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Healing with Botanicals 37

Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011

ABSTRACT The purpose of this study is to provide

knowledge about the cultural beliefs, mean-

ings, and practices of healing with botanicals

as recalled by elderly African American

women in the Mississippi Delta. The Missis-

sippi Delta is bordered by the Mississippi

River and is known for its agricultural pro-

duction. In this study, the term botanicals re-

fers to plants or plant parts valued for their

medicinal or therapeutic properties. Knowl-

edge about healing with botanicals enables

nurses and other health care providers to de-

sign and implement culturally congruent and

competent nursing care. Madeleine Lein-

inger‟s Theory of Culture Care Diversity and

Universality and the ethnonursing method are

used in the study. Eight key informants and

16 general informants participated in the

study. All informants have knowledge of

healing with botanicals and reside in the Mis-

sissippi Delta. The following themes emerged

from the data: (1) Defining health as getting

up and going about your business and illness

as the inability to go on; (2) Staying well by

caring about self and doing right; (3) Recall-

ing past times of need: healing with what na-

ture provided-making do; (4) Caring and heal-

ing in modern times: roots, herbs, and plants a

bygone era; (5) Caring and healing from

God: the answer to everything; (6) Caring and

healing from the hands of women: Woman as

healer; and (7) Preserving the old ways of car-

ing and healing: The treasure of the past.

Key Words: Healing with botanicals, elder

African American women, Mississippi Delta

When faced with illness, people rely

on what they know through their cultural

ways, the folkways or generic ways of heal-

ing, as well as professional health care. Cli-

ents may or may not share botanical health

care practices and beliefs if they exist. Under-

standing the cultural ways of the client when

providing care is important, and in order to

provide culturally congruent care, the nurse

utilizes both professional and generic care

knowledge (Leininger, 2002a; Leininger,

2006).

Historically, African Americans have

practiced healing with botanicals (Frate,

Croom, Frate, Juergens, & Maydrech, 1996;

Pachter, Sumner, Fontan, Sneed, & Bernstein,

1998; Wheaton, Blanck, Gizlice, and Reyes

2004). For the purpose of this study, the term

botanicals refers to plants or plant parts val-

ued for their medicinal or therapeutic proper-

Online Journal of Cultural Competence in Nursing and Healthcare

Volume 1 No. 1 (2011)

Beliefs, Meanings, and Practices of Healing with Botanicals

Recalled by Elder African American Women in the Mississippi Delta

Gunn, J., & Davis, S. (2011). Beliefs, meanings, and practices of healing with botanicals re-

called by elder African American women in the Mississippi Delta. Online Journal of

Cultural Care in Nursing and Healthcare,1(1), 37-49.

© 2011 The Authors. Reprints and permissions: www.ojccnh.org

http://www.ojccnh.org



ties, flavors, and/or scents (Office of Dietary

Supplements, National Institutes of Health,

2010). In a sample of 223 households in rural

Mississippi, Frate et al. found that more than

70 percent of adults used at least one plant-

derived medicine, and more African Ameri-

cans reported use than whites.

BACKGROUND AND SIGNIFICANCE

Healing in Africa can be traced back

as far as 5 million years (Curry, 2006). As

Africans were relocated to America, people

brought their cultural ways with them. Afri-

can Americans were so good at their medi-

cine, they were sometimes prohibited from

practicing traditional healing methods, be-

cause it frightened the European Americans

who thought they might use it to harm them,

and because they feared the passage of infor-

mation by the healers who visited the sick

from place to place (Evans, 1999).

African Americans in the rural south

sometimes see health differently from the way

others perceive and define it (Brangham,

1995). Care is often based on the African in-

digenous healing traditions adapted and de-

fined by their culture, beliefs and environ-

ment which satisfied the health needs of com-

munities over centuries (National Institute of

Health, African healing wisdom sect., 2005).

Furthermore, healing is greater than simply

applying a treatment with a plant or bark.

The botanicals (plants, roots, and bark) may

be important chemically in generic healing,

but healing may not depend solely on the item

used for healing; the passage of cultural ways

may be a source of comfort as well (Davis,

1997). Healing remedies are reminiscent of an

ethnic past and the heritage of an ethnic peo-

ple that promote the salience of the group

through remembering.

As African women came to America,

they brought their role as healer with them

(Fett, 2002). Women cared for the sick, and

even though families were often torn apart,

African Americans recognized the healing

women and saw healing as coming from older

generations. There was respect and recogni-

tion of woman as healer, and women have

been the healers in past times. Elders are usu-

ally considered the holders and transmitters of

knowledge (Stone, 2005). This passage by

elders was reinforced by the recent study of

the impact of women on folk healing or ge-

neric care in the African American popula-

tion. Boyd, Taylor, Shimp, and Semler (2000)

conducted a study within the African Ameri-

can population to determine what influenced

the use of folk medicine. They found parents

and grandparents were an important factor in

practicing and continuing to practice generic

care.

