The Russian Culture and the Various Domains of this Culture What Affect Health
The culture refers to the way of life that a group of people who are related identify with. The relationship under which culture thrives is that of ancestry, blood or interest. People so related will, therefore, have a particular way in which they live, transact interactions and interpret various domains of life. As such, culture, especially the one related to a large group of people who are in a similar geographical area and have similar practices, determines the way in which people undertake their lives and issues such as spirituality, gender, health and life. These domains are interrelated and affect one another. This term paper aims at exploring the Russian culture and how the various domains of this culture affect health. The paper will look deeply into understanding Russian spirituality, gender and life issues and how they affect health.
Russia is a country founded in the late 9th century as the Russian Federation. It has a rich history of revolutions and diplomacy battles that led to the formation and subsequent breakdown of the Soviet Union in 1991. The early history of Russia was characterized by empire battles, especially between the Mongols and the Muscovy. After a period of economic hardships and political instability, in 1613 for the first time the country became stable under the leadership of Mikhail Romanov, the tsar whose family ruled the empire for more than 300 years. The nineteenth century, however, saw the start of a political revolution in the country leading to the formation of the Soviet Union, which was a key player in the World Wars I and II. This union, however, broke in 1991 leading to the formation of the now known Russian Federation (Rickman, Mead & Gorer, 2001).
Russia occupies the largest part of Eastern Europe and Northern Asia. The physical land area of the country makes it the largest single sovereign country in the world. Most of the land in the country is fertile and covered with vegetation or forests, crops and irrigated land. The most recent population census in Russia gives a tally of about 150 million people with the majority of residents in this country being natives, and only about 1.5 million are citizens of other countries. The largest ethnic communities are the Russians (80%), Tatars, Ukrainians, Bashkir and Chuvash. In 1988 the Russian Orthodox Church was declared the state church in the country owing to its populous following (Todd, Belknap & Stanford University, 1998).
The economy of Russia is a prototype of an economy that has undergone major changes. This has been due to state rejection of the previously imposed Soviet state planning system and the subsequent adoption of free market elements of commerce. The economy is heavily dependent on trade and mining. This directly implies that most Russians are traders and miners. However, the lower-class Russians are concentrated in the 20% area of land that is arable and, therefore, practice farming. The government has institutionalized most of the transportation, communication and manufacturing industries(Todd, Belknap & Stanford University, 1998).
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According to the Purnell Model for Cultural Competence, there are various domains of culture that can be used effectively to compare the competitiveness of different cultures. For the sake of this paper, the domains of spirituality, communication, family roles and pregnancy and fertility practices (Rickman, Mead & Gorer, 2001).
Spirituality and Meaning of Life
This domain includes all culture-defined religious practices and the use of processes like prayers and intercessions. It also entails all behaviors that people follow as people believe they are related to the belief about the meaning of life and living. It is from the spiritual connection that people even in sickness will obtain courage and perseverance. The dominant religion in Russia is Christianity and specifically the Russian Orthodox Church. As such, the spirituality of the Russians like that of all other Christians in the world is based strongly on the teachings of the Bible. This means that a large proportion of Russians believe in the power of prayers to relieve sufferings, including prayer-based healing. The fundamental practice of the Russian Orthodox in this line is a general understanding that every person has a spiritual journey through life. Based on this, the Russians do not justify or support any hindrance with the fundamental rights of each person to make decisions about his or her health as well as the kind of service they accept for their health (Rosslyn, & Tosi, 2012).
The right to decision in this line of spirituality goes even as far as allowing individuals to accept or reject a form of therapy, even when the scientific, as well as medical knowledge, recommend otherwise. This involves sole decisions, even regarding life-support, transplants, blood transfusion and organ donation (Avdeev, 2011). However, it is a religious obligation of everyone to have a responsibility towards their health. This means that practices and behaviors that directly endanger the health are either highly restricted or advised upon to limit the danger. Activities such as health-seeking behavior are emphasized by the religion and form a part of the general spirituality of the Russians. This has been implemented to increase the awareness of the benefit of health check-ups in the country and also help the communities embrace hospital delivery and child welfare clinics. Russians support healthy lifestyle and behaviors; they report the illness incidences and also vaccination of people and animals as some of the measures to mitigate disease epidemics (Avdeev, 2011).
The spiritual life of Russians, this being a largely Christian community, recognizes the eligibility of the healthcare providers as the legitimate authority in healthcare and health matters. As the leaders of the health care team, these professionals are expected to guide the patients and the family in ensuring that health is maintained at the highest level. When, however, this is not attainable even after all efforts have been made, rituals related to death are common. The Russians are keen not to distress the dying. They, therefore, try as much as possible to become cheerful in front of the dying. The community comes together to support the family and allow positive grieving and transition. This follows the large respect that the Russians put for life and all the processes that lead to its beginning or end (Birman & Trickett, 2010).
Although most of Russians are Christians, studies have shown that less than 50% of those who claim to be Christians are real worshippers. Most refer to themselves as Christians due to their family affiliation. This explains the high prevalence of risky behaviors such as alcoholism, drug abuse and tobacco use that are not encouraged by Christianity (Rickman, Mead &Gorer, 2001).
