Cultural competency is one of the most significant dimensions of nursing competence in the twenty-first century. Culture has a myriad of effects on health perceptions and practices. By extension, nurses who are cognizant of how a patient's culture might inform their care are better equipped to deliver a high standard of that care than those who are not culturally competent. The following inquiry delves into Polish culture, affording particular respect to how the culture might impact the health and wellness of patients of a Polish or Polish-American background, family roles, and pregnancy practices.
Culture in Poland: Communism and Catholicism
Poland is distinct from the other Eastern European nations who were under communist rule for several reasons. Primarily, Poland has a markedly Western-oriented culture, with the large majority (96%) being Roman Catholic (Mucha. As one of the most Catholic nations in the world, the religion deeply informs the daily life of the Polish people and is accredited with successfully countering the atheist communist rule. The loyalty had by the Polish people to the Catholic Church connected the nation to the West and not the East.
Under communist rule, Poland transitioned from a rural, agricultural society to an urban-industrial society; this change had significant implications for the health and well-being of the Polish people. In short, a nation that was once able to adequately feed itself as well as supply Western Europe with grown foods was starving under communist rule. Socialized agriculture did not work for a range of reasons, and there was a surge of poor-nutrition related health issues that continued to pervade the nation until the 1990s.
The influence of Catholicism on pregnancy and family roles is considerable, with limited sex education being labeled an influence on the high teen pregnancy rate in the nation. The Roman Catholic Church has historically opposed sex education in schools, and Polish generally label their sex education as "Education in Family Life" rather than sex-related. Annually, 20,000 babies are born to girls under the age of consent, and the government intervened very recently in 2010 to make sex-related education mandatory in public schools. However, most schools have thus far ignored this mandate and teen pregnancy continues to be a considerable problem in the nation (Poland).
Health, Family, and Pregnancy in Poland
For both men and women in Poland, the incidence of heart disease has risen steadily during recent years whilst declining in most Western nations. Cancer mortality has increased as well, particularly related to the respiratory system. While life expectancy has increased slightly since the end of communism for women, it has remained largely the same for men due to poor working conditions. In general however, an unhealthy lifestyle is responsible for most of the health issues for Polish people. In his text entitled Health and Social Change in Russia and Eastern Europe, Cockerham writes that "a majority of Poles [take[ a relatively passive approach to their health and, at most, [engage] in only one or two healthy lifestyle activities" (p. 163). Drinking, smoking, and a lack of exercise are prevalent among Poles and Polish immigrants, and attitudes toward longevity are enigmatic, with long-life not being perceived as particularly valuable.
Health attitudes in general are fatalistic, with a widespread perception that whatever happens to a person's health will happen regardless of medical intervention; this is a common perception within Eastern Europe. Generally, Polish people do value seeing physicians, but are unlikely to regard healthy food or exercise choices as integral to their health and wellness even if a physician suggests these interventions. Smoking cessation is a particularly critical issue in a nation where nearly fifty percent of men smoke and smoking among women is rising.
Unhealthy food is inherent to Polish culture, with many of the staples of Polish food stemming from changes made to the agrarian economy by the communist regime. While the Polish diet was relatively healthy during the former half of the twentieth century, the consumption of whole grains and potatoes declined when the agricultural economy shifted toward urban-industrial. Meat, fat, sugar, and dairy content increased considerably in Polish food under communism and the consequent high fat content is a significant contributor to the heart disease issues had by the Polish people. Fruits and vegetables, for the most part, are not an integral aspect of Polish food.
Family roles in Poland are markedly traditional, due to the dominance of Catholicism and the prevalence of manual labor. The bulk of the jobs in post-communist Poland have been filled by men, and there is a strong gender disparity in the Polish labor force. The nuclear family was also supported by communism due to a lack of resources; it was financially feasible for the family, including extended family members, to live in one household. There was, by extension, several women in the same family involved in traditional child-rearing, including grandmothers, sisters, and aunts; these women often aid in the delivery of the baby.
Generally, pregnancies are hidden for as long as possible due to superstition. Though the roots of these superstitions are unclear, they are similar to those that exist in other predominantly Catholic nations such as Italy. For instance, both cultures have strong trepidations regarding the evil eye and its ability to harm the child. Baby showers are generally considered bad luck, and gifts are not given to the baby until after it is born. Breast-feeding is widespread and lengthy, with children being breastfed well into toddlerhood.
The influence of Catholicism has rendered abortion very minimally practiced and still illegal. There is significant attention given to prenatal care, and older generations encourage younger women to take advantage of the healthcare available, as they remember the lack of care under communism. Gaining excess weight during pregnancy is a problem, as Polish women may take the "eating for two" philosophy to heart. Fully paid maternity leave exists for most full-time, working women for ninety days, and postnatal care is extensive. Women are expected to rest for weeks following delivery.
Synthesis: Culturally Competent Care for Polish People
Nurses have a fundamental responsibility to understand the cultural background of their patients, and cultural backgrounds deeply inform care delivery. There is a dearth of information regarding prenatal care and post-natal care in Poland, but the healthcare system in general is a challenged one. The most significant points emerging from the literature are poor diet, alcohol consumption, smoking prevalence, superstitions, and the traditional gender roles inherent to the nation.
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