African Americans comprise a very diverse population. Variations are based on regional, urban, and rural differences, age, education, and socioeconomic status.
Preferred term. Several terms used depending on individual's age and socialization. Best to ask what they prefer; colored, Negro, black, Afro-American, or African American.
History of immigration. Earliest arrival was of 20 black indentured servants in Jamestown, Virginia in 1619. Some eight million slaves were brought to U.S. during 18th and 18th centuries. African Americans who are descendants of American slavery are not immigrants. Important historical influences include emancipation, migration from rural areas to cities, and civil rights movement. Immigrants from Caribbean Islands and parts of Africa share some history but perceive it differently.
Nonverbal communication. African Americans are affectionate people. Affections shown by touching, hugging, and being close to friends and family. Maintaining eye contact to show respect and to assess/establish trust. Silence may indicate lack of trust for caregiver.
Greetings. On first meeting, address as Mr. or Mrs. or by professional title and last name. Handshake appropriate.
Tone of voice. When speaking to each other, conversations can get loud and animated. May get agitated or emotional when feeling anxious/frightened.
Pain. Expression of pain generally open and public but can vary. Avoid pain medication for fear of addiction. Pain scales helpful to rate discomfort levels.
Dyspnea. "Difficulty catching breath;" acceptance of oxygen, and/or opiates to control dyspnea if explained (fear of addiction is strong).
Nausea/vomiting. Prefer non-pharmacological methods, i.e., ginger ale and soda crackers, teas. With severe symptoms IV medications welcomed.
Constipation/diarrhea. Open attitude about reporting constipation - "bowels blocked up;" accepts nutritional controls such as fruits, "roughage," especially prune. Will welcome enema for control of symptoms. Older persons become upset if not moving bowels daily.
Fatigue. Report feeling fatigued or tired; will take sleeping pill to aid in sleeping.
Depression. Seldom acknowledge depression; may view as a "tired" state; accepting of medications to assist with symptoms.
Self-care for symptom management. Home remedies used first, usually role of mother or wife to provide or obtain remedy from a "knowing person".
Source: Lipson, Juliene G., Dibble, Suzanne L., Minarik, Pamela A. Culture & Nursing Care: A Pocket Guide. The Regents. 1996