Italy is a republic located in the Southern part of Europe and surrounded by the Mediterranean Sea. It shares borders with a number of European countries, including Switzerland, France, Austria, and Slovenia. Furthermore, two states, Vatican City and San Marino, are situated inside the territory occupied by Italy which means that they share a border with Italy exclusively. The country’s population amounts to approximately 60 million people, which places the nation in the twenty-third position on the list of countries by the number of citizens (“Italy population,” 2018). The country experiences a continuous decline of the population, although the rate of migration remains stable (“Italy population,” 2018). The majority of all Italian residents – more than 70 percent – live in urban areas. The official language of the state is Italian, although the country recognizes some minority languages as historically significant. Such languages include Catalan, Sardinian, Catalan among others.
Italians have a very rich history and culture. Their main values are work, family, religion, architecture, arts, and food (Zimmermann, 2017). This community has many distinguishing characteristics. For example, normally, Italians respect authority and their religion. However, when it comes to political figures or the church hierarchy, Italians might become very impudent. Due to different cultural specificities, Italian patients require special attention. There are different aspects such as communication or ethics that are relevant to health care. The main goals of this paper are to discuss cultural differences of this population and analyze factors pertinent to delivering professional care to Italian patients.
There are different factors that have an impact on communication with Italians when they are outside their ethnic group. There are several types of such factors: physiological, environmental, and psychosocial. Psychological aspects are closely interrelated with psychosocial ones. Italians are usually direct communicators. They do not hide their emotions and are very forthright (“Italian culture,” n.d.). Therefore, people within this ethnic group expect similar attitude. They want their conversation partner to talk in a similar manner. They tend to dislike ambiguity and indirect speech. In addition, they typically prefer discussing their background.
Another important psychological characteristic is that Italians are eager to share their opinions. Therefore, they often can pay particular attention to small errors and give advice on how to correct them. It is important to avoid ignoring their inquiries and remarks. Finally, non-verbal communications such as physical contacts or gestures are very important to Italians. One of the most important environmental factors is silence. Italians tend to feel uncomfortable in a quiet and calm environment. They have a natural tendency to interact much, thus they require special attention. Such an aptitude might also manifest itself in a distinctly loud voice. One of the main psychosocial factors is stress. In order to cope with it, Italians often use humor. They might talk about very sensitive topics and be very sarcastic.
All the above-mentioned factors are especially important when communication occurs within this ethnic group. Italian people feel much more comfortable when they are in a familiar psychological and psychosocial environment. Therefore, the impact of such factors becomes more intense. For example, Italians often try to talk over each other, making their voices louder and louder (“Italian culture,” n.d.). Therefore, Italians get more outgoing when they come into contact with members of their ethnic group.
Beliefs and Health Practices
Italians often complain of all of their symptoms and require an immediate medical response. They hold some traditional beliefs related to the causes of different diseases. For example, Italians tend to think that the most important factors include winds, contamination, genes, and psychosomatic interactions (Spector, 2017). Such beliefs influence their decisions regarding medical interventions. Some Italian patients might refuse to have surgery because it exposes internal organs to the air. They suppose that it causes a more quick progression of a disease. Therefore, they are very sensitive to drafts. However, Italians often believe that fresh air is one of the most important factors that have a positive effect on health. Therefore, it is vital to keep rooms well ventilated. Another pertinent factor is a Mediterranean diet (Prinelli et al., 2015). Italians perceive this type of diet as very healthy, thus they emphasize its importance.
Another common belief is that contamination is one of the most dangerous health hazards. Therefore, Italians might tend to avoid sharing different things with individuals who are perceived to be unclean. Moreover, they might refuse to share a hospital’s room with such people. Also, Italian women have some superstitions related to pregnancy. For example, they believe that they have to eat food that they smell or should avoid certain moves to prevent miscarriage.
Barriers to Competent Health Care
Professional care providers should be aware of the existing cultural barriers that might affect delivering their services. First, Italians are strongly influenced by their religion. They believe that their faith helps them to restore health. Moreover, there are many fatalists in this community. This factor might turn into a barrier as they believe that terminal diseases are the manifestation of the will of God. For this reason, they might refuse to not only discuss their condition but also follow a prescribed treatment plan. Second, there may be a serious problem posed by the social peculiarities of the Italians. They may prefer not to address a hospital if they anticipate anxiety.
This barrier is rather crucial since healthcare workers need to have access to patients’ medical records and listen to their complaints in order to create an effective plan of treatment. As Cavalieri (2013) remarks, there are several vulnerable groups among the Italians whose health needs are not sufficiently met: low-income citizens, females, individuals living in distant regions, young people, and those who are divorced or widowed. The third significant barrier concerns gender issues. Female Italians may refuse to visit a male doctor due to the fear of exposing their body. If the only specialist available belongs to the opposite sex, the woman may choose not to use his services, which may lead to adverse health outcomes. Thus, healthcare employees should be aware of the Italians’ preferences and superstitions to be able to avert them and provide patients with the highest level of care.
Potential Ethical Dilemma
Taking into consideration the above-mentioned facts, some ethical dilemmas related to delivering care might take place. One of the most common problems of this kind is a refusal to continue or agree to the treatment due to religious beliefs. When a patient refuses all care, medical personnel have to resolve an ethical dilemma. On the one hand, each patient has a right of making autonomous choices. On the other hand, clinicians feel the need to abide by principles of beneficence and non-maleficence. Hence, different values come into conflict. For some nurses, for instance, it may be hard to agree with patients’ decision to forgo treatment regardless of their ability to assess the situation (Ingravallo, Sandroni, D’Addio, & Miccinesi, 2015). In this case, each situation may present a different possible solution. End-of-life care is the topic of debate in Italy, where this area of care was grey until 2017 when adults were granted the freedom to decide end-of-life medical care (Podoledo, 2017). These examples show a dismissal of patients’ autonomy from the clinicians’ side.
Another perspective reveals neglect from the patient’s side. The influence of religion on Italians leads to them still using practices that were created centuries ago and did not change under the force of innovation and technology (Romeo, Gallo, & Tagarelli, 2015). For example, blessings and healing prayers are still essential to Italian culture. Some Italians still use sacred objects and follow rituals to heal their ailments (Romeo et al., 2015). The prioritization of these methods over modern health care should be addressed in education and training of personnel. Medical workers should have sufficient cultural knowledge to deal with these situations and avoid conflicts with patients while helping them get better.
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Ingravallo, F., Sandroni, S., D’Addio, L., & Miccinesi, G. (2015). Do you agree with the doctor’s decision to continue treatment? A scenario-based study of hospital nurses in Italy. Annali dell’Istituto Superiore di Sanita, 51, 352-357.
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