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Introduction

The world is rapidly becoming a multicultural global village. The spread of cultural diversity has created a room for the existence and development of many previously neglected world religions and cultures. Jewish culture represents the Jewish people in terms of their religion and worship, literature, mode of dressing, lifestyle and other aspects of life. The term Jews is translated as “The Children of Israel” and its origin can be traced back to the Biblical times since the Jewish ancestry lineage is directly linked to Israelites residing in the Ancient East. Evolution of Jewish culture and religion dates back to the Biblical tribe of Judah and partially the Israel tribes of Levi which formed the Ancient Kingdom of Judah (Katz, 2004).

Over the years, Judaism has spread across many continents with its culture being boosted and followed all over the world. The State of Israel upholds and maintains the basic laws in accordance to laws and principles of Judaism. Diverse and rich Jewish culture has been preserved by Jewish communities from the ancient period. The Jewish culture is unique in relation to its religion, worship, economic activities and general way of life. The Hebrew language constitutes the main language of communication among the Jews. However, with the wide world spread of Jewish religion, English has also become commonly spoken by Jewish people (Whitfield, 2001). The Jewish culture celebrates various historical events that can be traced back to the initial festivals celebrated during the ancient period of Judaism. The following essay discusses the Jewish culture, its background, historical events and various barriers to health care giving. Additionally, the paper analyses Jewish cultural practices in relation to health care and development of a nursing care plan through cultural assessment model with the aim of outlining the steps of its planning, assessment and implementation.

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Background

Israel is known as the historical home of the Jewish people. Israel is located in the Middle East region and is referred to in the Bible as the ‘promised land of Canaan’. In accordance to the Hebrew Bible, all Jewish descendants originate from Abraham, Jacob and Isaac who migrated to Canaan and occupied the land surrounding Israel. Theological research also indicates that a significant number of Jewish people trace their roots from Israel and the surrounding Middle East regions. Jewish population has gradually increased over the past decades in comparison to the previous years when many people were reluctant to appreciate and accommodate Judaism as prevailing religion. With the current widespread of Jews on a global scale, Israel however, is the only state with the majority of Jewish population. A survey conducted on world population prior to the World War II, established the estimated number of Jews worldwide as16.7 million people. However, the number significantly dropped at the end of the World War II where an estimated figure of 6 million Jews was persecuted and killed during the holocaust.

Nevertheless, the Jewish population has risen since then, and according to a 2010 survey,, the population of Jewish people worldwide was 13 million (Sheskin & Dashefsky, 2013). This figure translates to a total percentage of 0.2% of the world total population. Hence, for every 514 people, there is one Jew. After the Holocaust and destruction of the Jewish temples, many Jews opted to live in the Diaspora (Boyarin & Boyarin, 2002). However, Israel holds the highest percentage of Jewish population at an estimated 44% ; the USA is the second country with the highest Jewish population of 39%. The remaining percentage of the population is spread across other regions such as such as Europe, Canada, Africa, Australia, Iran and Chile. Notably, these estimated figures represent both self-identified Jews and those identified as Jews in the respondent households. However, it is difficult to define the exact population of Jewish people due to religious and cultural disputes within the Jewish community on who is a true Jews with political, secular and ancestral factors being the largest identification determinants that largely affect the census figures (DellaPergola, 2013).

History plays a fundamental role in understanding Jewish culture and its people. Unlike other cultures, the Jewish culture and religion is framed along the Jewish Bible and the conservation of historical narratives and events in order to maintain the connection between a modern day Jew and his ancestors. There are several major historical events that are unique to Jewish culture. According to Judaism, one of the most important historical events is the relationship between Abraham the forefather and God. This relationship is marked as an important event in the history of Jews because Abraham is seen to develop and grow his belief in God, hence, paving the way for the redemption of the children of Israel (Yerushalmi, 2012). Other interesting major Historical events of the Jewish history are summarized as follows:

  • God handed the Torah and the Ten Commandments to the Hebrews
  • The Exodus of the Hebrews from Egypt to Canaan under Moses’ leadership
  • The conquest led by Joshua for the promised land of Canaan
  • The birth and rise of Christianity
  • The division of the Holy (monarchy) land into Judea and Israel
  • The Holocaust
  • The Destruction of the first and the second temples, which led to the Diaspora period for many Jewish people.
  • Saul is crowned as the first Hebrew King
  • The fall of the Kingdom of Israel to the Assyrians.
  • The capture of the city of Jerusalem by King David
  • Establishment of the state of Israel in 1948
  • Achievement of political and religious freedom for Jews in the 19th century
  • Khazars ‘ mass conversion to Judaism
  • Development and growth of the Zionism culture
  • US favors the immigration of the Jewish people leading to the widespread of the Jewish community
  • The rise of Communism/Marxism which acted as a liberating force for the freedom of Jews
  • Development of Conservative Judaism
  • The Yom Kippur war which the State of Israel survives

Before man sinned and turned away from the glory of God, there were no diseases or death. Unfortunately, with sin being manifested in humanity, illnesses and poor health issues have become an inevitable complement of humanity. The Jewish people hold quite different views on health and health practices from those of the western culture. Unlike other religions and cultures that have long considered health practices as interfering with God’s work of creation, the Jewish people strongly believe that god himself ordained man to take care of himself and be of good health. Therefore, Jewish culture views health practices as being in partnership with God in making humanity well and the world a better place to live. Jewish culture and traditions have for a long time upheld the infinite value of human life and the need to maintain good health citing that God gave man the wisdom and understanding to safeguard the value of life (Liu & Hilton, 2005).