Of the 150 million Russian population, the vast majority (80%) are from the Russian tribe. The rest includes the Tatars, Ukrainians, Armenians and others from different neighboring nations. The official language is, therefore, Russian (WHO, 2009). This is the language that at least 80% of the Russian population will understand and communicate in. It is the language used in governance, politics and education. This means that to effectively mingle with this population, it is very important to learn the language. The ethnic minorities who command at least 100 other languages face a great deal of opposition from the majority. This hostility has led to many Russians advocating the expulsion or strong restrictions of the ethnic minorities. This kind or restriction is openly observed in the state offices, education and even the health care status (Birman & Trickett, 2010).
Besides the verbal communication and language, the Russian culture recognizes the use of non-verbal communication. These are wordless gestures that have their meaning. Sometimes Russians may be considered rude by foreigners. This is due to the emphasis that the culture has compelled them to put on non-verbal communication. Wrong gestures and signs will definitely meet a considerable level of opposition and sometimes hostility. The acceptable non-verbal communications in the Russian culture includes eye contact during any communication, handshake as the premier and appropriate greeting as well as a farewell sign. The thumbs up sign are used as a sign of approval. Speaking out loudly or laughing out is discouraged, whistling in an enclosed place is superstitiously discouraged as does summon a person with a finger. These actions are considered rude, and a person can face disapproval as these gestures are considered insulting.
Besides the use of gestures as a non-verbal form of communication, the dress code is also regarded another form of communication. Among the native Russians, the female is not allowed to wear revealing clothes. For the vast majority of the Russians, decency is a virtue whose observance provides a person with respectable audience, and people can easily identify a decent person. Bright colors are also reserved for the joyful moments while the warm, dark colors and boots are considered for cold seasons and not so joyful moments. It has been reported that failure to observe this can lead to hostility (Birman & Trickett, 2010).
Every culture in the world has traditions that direct the roles that every member in the family has. The keyword 'dependence describes family in the Russian culture.' This means that Russians have a particularly strong attachment to their families. This is strongly depicted by the settlement format of the Russians. Many stay in apartments or large blocks of structures that house large families of several generations. It is common for Russians to marry early, and singlehood is regarded as a negative display regardless of the person’s occupation or income (Birman & Trickett, 2010).
A male member of the family is the head and the sole decision maker on behalf of the household. He is also the breadwinner for the family and, thus, has the responsibility to provide for all the members of the household. This includes his wife and children as well as any other member, relatives and elders who may be staying with them. The female member is responsible for the housework and caring for the children. With the current changes in the economic status, however, the role of breadwinner is currently shared. The female is now able to participate in decision-making and ensuring that the family is provided for. However, females, almost solely, retain the responsibility for the care of the family, looking after their health and wellbeing, although the financial support is largely the responsibility of the man (Miller et al, 2010).
The elderly are common members of the family. They are encouraged to stay around their children so as to ensure they receive good care, especially with the health issues related to old age. This is because there are no adequate pension programs to take care of them, and most were never employed in their productive years. The elderly are involved in the family only for the role of advising the family on issues related to traditions and also in life skills owing to their presumed experience with years of living. They, however, must remain within the regulations set by the head of the family. At times, the elderly also help to take care of the grandchildren in the absence of the parents (Treas & Mazumdar, 2012).
Women, Pregnancy and Fertility
Russians regard life highly. All activities related to the beginning, transition and end of life are also taken seriously. A woman is considered to have the ability to provide care and warmth to the family. This arises from their ability to bear children and take care of them. There is a high ideological value attached to maternity and childbearing in the Russian tradition. Bearing a child by a Russian woman is perceived with joy by the whole family and the community. The first child is considered the first fruit of love, and early first births are quite popular (Rotkirch, Zdravomyslova & Temkina, 2010).
The ageing population in Europe is currently increasing. This is true even in countries such as Russia, whose general population is expected to reduce in the next few years as a result, of the embrace of small family and family planning practices. Although it is unlikely to find a family that lacks children in Russia, research into this population indicates a pattern characterized by early entry into motherhood and low overall number of children (Avdeev, 2011). According to Rotkirch et al. (2010), the birth rates in the country have decreased steadily in the last half a century.
Despite this, the regard for pregnancy as noble and precious is still there in the large proportion. There is a considerable low condone for abortion in most parts of the country. Care after the pregnant mothers and the unborn is also fairly done in the hospitals and mothers are encouraged to seek antenatal care during pregnancy and deliver the baby in the hospital. Women and their issues are also taken seriously. Like other developed countries, Russia recognizes the position women play in the overall country economy and development. However, some traditions still hold them low and inferior to men, a situation that most of them are ready to admit and assume cannot be changed. Most families in Russia have one or two children, born early in the marriage before their mothers undertake the various methods of birth control and avoid having more. This has been argued to allow them chances to develop themselves economically as well as in education (Rossow & Rise, 2010).
