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Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Polish American Culture Larry Purnell, PhD, RN, FAAN

Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition

Polish Overview/Heritage

Over 9 million people in the United States and 800,000 people in Canada identify their ancestry as Polish.

Displaying fierce patriotism, courage, and determination to resist another occupation, Poland was the only country to combat Germany from the first day of the Nazi invasion until the end of the war in Europe.



Between the 1939 Nazi invasion and the end of World War II in 1945, nearly six million Poles, comprising over 15 percent of Poland’s total population, perished.

Many Polish Jews were exterminated by the Nazis in the Holocaust, prisoners killed in concentration or forced labor camps, soldiers, and civilians.



After Stalin’s death, Polish communism vacillated between repression and liberalization until about 1970.

Poland’s resistance to Communist rule began in 1970 with the emergence of Lech Walesa, the leader of a strike in the Gdansk shipyards.



The 1980 emergence of Solidarity and the election of a Polish Pope rekindled a religious rebirth in the Poles, an increased sense of self, social identity, and the realization of their collective strength.

Solidarity became a major social movement and phenomenon unheard of within the Soviet bloc’s political system.


Polish Overview/Heritage In July, 1989, the newly elected Parliament

changed the country’s name and constitution, establishing the Third Republic of Poland and a democratic system of government.

Polish immigrants have maintained their ethnic heritage by promoting their culture, attending Catholic churches, attending parades/festivals, maintaining ethnic food traditions, speaking the Polish language.



Newer immigrants are less concerned with raising consciousness over Polish American issues as they are with financially helping families who remain in Poland and raising concerns over the political/economic climate in their homeland.



Like any other group that perceives themselves as unaccepted, displaced, and different, Polish immigrants established a geographically and socially segregated area which was called a “Polonia”.

Polish immigration to America continues today; many come to earn money then return to Poland.



At the peak of Polish migration, Chicago was considered the most well-developed Polish community in the United States.

Poles are a heterogeneous group. As such, they were slow to assimilate into multicultural America.


Polish Overview/Heritage Even after displaying a sense of duty, honor,

and patriotism during wartime, Polish Americans often experienced discrimination during and after the war.

Poles were passed over for jobs because they had difficulties speaking English and their names were difficult to pronounce or spell.

Name changes became common for Polish Americans seeking upward mobility.



Polish Overview/Heritage Many Polish Americans still experience

discrimination and ridicule through ethnic Polish jokes, which are similar in scope to those about Irish, Italian, and Mexican Americans.



Polish Communication The dominant language of people living in

Poland is Polish, although there are some regional dialects and differences.

Generally, most Polish speaking people can communicate with each other.

Recently, a resurgence of interest in learning to speak the Polish language has occurred among Polish Americans.



Polish Communication Touch is common among family members and

friends, but Poles may be quite formal with strangers and health-care providers.

Handshaking is considered polite. In fact, failing to shake hands with everyone present may be considered rude.

Most Poles feel comfortable with close personal space: distances increase with strangers.



Polish Communication First-generation Poles and other people from

Eastern European countries commonly kiss “Polish style.” That is, once on each cheek and then once again. For Poles, kissing the hand is considered appropriate if the woman extends it.

Two women may walk together arm in arm, or two men may greet each other with an embrace, a hug, and a kiss on both cheeks.



Polish Communication Many consider the use of spoken second person

familiarity rude. Polish people speak in the third person. For example, they might ask, “Would Martin like some coffee?” rather than “Would you like some coffee?”

Many Polish names are difficult to pronounce. Even though a name may be mispronounced, a high value is placed on the attempt to pronounce it correctly.



Polish Communication Polish Americans use direct eye contact when

interacting with others. Many Americans may feel uncomfortable with this

sustained eye contact and feel it is quite close to staring, but to Poles, it is considered ordinary.

Poles tend to share thoughts and ideas freely, particularly as part of their hospitality.



Polish Communication Americans talk of sports while Poles speak of

their personal life, their jobs, families, spouse, aspirations, and misfortunes.

Punctuality is important to Polish Americans. To be late is a sign of bad manners.

Even in social situations, people are expected to arrive on time and stay late.



Polish Communication Polish Americans are both past and future

oriented. The past is very much a part of Polish culture,

with the families passing on their memories of WW II, which still haunt them in some way.

A strong work ethic encourages Poles to plan for the future.



Polish Communication Traditional Polish names are often a

description of a person (e.g., John Wysocki means John the tailor), or a profession (e.g. the surname Recznik means butcher), or a place (e.g., Sokolowski means one from a town named Sokoly, Sokolka, etc.)



Polish Communication Changes in surnames may have been made

during the country’s record keeping process or during the immigration processing on Ellis Island.

The transfer of information from emigrant to official records was highly dependent on the pronunciation, spelling, and writing skills of both the recorder and the applicant.


Polish Family Roles and Organization

Life in the Polish culture centers on family. Each family member has a certain position, role,

and related responsibilities. All members are expected to work, make

contributions, and strive to enhance the entire family’s reputation, social, and economic position.


