Influence of Cognitive Style on an American Subculture's Health Seeking Behavior and View of Nurses.

Abstract

The Old Order Amish follow an unusual lifestyle. Consequently, modern health providers may be unsure how to meet the health needs of this ethnoreligious minority. In order to provide information that would better enable the nurse practitioner to offer client-centered nursing services, this study compared 23 Old Order Amish and 23 rural non-Amish, all 60 years of age or over who lived in proximity in a midwestern community. Four major variables were examined: ethnicity (Old Order Amish/non-Amish), cognitive style (field-dependent/field-independent), health seeking behavior (indigenous/modern), and characteristics desired in the nurse practitioner (affective/technical). These variables were studied in two contexts: between the sample groups (Old Order Amish and non-Amish) and within each group. In five of the seven hypotheses, the cognitive style construct was the focus. Ethnicity was determined by sample group classification. The Children's Embedded Figures Test measured cognitive style. Health seeking behavior and characteristics desired in the nurse practitioner were assessed through scales designed by the investigator. Data were analyzed using the Mann Whitney U and Kendall's tau. Findings indicated that the Old Order Amish were not significantly more field-dependent than the non-Amish. Neither among the Old Order Amish nor among the non-Amish was cognitive style significantly related to health seeking behavior or to characteristics desired in the nurse practitioner. The anticipated cognitive style results, based on ethnic isolation and cultural idiosyncrasy, were not statistically supported. However, statistically significant differences supported the culturally-explained desire of the Old Order Amish, more than non-Amish, to prefer indigenous health care and affective qualities in the nurse practitioner. This illustration of the impact of ethnicity should provide guidelines for nurse practitioners dealing with a specialized clientele such as the Old Order Amish, whose way of life separates them from general society.