Using Stories to Bridge Cultural Disparities One Sub-Culture at a Time

Sunday, November 1, 2009

Eugenia I. Millender, BSN, MS
College of Nursing, Florida Atlantic University, Boca Raton, FL

Learning Objective 1: recognize the Guatemala-Mayan as a very distinct subculture within the Hispanic culture.

Learning Objective 2: identify Story Path as a culture-sensitive approach to obtain stories to guide research.

Purpose

Guatemala-Mayan immigrants in the US are frequently labeled as “other Hispanic”, expressing cultural insensitivity which contributes to disparities in their health care.  This project seeks to discover the health challenges of stress for these immigrants, as well as how this may relate to substance abuse, in an effort to advance nursing knowledge and begin bridging cultural disparities, one sub-culture at a time.

Significance
Cultural diversity in our communities is increasing dramatically.  Nursing knowledge and practice have lagged behind this escalating pace, widening the gap of cultural disparities in health care. Guatemalans almost always are categorized as “other Hispanics.” The label is accompanied by assumptions that contribute to the health disparity gap. Nurses are uniquely positioned to obtain stories from individuals in their care, and stories can help identify diversity in subcultures, promising potential for bridging disparities. 

Method
Story path, a qualitative methodology and theory-guided approach, was used to collect descriptions of stress experiences from Guatemala-Mayan immigrants living in the US. The 30- to 40-minute stories included why participants decided to immigrate, daily stressors, and future hopes and dreams. This pilot study assessed the feasibility of using story path with a Guatemala-Mayan population.

Findings
Three participants shared their stories. They equated stress with “thinking a lot.”  Four themes emerged from their descriptions: leaving family behind, succeeding through finding work, cultural difference, and struggling with resolution.  Substance abuse was identified as an approach participants used to manage stress. Story path was a culturally appropriate approach shown to be feasible for use in this population.  

Discussion
Story path was a bridge enabling culturally respectful research to identify health challenges in Guatemala-Mayans. Honoring stories of sub-cultures assists in narrowing health disparity gaps.  Nurse researchers wishing to study health issues in sub-culture groups could consider story path methodology as a culturally sensitive data-gathering approach.