The Mississippi Delta

Participants in this study are from the

Mississippi Delta. The Delta is bordered by

the Mississippi River and is known for its ag-

ricultural production. Poverty and disparity

have claimed the Delta. Pierre (2004, p. A03)

describes the buildings in Delta towns as “a

glum backdrop for the youngsters who sit in

front of them for hours, idly chatting and star-

ing into the occasional passing car. A liquor

store and convenience store are the only

places to shop.” Poverty has become common

in most counties like Coahoma County where

“fifty-five percent of households in this com-

munity of 350 take in less than $15,000 a

year, well below the federal poverty line of

$18,850 for a family of four” (p. A03).

The Delta‟s economic woes are

blamed on the lack of education and an un-

educated workforce. Industries are not willing

to come to a community that lacks manpower.

McCoy, Davis, and Hudson (1994) studied

patterns of those requiring disability monies,

and the Delta was included as an area with

one of the highest social security income rates

for the population. Casey et al. (2006) found

the rural Mississippi Delta has a large minor-

ity, impoverished population at high risk for

health problems such as diabetes, hyperten-



sion and high cholesterol. Obesity was found

to be common in children, and adults were

twice as likely to be obese when compared to

a d u l t s i n t h e n a t i o n .

Healing in the Mississippi Delta

The old healing ways continue in the

Delta. Frate, Croom, Frate, Juergens & Mey-

drech (1995) found 71% of people in rural

Mississippi continue to use plant medicine.

Smitherman, Janisse, and Mathur (2004)

found that folk remedies are tradition handed

down by the elders of this culture as a part of

child rearing. The study concluded that folk

remedies are often tried before parents take

their child to a physician, and all parents use a

home remedy to treat their children at one

time or another (2006). Arcury, Bell, Vitolins

and Quandt (2005) conducted interviews with

African Americans, Caucasians, and Native

Americans over the age of 70 years to deter-

mine their use of alternative medicines. The

researchers found the people used folk reme-

dies, vitamins, and minerals in addition to

professional medicine.

African Americans, like other cultural

groups, often have beliefs that could ad-

versely affect the outcome of health care de-

livery if not understood. For example, Wilson

(2002) found some African Americans in low

to middle-socioeconomic levels had beliefs

about hypertension that diverged sharply from

current medical understanding. Failure to ap-

preciate these beliefs may contribute to non-

compliance and poor rates of hypertension

control, increased cardiovascular disease and

other conditions.

METHODOLOGY

For this ethnonursing study, the do-

main of inquiry was the examination of be-

liefs, meanings, and practices of folk

(generic) healing with botanicals recalled by

elder African American women in the Delta

area of Mississippi. The purpose of this re-

search was to discover those beliefs, mean-

ings and practices of healing with botanicals

(plant, root, or bark parts).

Study Goal and Research Questions

The goal of the study was to provide

insight into the cultural beliefs and ways of

the people by identifying generic practices of

the elders; thus providing the knowledge

needed to design and implement culturally

congruent care, safe, and meaningful care to

clients (Leininger & McFarland, 2002, 2006).

The research findings provide new knowledge

for nurses and other health care providers so

culturally congruent care may be provided to

the people of the Delta and similar areas and

populations.

Interview questions included: What

are the meanings of health and illness for Af-

rican American elder women? How does one

maintain health? What healing practices with

botanicals are remembered from the past?

When might these practices be used for heal-

ing or comfort and under what circumstances

would botanicals be used? What healing prac-

tices are being currently used? When sick,

what does one do to get better or when well

what does one do to stay well? Who provided

healing with botanicals and is that important?

How have African American elders come to

know the practices of healing from the old

ways with botanicals? Is it important if the

one supplying the healing is female or male,

or is an elder? What are the life-ways in the

African American culture for women with

respect to generic care and professional nurs-

ing care? Is it important to preserve the old

ways of healing?

DESIGN

Theoretical Framework

This study was guided by Leininger‟s

Theory of Culture Care Diversity and Univer-

sality and the method was ethnonursing

(Leininger & McFarland, 2002b, 2006). For

fur ther informat ion v is i t ht tp : / /

www.madeleine-leininger.com.

http://www.madeleine-leininger.com

http://www.madeleine-leininger.com



Sample and Setting

Both key and general informants were

sought for this study. Key informants were

identified as African American females 80

years of age or older, born in Mississippi and

residing in the Mississippi Delta, having Eng-

lish as their natural language, the ability to

give consent, and knowledge about botanicals

used for healing. General informants were

identified as African Americans 18 years of

age or older, residing in the Mississippi Delta,

having English as their native language, and

some knowledge of botanicals used for heal-

ing. Informants were recruited by snowballing

techniques. All eight key informants were Af-

rican American women ranging in age from

81 to 91 years of age. Sixteen general infor-

mants and eight key informants participated

in the study.