Polish Family Roles and Organization

Individual concerns and personal fulfillment are afforded little consideration and sacrifices for the betterment of the family are expected.

In most Polish families, the father is perceived as the head of the household.

Depending on the degree of assimilation, the father may rule with absolute authority


Polish Family Roles & Organization Among some third- and fourth–generation

Polish Americans and second- and third–wave immigrants, more egalitarian gender roles are becoming the norm.

Historically, large families were commonplace. Polish women, following the Roman Catholic

Church’s teachings, often experienced between 5 and 10 pregnancies.


Polish Family Roles & Organization

The most valued behavior for Polish American children is obedience.

Taboo childhood behaviors include any act that undermines parental authority.

Parents are quite demonstrative with children. Many parents praise children for self-control and

completing chores.



Little sympathy is wasted on failure but doing well is openly praised.

Children are taught to resist feelings of helplessness, fragility, or dependence.

For many, important family priorities are to maintain the honor of the family in the larger society, to have a good jobs, and to be good Catholics.



Older people are highly respected. They play an active role in helping grandchildren

learn Polish customs and in assisting adult children in their daily routine with families.

For some families, one of the worst disgraces, as seen through the eyes of the Polish community, is to put an aged family member in a nursing home.



Third- and fourth–generation Polish Americans may consider an extended-care or assisted living facility.

Extended family, consisting of aunts, uncles, and godparents, is very important to Poles.

Longtime friends become aunts or uncles to Polish children.


Polish Family Roles & Organization Alternative lifestyles are seen as part of

assimilation into the blended American culture. Same-sex couples are frowned upon and may

even be ostracized, depending on the level of assimilation.

The Polish value for family solidarity is strong and divorce is truly seen as a last resort.

When divorce does result, single heads of households are accepted.


Polish Workforce Issues Polish Americans have extensive social networks

and their strong work ethic enables them to gain employment and assimilate easily into the workforce.

Some Poles entering America are underemployed and may have difficulty working with authority figures who are less educated than themselves.


Polish Workforce Issues

Poles are usually quick learners and work hard to do a job well.

The Polish characteristic of praising people for their work makes Poles strong managers, but some lack sensitivity in their quest to complete tasks.

Foreign-born Poles may have some difficulty understanding the subtle nuances of humor.


Polish Workforce Issues

Because Poles learn deference to authority at home, in the church, and in parochial schools, some may be less well suited for the rigors of a highly individualistic, competitive market.

Polish immigrants who worked under a communist bureaucratic hierarchy may have some difficulty with the structure, subtleties, and culture of the American workplace.


Polish Biocultural Ecology

Most Poles are of medium height with a medium-to-large bone structure.

As a result of foreign invasions over the centuries, Polish people may be dark and Mongol looking or fair with delicate features with blue eyes and blonde hair.

Poles consider themselves tough and be able to tolerate pain from injuries, illness, and disease.



In 1986, the Chernobyl radiation incident in Russia contaminated the land and water systems of eastern Poland.

The full impact of this disaster on the incidence of cancer in Poland, as well as for Poles emigrating to other parts of the world, remains unknown.



Health conditions common among Poles include cardiovascular disease, stroke, obesity, and cervical cancer.


Polish High-Risk Behaviors

Alcohol misuse, with its subsequent physiological, psychological, and sociological effects and its related financial impact, continues to be an ongoing concern among Polish Americans.

Illicit drug use is becoming more commonly used by Polish urban residents.

Cannabis is the most popular illicit drug.


Polish Nutrition Most Poles extend the sharing of food and drink

to guests entering their homes. Eating and/or drinking with the host is perceived

as social acceptance. Polish foods and cooking are similar to German,

Russian, and Jewish practices. Staples of the diet are millet, barley, potatoes,

onions, radishes, turnips, beets, beans, cabbage, carrots, cucumbers, tomatoes, and apples.


Polish Nutrition Common meats eaten are chicken, beef, and

pork. Traditional high-fat entrees include pigs’ knuckles

and organ meats such as liver, tripe, and tongue. Kapusta (sauerkraut), golabki (stuffed cabbage),

babka (coffee cake), pierogi”(dumplings), and chrusciki”(deep-fried bowtie pastries) are common ethnic foods.


Polish Nutrition The Polish American diet is frequently

high in carbohydrates, sodium, and saturated fat.

Except for individuals living near the Baltic Sea in northern Poland who consume fish regularly, Poles are in danger of developing nutritional problems related to the lack of iodine in their diet.


Polish Pregnancy & Childbearing Practices

Because family is very important, most Poles want children.

In Poland, the Catholic Church strongly opposes abortion, which is the prevailing attitude of many Poles in America.

Fertility practices are balanced between the needs of the family and the laws of the Church.



Pregnant Polish Americans are expected to seek preventive health care, eat well, and rest adequately to ensure a healthy pregnancy and baby. The emphasis is on “eating for two”.

Many consider it bad luck to have a “baby shower.” Polish grandmothers may be reluctant to give gifts until after the baby is born. Birthing is typically done in the hospital.



