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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
Healing with Botanicals 38
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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-
Healing with Botanicals 39
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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.
Healing with Botanicals 40
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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-
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Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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.
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Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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
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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
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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
Healing with Botanicals 45
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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-
Healing with Botanicals 46
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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
Healing with Botanicals 47
Online Journal of Cultural Competence in Nursing and Healthcare Vol. 1, No. 1, 2011
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
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