Heriatage Assessment Essay

538 words - 3 pages

BOX 6–1

Heritage Assessment Tool
16. Is your spouse the same ethnic background as you? (1) Yes _____ (2) No _____ 17. What kind of school did you go to? (1) Public _____ (2) Private _____ (3) Parochial _____ 18. As an adult, do you live in a neighborhood where the neighbors are the same religion and ethnic background as yourself? (1) Yes _____ (2) No _____ 19. Do you belong to a religious institution? (1) Yes _____ (2) No _____ 20. Would you describe yourself as an active member? (1) Yes _____ (2) No _____ 21. How often do you attend your religious institution? (1) More than once a week _____ (2) Weekly _____ (3) Monthly _____ (4) Special holidays only _____ (5) Never _____ 22. Do you practice your religion at home? (1) Yes _____ (2) No _____ (If yes, please specify) (3) Praying _____ (4) Bible reading _____ (5) Diet _____ (6) Celebrating religious holidays _____ 23. ...view middle of the document...

Do you read your native language? (1) Yes _____ (2) No _____

Note: The greater the number of positive responses, the greater the person’s identification with a traditional heritage. The one exception to positive answers is the question about family name change. This question may be answered negatively. 1. Where was your mother born? ____________________________ 2. Where was your father born? ______________________________ 3. Where were your grandparents born? (1) Your mother’s mother? ______________________________ (2) Your mother’s father? ______________________________ (3) Your father’s mother? ______________________________ (4) Your father’s father? ________________________________ 4. How many brothers _____ and sisters _____ do you have? 5. What setting did you grow up in? Urban _____ Rural _____ Suburban _____ 6. What country did your parents grow up in? Father _____ Mother _____ 7. How old were you when you came to the United States? _____ 8. How old were your parents when they came to the United States? Mother _____ Father _____ 9. When you were growing up, who lived with you? _____ 10. Have you maintained contact with a. Aunts, uncles, cousins? (1) Yes _____ (2) No _____ b. Brothers and sisters? (1) Yes _____ (2) No _____ c. Parents? (1) Yes _____ (2) No _____ d. Your own children? (1) Yes _____ (2) No _____ 11. Did most of your aunts, uncles, cousins live near your home? (1) Yes _____ (2) No _____ 12. Approximately how often did you visit your family members who lived outside your home? (1) Daily _____ (2) Weekly _____ (3) Monthly _____ (4) Once a year or less _____ (5) Never _____ 13. Was your original family name changed? (1) Yes _____ (2) No _____ 14. What is your religious preference? (1) Catholic _____ (2) Jewish _____ (3) Protestant _____ (4) Denomination (5) Other _____ (6) None _____ 15. Is your spouse the same religion as you? (1) Yes _____ (2) No _____

Source: Spector, R. E. (2000). CulturalCare: Guide to heritage assessment and health traditions (5th ed.). Pearson Education/PH College.

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