Pregnant women usually follow the physician’s orders carefully.

The birthing process is considered the domain of women.

Newer Polish immigrants may feel uncomfortable with men in the birthing area or with family-centered care.


Polish Pregnancy and Childbearing Practices

Women are expected to rest for the first few weeks after delivery.

For many, breastfeeding is important.


Polish Death Rituals

Most Poles have a stoic acceptance of death as part of the life process and a strong sense of loyalty and respect for their loved ones.

Family and friends stay with the dying person to negate any feelings of abandonment.

The Polish ethic of demonstrating caring by doing something means bringing food to share, caring for children, and assisting with household chores.


Polish Death Rituals Most Polish women are quick to help with the

physical needs of the dying. Home hospice care is acceptable to most Poles. Polish American family members follow a funeral

custom of having a wake for 1 to 3 days, followed by a Mass and religious burial.

Most Poles honor their dead by attending Mass and making special offerings to the Catholic Church on All Souls Day, November 1.


Polish Spirituality The Catholic Church requires attendance at

Mass on all Sundays and holy days of obligation and is an integral part of the lives of most.

There are “holy days” in almost every month of the year in addition to the rituals of baptism, first holy communion, confirmation, marriage, sacrament of the sick, and burial.

Birthdays are important religious events.


Polish Spirituality

One very popular song is “Sto Lat,” which conveys wishes that the celebrant live 100 years.

Primary spiritual sources are God and Jesus Christ, the Virgin Mary, saints, and angels to ward off evil and danger.

Honor and special attention is paid to the Black Madonna or Our Lady of Czestachowa


Polish Spirituality Many older Polish people believe in the special

properties of prayer books, rosary beads, medals, and consecrated objects.

Polish Americans commonly exhibit devotions to God in their homes, such as crucifixes and pictures of the Virgin Mary, the Black Madonna, and Pope John Paul II.


Polish Health-care Practices Most Poles put a high value on stoicism and

doing what needs to be done. Many only go to health-care providers when

symptoms interfere with function; then they may consider the advice provided carefully before complying.

Many Poles are reluctant to discuss their treatment options and concerns with physicians and routinely accept the proposed care plan.


Polish Health-care Practices

If Poles believe they are unable to pay the medical bill, they may refuse treatment unless the condition is life-threatening.

Many have a strong fear of becoming dependent and resist relying on charity.

Since many Poles consider Medicare, Medicaid and managed care as forms of social charity, they are reluctant to apply for them.



Poles usually look for a physical cause of disease before considering a mental disorder.

If mental health problems exist, home visits are preferred.

Talk oriented interventions/therapies without pharmaceutical or suitable psychosocial strategies are dismissed unless interventions are action oriented.



Given the continuation of limited access to care and the strong work ethic of this cultural group, health promotion practices are often undervalued by Polish Americans.

Older Polish Americans and newer immigrants commonly smoke and drink, engage in limited physical exercise outside of work, and receive poor dental care.


Polish Health-care Practices Attention to health promotion practices among

Polish American women may be complicated by their sense of modesty and religious background.

Breast self-examination and Pap smear tests are poorly understood by many women, depending on the assimilation into American culture.


Polish Health-care Practices The Polish ethic of stoicism discourages the

use of over-the-counter medications unless a symptom persists.

Most Poles refuse to take time off from work to see a health-care provider until self-help measures have proven ineffective.

Herbs and rubbing compounds may also be used for problems associated with aches, pains, and inflammation from overworked joints.



Being unable to speak and understand English, the cost of health care, and the complexity to navigate the US system are the greatest barriers to health care for Polish immigrants.



Due to their strong sense of stoicism and fear of being dependent upon others, many Polish Americans use inadequate pain medication and choose distraction as a means of coping with pain and discomfort.

When asked, many Poles either deny or minimize their pain or level of discomfort.



Few Poles turn to psychiatrists or mental health providers for help. Those who seek help from mental health professionals do so as a last resort.

Many individuals choose their priest or seek assistance from a Polish volunteer agency before going to a health professional for psychiatric help.



Given the ethic of being useful, independent and a good Catholic influences one to refrain from using extraordinary means to keep people alive.

The individual or family determines what means are considered extraordinary. Receiving blood transfusions or undergoing organ transplantation is acceptable.


Polish Health-care Practitioners Immigrant Poles often assess health-care

providers by their demeanor, warmth, and displays of respect.

Health advice may be sought from chiropractors and local pharmacists as well as neighbors and extended family.

Biomedical advice is sought when a symptom persists and interferes with daily functions of life.


Polish Health-care Practitioners Physicians are held in high regard in Polish

communities. Poles may change physicians if they believe their

recovery is too slow or if a second opinion is needed.

Educated Poles are more willing to follow medical orders and continue with prescribed treatment than those less educated.


Polish Health-care Practitioners Polish women are modest and self-conscious.

They may refuse health care when asked to disrobe in front of a male health-care provider.

In some cases, it may be critical to request a female provider.

Poles expect health-care providers to appear neat and clean, provide treatments as scheduled, administer medications on time, and enjoy their work.

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