Cultural Comprehensive Healthcare Analysis

Developmental and Cultural Comprehensive Healthcare Analysis

The Garcia’s are a Cuban American family who have been making regular visits for healthcare. The family of four presents with different persistent problems that require that they see a doctor frequently. Nursing care for the family must be consistent with both their stage-of-life needs and respect their culture at the same time. this paper is a view of the cultural and developmental aspects of each member of the family that must be considered by the nurse during each visit.

Gerardo Garcia

Gerardo is a 25-year-old male who is second first generation born in the United States. His presenting issue have been strep and tonsillitis. Gerardo has also informed the nurse that he is gay and that this has caused a rift between himself and his father.

As a 25-year he is trying to work through intimacy vs. isolation. This means that he is learning how to establish relationships, but that there is a danger of isolation if he is not successful (Springhouse Corporation, 1990). From the information that the nurse has, Gerardo has just ended a long-term, monogamous relationship and he is going to gay bars to find dates. This probably means that he desires to have another long-term relationship and he is trying to find that.

One issue that he is having is that his father is having difficulty accepting the fact that he is gay. This issue brings culture and developmental stage together for Gerardo and it is critical that the nurse realize this. Family is incredibly important in Cuban American culture (Franco & Wilson, 2008), and his relationship with his father is a very important aspect of his development. Since his relationship is troubled, this could affect him physically and should be a consideration.

Mercedes Garcia

This is the grandmother of the group. Mercedes is a 70-year-old woman who is a native of Cuba. She is somewhat bilingual, but because English is her second language, she is much more comfortable communicating in Spanish.

The developmental stage for this age group is a fight between integrity and despair. Older adults are trying to maintain their dignity while realizing that they are nearing the end of their lives and the physical issues that this entails. The integrity side of this stage occurs when the individual realizes the issues that come with aging, but is able to maintain their dignity. A person who progresses unsuccessfully through this stage will despair about the prospects of death, physical ills and loss (Springhouse Corporation, 1990). The nurse needs to understand that the individual can be worried about any issue which occurs and present problems in a caring, confidential manner.

This stage is complicated by the fact that Mercedes does not speak English very well and other cultural concerns. The text (Franco & Wilson, 2008) relates that older Cuban Americans are likely to either leave out personal information of just not answer personal questions. For this reason and because Mercedes does not speak English well, it would be advisable for the nurse to have Mercedes’ daughter-in-law, Lourdes, as both a source and an interpreter (Franco & Wilson, 2008). This will allow the nurse to gather the correct information and relay correct information.

Antonio Garcia

Antonio is the patriarch of the family, a successful businessman, and he is currently 47 years old. It was recently discovered that he had an MI and he was treated for the condition. He continues to smoke three packs of cigarettes per day, and he works approximately 60 hours per week at a stressful job.

Antonio is in the middle age adult developmental stage in which he is working out generativity vs. stagnation (Springhouse Corporation, 1990). He is the primary breadwinner for the family and this is how he identifies himself. He seems to be a type A personality who prides himself on the work that he does and the fact that he is able to care for his family.

As a Cuban American, Antonio comes from a patriarchal system in which he is looked on as the provider for the family (Franco & Wilson, 2008). However, it seems that this fact is killing him. Cigarettes are a habit, but they are often used by people who are overly stressed to combat the anxiety that occurs (Dichter, 1947). Thus, the fact that he is stressed by both his responsibility and by his actual job contribute to the smoking. The nurse needs to understand how his culture affects his need to continue working.

Lourdes Garcia

This is a 45-year-old woman who is a native of Cuba who works from home as a publisher of historical novels. She is the primary caretaker of Mercedes and she carries the burden of trying to be a go between for her husband and son. She has hypertension which is being controlled by medication.

Lourdes is, along with her husband, in the middle age adult stage of life. She is trying to work out generativity vs. stagnation, and she seems to feel that she is caught in the middle of a lot of issues. Lourdes is having issues with completing her work because of the demands placed upon her and this may increase her hypertension. Her developmental angst (trying to make something lasting of herself, while in danger of stagnating into traditional roles), may cause her medical issues to worsen.

Traditionally, the Cuban American wife is submissive to her husband and is likely to work as a homemaker (Franco & Wilson, 2008). This is true of Lourdes in one way because she does care for the home, but she is also trying to establish a business at home which is non-traditional. This could increase her angst since she is not following a typical Cuban American way.


The family has a myriad of health issues which can be overcome with some directed interventions. Someone needs to help with Mercedes and the stress that Lourdes feels could be alleviated if Mercedes went to a senior center three times per week. This would give Lourdes a break. The family also needs to seek counseling (at least Antonio, Lourdes and Gerardo) about the fact that Gerardo is gay. This could reduce the tension in the family further. Antonio needs to continue the smoking cessation, but he also needs to look into cutting his hours at work. Mercedes needs to have someone with her that she trusts during these visits also.


Dichter, E. (1947). Why do we smoke cigarettes? The Psychology of Everyday Living. Retrieved from

Springhouse Corporation. (1990). Erikson’s development stages. Retrieved from son.htm

Text book chapter 28 on Cuban Americans.

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