Data Analysis

Narratives were analyzed using Lein-

inger‟s four phases of data analysis

(Leininger, 1991). Analysis began on the first

day of data collection. The investigator also

examined how care was rendered from the

perspective of Leininger‟s three modes of

care decisions and actions: 1) Culture care

preservation/maintenance; 2) Culture care ac-

commodation/negotiation; and 3) culture care

repatterning/restructuring.

FINDINGS

Meanings of Health and Illness

From the narratives, the following

theme was developed: Defining health as get-

ting up and going about your business and

illness as the inability to go on. Being ill

meant a person was unable to take care of

business or to take care of self. Illness and

wellness were simply separated by the ability

to continue to do.

An 81 year-old key informant, de-

scribed herself as being healthy in this way:

“As long as I can get up and go.” Another key

informant said health “means you are doing

good…you don‟t have aches and pains…you

don‟t feel bad every time you move, you are

doing good.” A 30 year-old general informant

described health in a similar way:

Even though I have this huge

growth coming out of the side of my

neck, I can still do what I need to do,

so I don‟t need to go to the doctor…so

that‟s a belief of what health is, you

can functionally do what you have to

do…in spite of maybe not even feeling

well…so I don‟t need to go to the doc-

tor even though my temperature is

107, I‟m still going to work, I can do

what I got to do…when you cannot do

anything else, that‟s when you really

need to go see somebody.

A 31 year-old general informant said:

Ill means being sick or not be-

ing well…not being able to perform to

your full potential…in a way, so not

really, can‟t perform, anything that is

preventing you from…being able to

perform in a way that you normally

would.

Illness could also be brought on by

personal actions. A 91 year-old key informant

defined illness as a lack of self-care, and an-

other 81 year-old informant said illness may

be caused by eating improperly. Illness was

also described as a result of getting older and

as a punishment for bad deeds, from eating

incorrect foods or from outside causes.

An 82 year-old key informant said ill-

ness sometimes just happened and also won-

dered if it was caused from “overeating or

something like that.” Some informants talked

about pollutants causing illness. An 81 year-

old key informant thought the fertilizer being

sprayed from the air and applied to the ground

were contributing to illness.

How then does one maintain health

according to the elders? Health is an asset and

is maintained by eating correctly. The eldest

of the key informants at age 91 said, “I think

health, do I want to say, [is] the most impor-



tant asset a person can have?” Staying healthy

requires one to eat the right foods, specifically

vegetables. The theme discovered in these

narratives was: Staying well by caring about

self and doing right.

Being healthy is when you eat the

right kind of food, according to an 81 year-

old key informant:

"Vegetables and different

things like that is good for you...I like

sweets alright but I‟m a diabetic and I

just can‟t eat much of it…but I just eat

my greens, tea, eat a little salad, salad

is good for you…green salad, you

know stuff like that (85 year-old key

informant).

A 63 year-old general informant was

more specific about the proper foods for

health:

The most important healthy

foods…you have your sweet potatoes,

that‟s a really healthy food, it has

carotene, lycopene, all sorts of vita-

mins, minerals…that‟s your most

complete foods…then you have your

apples…simple little apples has a lot

of health cause it has fiber and it has

vitamins, it has minerals, it lowers

your cholesterol, it cleans your system

because it has fiber…that‟s another

good health food…vegetables all day

long.

Health was revealed to be maintained

by getting the proper rest and by taking care

of self. One 82 year-old key informant de-

scribed habits for good health as going to bed

on time and not drinking alcohol. A 30 year-

old general informant described health main-

tenance as “eating right, exercise, plenty of

rest, lots of water, being able to have good

outlets to relieve stress”.

Healing with Botanicals

Although very few people use botani-

cals today as they did in the early days, many

remembered their use in the past. In the old

days, people healed with what was available.

Plants, roots, and herbs were used along with

animal parts, human urine, and prepared

medicines like sulfur or tonics. The theme

from these narratives developed as: Recalling

past times of need: Caring and healing with

what nature provided-making do. Table 1

provides a complete list of healing items and

their reported uses as recalled by key and gen-

eral informants.