According to the Jewish culture, the provision of health care should be the primary obligation of every health care giver. Health care is viewed as a communal responsibility and not merely a doctor patient affair since protection of life is ranked as the most important consideration among other aspects of culture. Therefore, Jewish health care system is meant to ensure that health care is affordable and accessible to all people. Many doctors operate at reduced rate to accommodate the poor and when this is not sustainable enough, communal subsides are made available. With high cases of poor health care, the Jewish community holds that every person should be treated equally without prejudice. According to the Hebrew Bible; (Shulchan Aruch, Yoreh Dei-ah 336:1) “If the physician withholds his services, it is considered as shedding blood”. The Jewish community has openly come forth and taken a bold step in ensuring that all the citizens receive medical care and are treated with respect and fairness (Collins, 2004).

Analysis of the Culture Practices–Throughout the Life Span as It Affects Health Care

Establishment of a good health care system is grounded on encouraging the development of a culturally competent health care environment in order to accommodate all the diverse cultures in our modern age. Different cultures differ in terms of traditions and beliefs that need to be respected at all levels of receiving health care. The Jewish culture, however, faces several barriers that interfere with providing culturally competent health care. For example, the Sabbath day is marked as a Holy day of rest where all Jews are supposed to leave their work and observe the Sabbath day in worship. This practice, hence, leads to the controversy of whether it is right or wrong to work in a health care facility on the Sabbath day. Moreover, according to the Jewish laws, Jews are forbidden to operate or use electronic devices on the Sabbath Day and this limits the level of health care given in hospitals by Jewish doctors. In addition, Jewish patients are forced to take the stairs since they are not allowed to use lifts on the Holy Day and this can largely affect the patient’s health considering that the patient may already be too weak walk up the stairs. One of the main ethical dilemmas facing Jewish health care is the acts such as mercy killing, which is forbidden on the ground of the belief that death should be the God’s choice and not man’s choice. Other ethical dilemmas include sacrificing one person’s life for the purpose of saving another person and donation of body organs from an ailing patient. The Jew medical ethics is based on upholding to the laws of the Jews.

The presence of these Jewish health cultural practices is stretched out over the entire lifespan of a Jew: from the birth throughout infancy, adolescent stage, adulthood and in the old age. Over a period of time, many of these cultural practices became a hindrance to proper health care of Jewish people. Critical analysis of Jewish cultural practices in relation to health care providence outlines various practices that can negatively influence the degree of medical care provided to the patients. Such cultural practices include gender specification when receiving treatment, religious period of fasting and dietary restrictions, which may affect the long-term treatment of a patient.

Selection of culture assessment model and application of this model in the culture in order to develop a nursing care plan is vital for Jewish community. Nursing care plan includes the following steps: assessment, planning, implementation ans evaluation tools utilized to determine effectiveness.

The ABCD Cultural Assessment Model

The ABCD cultural assessment model is a mnemonic approach developed by Kagawa-Singer and Blackhall. The main objective of the model was to assess the level of cultural adherence when providing health care. This helps to ensure that there are no cases of prejudice and stereotyping, hence, minimizing any risk of miscommunication while providing health care. The ABCD model is designed as follows:

Attitude of the parents and family members

-What is the attitude of the family, patient and the culture towards diagnosis and prognosis?

-What is the attitude in relation to the topic of dying and death?

- Are there positive or negative attitudes towards any aspect of care give?

BELIEFS

-What spiritual and religious beliefs do the patient and his family uphold especially in relation to understanding dying, death, the afterlife and occurrence of miracles?

Context:

-Understand the patient’s political and historical background i.e. place of birth, immigration status, languages understood and spoken, discrimination experiences, poverty, health disparities and level of assimilation with the Western culture

-Find out where the patient and the family lives

 

Decision making style

-Determine the decision-making style of the patient and family in relation to their culture

- Where is the emphasis placed: at an individual or family decision-making level?

The ABCD cultural assessment model can generally be applied when providing health care for the members of Jewish community. Using the ABCD culture model facilitates development of a nursing care plan with consideration of cultural needs of the patients and their families (directive Finality & Suffering, 2007). The first important step when developing a nursing care plan is cultural assessment, where one understands ones’ own personal beliefs and attitude towards health care and is aware of the values and practices of the set health system to ensure that a culturally competent environment is achieved. Planning is the next important step in establishment of an effective nursing care plan.

Planning entails formulation of different health programs that can be used to cater for the needs of the patients. It also entails allocation of resources to ensure that the most efficient nursing plan is put in place. After planning has taken place, implementation of the nursing program is the next step. Successful implementation is essential in ensuring that the nursing care plan achieves its goals. Lastly, an evaluation tool should be used in order to determine effectiveness of the nursing plan and its practical and cultural applicability while providing health care. Pre and post evaluation approaches create better room for ensuring effectiveness and success of the nursing care plan (Leininger & McFarland, 2002).

Recommendations for Nurses/Conclusion

Jewish culture is considered to be among the cultures that have over the years aimed to maintain their ancient and historical aspects in accordance to the laws given to their forefathers. The history of the Jewish people is important in understanding their culture and way of life. The Jewish culture has a broad timeline of major events and traditions that shape the daily lifestyle and beliefs of the Jews. Health is an important issue in the rank of Jewish cultural values. According to Judaism, the value of life surpasses all other considerations in life. Therefore, health care composes a major element that defines the Jewish culture. Establishment of a culturally competent health care environment is important so as to cater for different needs of people with unique beliefs and cultural background. Hence, an important recommendation to the nurse, as a caregiver, is to understand and value patients’ beliefs. Gaining adequate skills and knowledge also boosts providing the best health care to the patients. Finally, maintaining a culturally competent health care system displays a high degree of professionalism in nursing and valuing life regardless of background and cultural differences.

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