Responding to the Research: Culture Care for a Migrant Dominican Community in the Northeastern United States

Background: The researcher observed the values, beliefs, and traditional health practices of people in rural areas of the Dominican Republic while participating in a service project there in 2007, and saw that their beliefs and practices differed from those of the professional nurse in the United States.  This sparked an interest in Dominicans who migrate to the Northeastern United States.  Current trends indicate the migrant Dominican population in the United States is increasing rapidly, and there is a higher prevalence of diabetes, hypertension, and obesity in first generation Dominicans, compared to other Latino populations living in New York City. Professional health care may be an unfamiliar concept to these migrant Dominicans. In addition, Dominicans make adaptive changes in their traditional health practices when they migrate, but their generic (folk) care practices remain largely unknown to people outside of their community.  Health care providers lack knowledge and understanding of traditional Dominican beliefs and practices that can create barriers for migrants seeking professional health care. In order to provide culturally appropriate care and risk-reduction interventions, nurses must understand Dominican health practices in their new environment.

Purpose:  This study aimed to discover and describe migrant Dominican cultural beliefs and practices related to health, the ways that migrant Dominicans take care of their health in their new environment, and their experience with professional health care in the northeastern United States.

Design: This descriptive qualitative study was guided by Leininger’s Theory of Culture Care Diversity and Universality and four-phase analysis method.  The health-related beliefs, practices and experiences of a convenience sample of 15 self-identified adult Dominicans living in the United States for six months or more were explored in three focus groups, assisted by trained culturally appropriate interpreters.

Findings: Data analysis of focus group transcripts and observations revealed four themes: (a) stress affects health and well-being, (b) family support and faith in God are essential for healing, and promoting health and well-being, (c) migrant Dominicans use both folk care and professional care to treat illness and promote healing, health, and well-being, and (d) perceptions about the quality of professional care are affected by access to care, cost, communication and expressions of caring practices.

Discussion and Conclusion: Findings from this study may lead to more culturally responsive professional health care for Dominicans, and help reduce health disparities in this group.  Better understanding may improve the quality of care provided, and may also improve patient-provider trust and communication, as well as help patients adhere to prevention and treatment plans. Implications and recommendations for nursing practice, education and research will be discussed.  Design and implementation challenges from this study, and strategies used to bridge cultural and linguistic barriers, may guide others in planning research with similar populations.