Healing Item Uses

Asafatedia Colds, colic, fever, gas, stomach ache, toothache, preventative medicine, for whooping cough and to keep the germs away. Aloe Vera Burns, scrapes, open wounds or drink to stay well. Bitter Apple Laxative and cleans the cold out. Bitter Weed Childbirth cramping. Capzasin Joint and muscle pain. Cloves Menstrual cycle cramping. Cotton Leaves Fever Cotton Seed Tea Measles and cold. Cranberry Diabetes Dirt Laxative, headache, pregnancy cravings, upset stomach, just to eat. Ginger Tea Worms, diarrhea, fever, diabetes, colds and building up system. Honey Colds and fever. Horehound Plant Candy Colds, whooping cough and black measles. Jimson Weed Fever and knee pain. Lemon Mix for other remedies, colds, fever, blood pressure and to flush the fluid. Mullein Fever (leaves), colds (tea), leg pain and swollen legs. Nutmeg tea Measles, whooping cough, fever and menstrual cramping. Oranges Sick, cold and fever. Palma Christi leaves Fever, pneumonia, wasp sting and headaches. Peach tree leaves Fever, malaria, typhoid, headache and keeps bowel moving.



Healing Item Uses

Peppermint Cold, clean out your system and fever. Peppers Sore throat. Pine Bark Cut or a bruise. Polk Salad Cleansing blood and anemia. Shuck tea Measles Sweet gum ball soot Burns or to stop bleeding. Soot Wood Stop the bleeding and cuts. Sticker Weed Stomach ache and sores. Sugar Carrier for other medicines, to improve taste, burned sugar, chest ruband for cold. Tobacco Cuts, bruises and stings. Willow Tree Fever, malaria, typhoid, and bowel movement. Prepared Items for Healing and Uses Alum Alum and sage, gargle for sore throat. Argon Starch Upset stomach. Aspirin Fever, menstrual cramps, toothache and takes care of everything. Baking Soda Whooping cough, bronchitis, cough, abscesses and fever. Black Draught Clean out your system, colds, pain and constipation. Blue Seale Vaseline Measles and cuts. Bluing Skin rash. Camphor Cold and headache. Castile soap Measles Castor Oil Measles, whooping cough, colds, fever, chest congestion, also used after pregnancy for dry skin. Castoria Measles, whooping cough, mucus, fever, stomach, cold and children‟s laxative. Coal Oil Cough, colds, to rub with, to rub your joints with, sores, cuts, fever, cold with Clorox Fungus Creomulsin Sick Epsom salt Cramps, swelling, laxative, boils, soreness, blood pressure, arthritis, to clean

out the system. Father Johns Feeling puny and to straighten out bowed legs. Gun powder For cuts. Iodine Tetter and sores. Kerosene For rubbing. Metals Coins for large navels. Quinine Fever, colic, aborting babies, muscle spasms, menstrual cramps and malaria. 666 Tonic Colds, malaria and coughs. Turpentine Preventing cramps, sores, abortions, worms, colds, sore tonsils, mumps, cuts,

lock jaw, muscle spasms, pain, fever, swelling, cough and ring worms. Sulfur Mumps, tonsils, sore throat, chicken pox, tetter, sore, and keeps snakes away. Vaseline Blisters, tetter, lubricate for birth, cuts, fever (use with baking soda) and burns. Vicks Salve Chest cold, sore throat, cold, sinus and to open your bronchial tubes. Vinegar Blood pressure, diabetes and good for your body. Whiskey Toddy, cold, building your system up, flu, cough and stopped up (nose). Natural Items for Healing and Uses Chicken poopoo tea Make measles break out. Cow manure tea Pneumonia Fat tallow Colds, chest colds, decongestants, sprain (salt pork), wood splinters and tonsils. Grease from frying Fish Clorox poisoning, asthma and bronchitis. Hog jaw bone marrow Mumps Hog hoof tea Cold and fever, whooping cough and cough. Sardines Mumps, cleaners of skin and for appearance. Toe frogs Black measles and whooping cough. Urine Bumps on the face, cold, sore throat, thrush on baby‟s tongue and to clean face. Water Cramping, birth pain and for measles to come out.

Table 1: Uses of Botanicals and Other Healing Items



Current Healing Practices

From the narratives it soon became

obvious that botanicals were not used as fre-

quently as they were in the past. Certain

plants like the Aloe Vera, garlic, and oranges

were still in use by two of the general infor-

mants but the use of others mentioned had

faded or were unavailable. Professional care

had replaced the use of the old remedies to a

great extent. Trust in professional care was

evident, and only one general informant re-

ported that professional care was harmful. As

exemplified by the narratives, two themes

were identified: Caring in modern times:

Roots, herbs, and plants as medicine-a by-

gone era, and Caring and healing from God:

The answer to everything.

A 91 year-old, key informant, said she

does not use any botanicals anymore. She re-

ported using alcohol on her legs for pain, but

cannot recall the last time she used a botanical

for healing. An 83 year-old key informant

said there were "no more old remedies

around. Professional care was on the increase,

and the old ways have disappeared…I never

did use all of it like they did, because of the

doctors taking place".