Providing healthcare to Russian population has in the recent years become a challenge due to the limited adequacy of medical training facilities and personnel. There is still a shortage of doctors and nurses and this limit the quality of healthcare provided.
Recommendations for Research
The above review of the literature adequately shed light on the issue of culture and its practice in Russian community. The literature, therefore, helps open our eyes into having a deeper insight of the effects that the Russian culture has on health seeking and healthcare. As such, the available information creates a mental image of what it means to be a Russian and how this affects the health through the domains discussed. The literature, however, creates the interest for a deeper search into the domains. Below are some research questions that can be pursued through further research.
1. Based on the need for personal decisions concerning health in the Russian community, what is the perception of the community regarding euthanasia?
This will be a qualitative research question. The researcher will have to record narrations from the respondents and, therefore, come up with research data. The data, however, will also include qualitative information in the form of numbers of respondents and those who had similar responses.
The researcher will have to use interview and questionnaires to collect data from the respondents. The best research sample for this should be randomly selected respondents in the streets and in the community, regardless of their age or occupation. This criterion will help obtain valid and varied data from which broad inferences can be made.
2. How effective is the use of Russian language in education of medical and healthcare personnel in Russia?
This is a hybrid study that will involve collection of both qualitative and quantitative data. The research into this question will involve the use of cohorts and control groups whose education status is known, and they are grouped according to the use of native Russian language. The researcher’s main activity will be the observation of the language and communication effectiveness in relation to the health outcomes. It is from this observation that the researcher will deduct the effectiveness (or lack of) of further education beyond Russian language in health outcomes.
3. How do the social and family roles differences between men and women in Russia affect or determine their health-seeking behavior?
From a review of the literature, the role of care for a family is solely woman’s. This in many cases makes a woman more exposed to the health sector and allows easier access to the services for herself. This research will be a descriptive study into the relationship between the roles that a family member has, their subsequent access to healthcare and their health seeking behavior. The study is, therefore, targeting all members of the family and data will be obtained through observations, interviews and questionnaires. Records from the hospitals can also be used to relate social roles to health seeking.
4. What is the overall perception of the Russian woman concerning family planning? Does this depend on the age of the woman?
The Russian woman has been described as an early child bearer. This would imply that there is a high proportion of children in the community. However, this is not the case because women stop bearing children often as early as they start. The use of contraceptives and birth control is, therefore, the highest in the country. The research question above will lead to a descriptive qualitative study to answer it. The researcher will be able to use the women of child bearing age as the respondent sample in this research. It is through following their reaction that the perception of the women towards birth control can be obtained. This perception can also be divided depending on the age of the respondents to see if there is any difference and, therefore, possibly explain the declining population growth in the country.
Application to Practice
In regard to this review, it is important to note that every culture and community is special and no culture is primitive. Whereas many things and considerations regarding practice and culture are common regardless of the community, there are specific points, regarding Russian culture, that are important in practice.
First, Russians do not embrace cultural diversity. A large population of people subscribing to the same culture in a single country (80% of 150 million) indicate that any foreign practice will be met with a considerable level of hostility. It is, therefore, not enough to respect the culture of Russians, but if possible any foreigner should try to identify with it as long as you are among them. Secondly, the female gender is still at a submissive position in Russia. This is particularly of importance because the economic development of the country can be deceiving to make one relate everything to other first-world countries (Rosslyn & Tosi, 2012). Thirdly, maternal health in the country is highly valued and quite risky. This is specifically because of the proportion of young mothers whose coping with labor and delivery may be a problem. Fourthly, the Russian population is likely to be characterized by a majority of older people in the near future. For this reason, the focus should be shifted towards increasing the health sector capability of handling geriatric issues of health through increased training and improved remunerations to attract people to the field. Fifthly, the increased use of contraceptives and their initiation at an early age is likely to pose a health risk associated with their side effects. Research should be conducted on this issue to ensure that the community does not risk long-term morbidity of its productive population (Birman & Trickett, 2010).
Culture is as important as life is. As such, culture, especially one related to a large group of people who are in a similar geographical area and having similar practices, determines the way in which people undertake their lives and issues such as spirituality, gender, health and life. These domains are interrelated and affect one another. A person without culture lacks the taste associated with identity in life. When people identify with a specific culture, it is common that they will defend all that concerns that culture and practices associated with it. When their population is large compared to the others with a different culture in the same environment, they will try to make others follow them or compel the authority to get rid of them. This has been the situation in Russia. Russian language and Russian Orthodox religion are two cultures that have merged to make up the largest population in the country. This paper has explored in depth the Russian culture in line with its effect on health and healthcare practice. By looking at four of the twelve domains that determine the competitiveness of a culture, the paper has clearly put the issues in the Russian culture; spirituality, language and communication, fertility and pregnancy, family roles and their effect on health. This has been related to the practice of healthcare and nursing in the community. From the review of the literature done, further research can be done on the identified research questions to bring a deeper understanding into Russian culture. The paper has lastly identified specific points concerning the culture that relate to the practice of nursing and the issues that require to be addressed.