The differences that may affect Cuban-American patients who immigrated at different times

Freedom Flights/Camarioca Boatlift (Mid-1960s–Early 1970s):

Characteristics: More socioeconomically diverse, including working-class and skilled laborers. They often faced greater linguistic and occupational challenges than the first wave.

Impact on Healthcare: May experience greater health disparities due to lower initial socioeconomic status. They are often proficient in Spanish and may prefer it for healthcare communication. They tend to have a strong community orientation within established Cuban enclaves (like Miami).

Mariel Boatlift (1980) and Cuban/Haitian Migration Agreement (Post-1994):

Characteristics: These later groups, particularly the Marielitos, were more diverse, including some individuals with less education, mental health issues, or criminal records (the "push" factors were largely economic desperation). The 1994 wave often arrived with fewer resources.

Impact on Healthcare: Experience the greatest health disparities, including higher rates of poverty, limited English proficiency, and potentially higher rates of infectious disease or untreated chronic conditions. They may view healthcare institutions with greater distrust due to experiences with government control or instability in Cuba, requiring nurses to build rapport carefully.

Culture-Specific Care for an Amish Client in the Hospital

To make the hospital stay more culture-specific for an Amish client, a nurse should focus on respecting the patient's strong values regarding community, modesty, simplicity, and non-technological life.

Respect Modesty and Gender Norms:

Ensure that all necessary physical exams and procedures are done with utmost attention to privacy.

Whenever possible, assign a same-sex nurse for personal care.

Be aware that modesty is crucial, and the client may be uncomfortable with hospital gowns; allow them to wear their own simple clothing if clinically safe.

Consult with the patient (or their family/Bishop) regarding any procedures involving blood transfusions or certain high-technology interventions, as some sects may have restrictions.

Sample Answer

Differences Affecting Cuban-American Patients by Immigration Cohort

The timing of immigration significantly affects the cultural, linguistic, socioeconomic, and political characteristics of Cuban-American patients, which in turn impacts their healthcare experiences. The three major waves are:

Golden Exiles (1959–1962):

Characteristics: Predominantly upper and middle-class, highly educated professionals, business owners, and political elites. They were often welcomed as political refugees in the U.S. and received significant assistance.

Impact on Healthcare: Generally possess higher health literacy and socioeconomic status, leading to better access to high-quality care. They often hold a strong anti-