Julia, an 81 year-old key informant

said that botanicals:

"Don‟t look like it works like

it use to…all my children, I raised

them, but I had to take them to the

doctor…now, you go to the doctor and

he puts some stitches on you…it does-

n‟t cure it now, you got to go to the

doctor now…back in them days you

didn‟t go to the doctor.

In spite of the move toward profes-

sional ways, many believed the old ways with

botanicals did work back in the days when

they were prevalent. A 31 year-old general

informant, said Aloe Vera and whiskey both

worked. An 83 year-old key informant,

agreed:

They use to work then, but I

don‟t know if they work now cause

sometimes they don‟t, I don‟t know…

I really don‟t know cause they sure

worked then…a lot of folks don‟t use

them no way".

Reasons for the lack of dependence on

the home remedies also emerged. Informants

revealed that things have changed and we live

in a different world. A 30 year-old old nurs-

ing student believed things were not as abun-

dant in the fields and woods for healing medi-

cines as they once were, and that people are

now more likely to want a quick fix. Even

though her parents used the old generic ways,

she said now with her busy lifestyle, she buys

medicines over the counter or sees the physi-

cian.

There were many narratives that re-

flected the people‟s belief in God as healer

and maintainer of health. The practice of re-

ligion and belief in God was handed down

from the informants‟ parents. According to a

91 year-old key informant, "not even the rain

stopped the people from going to church.

God centered everything for the infor-

mants. The belief in God governed everything

from healing to the dating behavior for the

young (81 year-old key informant). Prayer, in

the words of this informant “was the answer.”

Another informant agreed and added health

and well being also depend on God.

If I wanted to do my documen-

tary, that‟s it, they said prayer was the

answer because all the other stuff,

prayer is the answer, we really do be-

lieve it and that is all I can say about

my well being and why I‟ve gone this

far. My belief is that is the only way a

person can get healed is through

God…I don‟t care what kind of medi-

cine you use, or I think it all comes

back to God, and I mean this is his

body, and he made it, and I think that

he knows what it takes to repair it or

restore it."

Healing resulted from prayer,

and prayer sometimes takes the form of a plea



for help. According to an 81 year-old infor-

mant,

There are doctors now, they

say they have patients that they give

up…don‟t know nothing else to do…

they are not going to live…and they

look around and the patient is all right.

Well, wasn‟t nothing they did, it was

God…that‟s where all our help come

from.

God also provides strength as well as

healing during illness. An 83 year old key in-

formant said:

Now you know one thing,

that‟s a good thought…the Lord give

our strength, he‟s our all and all. And I

think if you go to him and talk to him,

he‟s the God over all your healings,

your sickness, you go to him…and I

think that‟s how you get your heal-

ing…cause there is nothing we can do.

Providers of Botanical Healing

The narratives overwhelmingly re-

vealed women were the healers, and the ways

were handed down from woman to woman.

The theme that emerged from these narratives

was: Caring and healing from the hands of

women: Woman as healer. All informants but

one revealed the mother or grandmothers

were the healers. A 91 year-old key informant

simply said her momma was the healer. An

85 year-old key informant said her mother

was “the doctor in the house.”

Grandmothers were often described as

healers. An 83 year-old key informant said

her grandmother treated everyone, even white

people. Grandmothers taught the ways to the

children as reported in this narrative from a

30 year-old general informant:

My grandmother (was the

healer) when I was younger, she

would take me out and point me out

the different barks and the different

trees and mushrooms that she used to

make the different brews or teas…

depending on what she was doing,

some of it would have a very bitter

smell or a putrid smell and the others

would smell clean, very clean…her

mother and her grandmother taught

her.

If mother was not around, other

women stepped in as healers as reported by

this 20 year-old general informant. “If I‟m

sick, either my mom or my cousin, which I

call my second mom, provided care”.

A 40 year-old general informant, re-

ported with fondness how her mother took

care of her. “(Momma) put you to bed and

made sure you got some rest and some Bayer

aspirin and some oranges.” Mothers pulled

teeth (63 year-old general informant), fash-

ioned mosquito netting around sick children

(81 year-old key informant), made syrups and

medicines like horehound candy (84 year-old

key informant), worked in the fields, cooked,

and gave birth (81 year-old key informant).

Community women were also mid-

wives, who delivered babies, washed clothes,

kept the mother company, and provided com-

fort. They may have cleaned the house,

washed the baby, changed the bed or even

cooked a meal after the baby was delivered.

Midwives provided comfort to the women

and a helping hand. An 81 year-old key infor-

mant recalls this memory:

I saw her coming in the door,

and when I get back, she would be

gone. But at that time, it was only 5

dollars to deliver a baby, and she

would come and for a dollar more, she

would wash the clothes, my mother‟s

bed clothes and whatever.

