explore exercise options that are appropriate for Mrs. Hernandez’s age and physical condition. Walking, dancing, or gentle stretching can be good options. Encourage her to participate in activities she enjoys.
• Practical Tips: Provide practical tips for grocery shopping, meal preparation, and portion control. Offer resources in Spanish if available.

3. Addressing Herbal Remedies:

• Respectful Approach: Acknowledge Mrs. Hernandez’s belief in herbal remedies and avoid dismissing her concerns. Explain that while some herbs may have medicinal properties, it’s essential to understand the potential risks and interactions with other medications.
• Open Dialogue: Engage in an open dialogue with Mrs. Hernandez about her desire to use herbs. Explore her reasons for preferring herbs over the prescribed medication.
• Education: Provide accurate and unbiased information about the prescribed oral hypoglycemic agent and its benefits. Explain how it works to lower blood sugar and the importance of taking it as directed.
• Collaboration: If Mrs. Hernandez is still interested in using herbs, encourage her to discuss this with her doctor. Some herbal remedies can interact with medications or have adverse effects. A collaborative approach that integrates both conventional and complementary therapies, if appropriate, might be considered. However, emphasize that the prescribed medication is essential for managing her diabetes.

4. Common Cuban Folk Practices:

• Herbal Remedies (Botanica): As mentioned, Cuban families often use herbal remedies for various ailments. The botanica is a store that specializes in herbs, spices, and other traditional healing products.
• Santería: Santería is an Afro-Cuban religion that incorporates elements of Catholicism and African beliefs. It involves rituals, offerings, and consultations with spiritual healers to address physical and emotional health issues.
• Home Remedies: Cuban families often have traditional home remedies for common ailments, such as teas, poultices, or soups.
• Cupping: Cupping is a traditional practice that involves placing heated cups on the skin to create suction. It is believed to draw out toxins and promote healing.
• Belief in “Hot” and “Cold” Imbalances: Some Cubans may believe that illnesses are caused by imbalances in “hot” and “cold” energies in the body. This belief system can influence food choices and other health practices.

It’s crucial to approach these practices with cultural sensitivity and respect. Avoid making judgments or dismissing them as “unscientific.” Instead, focus on understanding the patient’s beliefs and integrating them into the care plan whenever possible.