Cultural Transmission of Healing Knowl-

edge

Passing the heritage in the form of old

ways of healing knowledge was important to

the study informants. New medicines may be

seen as a modernized version of the old way.

One informant likened knowing the past to



knowing about ancestors. Others believed that

it would make the children more rounded to

know the healing past and allow them to

make choices of their own. Through the nar-

ratives the last theme emerged: Preserving the

old ways of caring and healing: The treasure

of the past.

In the words of a 91 year old key in-

formant, "I really think it‟s important to know

cause now a days, these medicines they use is

a concoction of some of that same stuff that

we got a hold to then, they just got it modern-

ized and sophisticated…."

Leininger’s Three Action Modes Culture

Care

To provide culturally relevant, mean-

ingful, and appropriate care, the nurse must

first understand the culture of the client.

When nursing care includes the client‟s cul-

tural beliefs and practices, the care is cultur-

ally congruent. Leininger describes three cul-

ture care modes to provide care that is cultur-

ally congruent: Culture Care Preservation/

Maintenance, Culture Care Accommodation/

Negotiation, and Culture Care Repatterning/

Restructuring (Leininger, 1991; Leininger,

2002a; Leininger, 2002b; Leininger, 2002c;

Leininger, 2006). The modes direct the nurse

in utilization of research findings in a manner

that is efficacious for clients and patients.

In Culture Care Preservation/

Maintenance, nurses encourage, facilitate and

maintain the clients‟ ways of cultural caring.

The African American elders in the Delta, for

example, depended on God for assistance and

healing. Nurses may pray with the elder as a

way of maintaining and preserving culture

care. In preserving the cultural ways, time for

the minister or other spiritual/religious needs

are planned. Due to the importance of family

to African Americans in the Delta, allowing

time for visiting is another nursing action that

helps to preserve and maintain culture care.

The mother is an important visitor to the cli-

ent, often in her role as family healer. Nurses

may encourage family participation in care

planning, implementation, and evaluation.

Providing foods that elders believe promote

health and prevent disease is another example

of culture care preservation/maintenance that

will lead to culturally congruent care.

In Culture Care Accommodation/

Negotiation the utilization of some comfort

measures, such as alcohol rub, salve to the

chest or Vaseline, should be allowed even

though they may not be part of the usual hos-

pital protocols. Nurses need information on

contraindications to be able to explain why a

cultural healing measure is or is not appropri-

ate. For evidence-based information about the

efficacy of specific botanicals, nurses should

contact agencies such as the National Center

for Complementary and Alternative Medicine

(http://nccam.nih.gov/) or the Office of Die-

tary Supplements of the National Institutes of

Health (http://ods.od.nih.gov/).

Accommodation/negotiation may be

called for in deciding who takes care of the

client and what treatment or intervention will

be used. For example, elders with knowledge

of botanicals having medicinal or therapeutic

qualities might be included as members of the

health care team deciding on treatment.

The theme, defining health as getting

up and going about your business and illness

as the inability to go on, may indicate that

culture care repatterning/restructuring is

needed. If a person has an illness, rest may be

indicated. By saying illness is the "inability to

go on," clients may continue daily work even

though the body is in need of rest. For clients

with hypertension, the cultural belief that

health is present if the person can "still get up

and go" might result in a catastrophic out-

come. Culture care restructuring/repatterning

might include reducing or restricting dietary

sodium intake and taking prescription medi-

cations rather than botanicals for which there

is no evidence of efficacy. Some of the reme-

dies for healing that are currently used may

require substitutes. It is important to ask eld-

http://nccam.nih.gov/

http://ods.od.nih.gov/



ers about the use of items such as coal oil or

Vicks salve. Many elders reported eating

Vicks Salve when ill. Allowing the use of

Vicks salve as a rub, while explaining the

dangers of eating it, is an example of repat-

terning. Eating dirt may also be hard on teeth

and gastrointestinal system and parasites may

be contained in the soil.

DISCUSSION

Findings from this study will enhance

the understanding of generic care and assist in

providing culturally congruent and competent

care. Through this research, it was noted that

family inclusion is important in care and care

planning. Family rituals should be allowed,

and certain foods may have cultural ties and

should be offered in health care facilities. Re-

ligious and spiritual practices were found to

be an integral part of life of the people in this

study, and understanding the belief that God

heals all and guides all will add insight into

care. The research findings demonstrated the

role of woman, mother and grandmother as

healers. Mothers and other women are care-

givers and should be allowed to stay with sick

family members as desired. Family members

should be allowed to visit the sick, and

women from the family should be included in

the care decision-making and provision.

The informants in this study identified

what health and illness meant to them. Being

healthy is the ability to get up and go on with

daily activities while being ill means you can-

not do daily activities. When ill, clients

should be encouraged to use the old safe ways

of healing if the person desires. Teas, rubs,

and over the counter medicine, when safe,

should be allowed. Clients often use the items

in order to be more congruent with their own

values, beliefs, and philosophical orientations

toward health and life (Astin, 1998).

One of the most important implica-

tions is that a nurse may be raised next door

to another cultural group, and yet not know

the health-related cultural beliefs or practices

of others. The researcher admits to not fully

understanding the culture care of African

Americans in the Mississippi Delta prior to

conducting this study. There were times the

researcher felt the mistrust of the informants

and felt the need to prove herself to them and

show them that although a white person, the

researcher still cared. The importance of do-

ing no harm and sharing what the findings

were came to mind as well. This study dem-

onstrated the need to understand each other.

Implications for Nursing

The first implication from the study is

the need to promote learning about others

who are different from one‟s self. This learn-

ing ideally begins prior to nursing school and

continues as students enter their professional

education and training.

The second implication is the impor-

tance of research that explicates the cultural

meanings, beliefs, and practices of people of

African American descent residing in the

Mississippi Delta and their use of botanicals

for healing. The informants define health as

the ability to get up and go about your busi-

ness. When people are no longer able to get

up and complete normal activities, they are

perceived as unhealthy. Over-reliance on bo-

tanicals means that the person may ignore

symptoms, try botanicals that are ineffective

in relieving symptoms, and/or wait until they

are quite severely ill before seeking care evi-

dence-based interventions from professional

providers and healing systems.

Recommendations for Future Research/

Study Limitations

Whites and African Americans have

lived in close proximity in Mississippi since

the earliest part of our nation‟s history. Heal-

ing ways in the Mississippi Delta are mixture

of European, Native American, and African

American traditions. A similar study inter-

viewing white older women as well as other

cultural groups within the Mississippi Delta



area is a future study recommendation. Eld-

erly key and general informants alike were

vocal about stories of oppression. Future stud-

ies that open the dialogue and improve racial

understanding are recommended. In focusing

the research on botanicals, this limited the

researcher from considering other ways of

healing, such as laying on of hands. An ongo-

ing recording of stories from the elders is de-

sirable. As the elders grow older and eventu-

ally die, their stories will be lost forever.

CONCLUSION

An important route of interpretation

for the researcher is poetry. The following is a

poem written by the investigator as a result of

the resea rch and i t s f indings .

The Elders

I came knowing little about you, but I sat in

anticipation as you surveyed me.

It was simply research, I thought, the collec-

tion of data, but you showed me something

new.

As you wound your life into the questions I

asked, unknowingly a golden ray came

through,

and I saw more than I asked, was given more

than I knew existed, and I became more,

because you let me into your heart, into your

memories, and into your life.

Simply, how do you heal? I asked. What do

you do?

You smiled and your eye glinted…you knew.

It‟s not so simple as a plant, for there is na-

ture, caring, love, and God.

It was not simply the root or acorn or stem; it

was much more.

And with the healing item comes years of car-

ing and love passing through with it…

like white down on the wings of a dove.

And I was ignorant, presupposed by my plan,

dumb to your life, but you took my hand and

showed me the way, and I eagerly listened,

and now I am in awe of you.

For you are much smarter than all the re-

searchers in the world,

and I am sad that I never knew you before. Jennie Gunn

REFERENCES

1. Arcury, T., Bell, R., Vitolins, M., &

Quandt, S. (2005). Rural older adults' be-

liefs and behavior related to complemen-

tary and alternative medicine use. Com-

plementary Health Practice Review, 10

(1), 33-44.

2. Astin, J. (1998). Why patients use alter-

native medicine: Results of a national

study. Journal of the American Medical

Association, 279(19), 1548-1553.

3. Boyd, E., Taylor, S., Shimp, L., & Sem-

ler, C. (2000). An assessment of home

remedy use by African Americans. Jour-

nal of National Medical Association 92

(7), 341-353.

4. Casey, P., Horton, J., Bogle, M., Fomby,

B., Forsythe, W., Goolsby, S., Gossett, J.,

Kramer, T., & Neal-Hyman, E., (2002).

Self-reported health status of residents of

the lower Mississippi Delta of Arkansas,

Louisiana, and Mississippi. Washington,

D.C.: United States Department of Agri-

culture. Retrieved June 28, 2006, from

http: / /www.ars .usda.gov/research/

publications/publications.ht

5. Ciment, J. (2001). Atlas of African-

American history (Vol. 1). New York:

Checkmark Books.

6. Curry, A. (2005, Feb. 19). Celebrating

the African family tree. Mississippi

Catholic, p. 6.

7. Davis, R. (1997). Understanding ethnic

women's experiences with pharmacopeia.

Health Care for Women International, 18

(5), 425-438.

8. Evans, C., & Cunningham, B. (1996).

Caring for the ethnic elder: Even when

language is not a barrier, patients may be

reluctant to discuss their beliefs and prac-



tices for fear of criticism or ridicule. Geri-

atric Nursing, 17(3), 100-110.

9. Evans, T. (Ed.). (1999). Staying strong.

New York: Avon.

10. Fett, S. (2002). Working cures: Healing,

health, and power on southern slave plan-

tations. Chapel Hill: University of North

Carolina Press.

11. Frate, D., Croom, E., Frate, J. Juergens, J.,

& Meydrech, E. (1995). Self-treatment

with herbal and other plant-derived reme-

dies-rural Mississippi. Morbidity and

Mortality Weekly Report, 44(11), 204-207.

12. Frate, D., Croom, E., Frate, J., Juergens,

J., & Meydrech, E. (1996). Use of plant-

derived therapies in a rural, biracial popu-

lation in Mississippi. Journal of Missis-

sippi State Medical Association, 37(1),

427-429.

13. Kanengiser, A. (1999). Students: We

„would stay if the opportunities were here'.

Clarion Ledger, p. 1.

14. Leininger, M. (1991). Culture care diver-

sity & universality: A theory of nursing. In

M. Leininger, The theory of culture care

diversity and universality (1st ed.) (pp. 5-

68). New York: National League for Nurs-

ing Press.

15. Leininger, M. (2002a). Culture care the-

ory: A major contribution to advance

transcultural nursing knowledge and prac-

tices. Journal of Transcultural Nursing,

13(3), 189-192. New York: National

League for Nursing Press.

16. Leininger, M. (2002b). Transcultural

nursing: concepts, theories, research and

practice. In M. Leininger & M.R.

McFarland (Eds.), Toward integrative and

genetic an professional health care (3rd

ed.) (pp. 145-154). New York: National

League for Nursing Press.

17. Leininger, M. (2002c). Transcultural

nursing: Concepts, theories, research and

practice. In M. Leininger & M.R.

McFarland (Eds.), Theory of culture care

in ethnorusing research methods (3rd ed.)

(pp. 71-116). New York: National League

for Nursing Press. 18. Leininger, M. (2006). Culture care diver-

sity and universality: A worldwide nursing

theory. In M. Leininger & M.R.

McFarland (Eds.), Culture care diversity

and universality theory: Evolution of the

ethonursing method (2nd ed.) (pp. 1-41).

Boston, MA: Jones and Bartlett Publish-

ers.

19. McCoy, J., Davis, M., & Hudson, R.

(1994). Geographic patterns of disability

in the United States. Social Security Jour-

nal, 57(1), 25-26.

20. National Institute Health (2005). African

healing wisdom from tradition to current

applications and research. Paper pre-

sented at the African Healing Wisdom,

Washington, D.C.

21. Office of Dietary Supplements, National

Institutes of Health (2010). Retrieved from

http://ods.od.nih.gov/botanicals

22. Pachter, L., Sumner, T., Fontan, A.,

Sneed, M., & Bernstein, J. (1998). Home

based therapies for the common cold

among European American and ethnic mi-

nority families. Archives of Pediatrics

Adolescent Medicine, 152(11), 1083-1088.

23. Pierre, R. (2006). Poverty tightens grip on

Mississippi Delta-number of young rural

poor rises. Washington Post Writer, p.

A03.

24. Smitherman, L., Janisse, L., & Mathur, A.

(2004). The use of folk remedies among

children in an urban black community:

Remedies for fever, colic, and teething.

Pediatrics, 115(3), 297-234.

25. Snow, L. (1983). Traditional health beliefs

and practices among lower class black

Americans. The Western Journal of Medi-

cine, 139(6), 820-828.

26. Stone, M. (2005). Appalachian folk medi-

cine. Retrieved October 29, 2005, from

www.home.wlu.edu/~lubint/Touchstone?

AppalachianFolkMed~Stone.htm



27. Wheaton, A., Blanck, H., Gizlice, Z., &

Reyes, M. (2004). Medicinal herb use in a

population based survey of adults: Preva-

lence and frequency of use, reasons for

use, and use among their children. Annals

of Epidemiology, 15(9), 678-685.

28. Wilson, R., Freeman, A., Kazda, M., An-

drews, T., Berry, L., Vaeth, P., & Victor,

R. (2002). Lay beliefs about high blood

pressure in a low-to middle-income urban

African-American community: An oppor-

tunity for improving hypertension control.

The American Journal of Medicine, 112,

26-30.

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