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UTSW 2011 HB Culture

UT Southwestern - Human Behavior - Culture

What is the definition of patient culture? implicit/explicit rules instructing how to view world emotionally & behave w/people, gods, environment
What are the cultural sources of medical disparity? 1 No/limited Insurance or large co-pays, 2 Patient mistrust & refusal, 3 Linguistic barriers, 4 Clinician-> conservative treatment w/unfamiliar ethnicity, 5 sterotypes, 6 Clinician no time for special consideration
What is Cultural Competence? A set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization or professionals that engable s effective work in cross-cultural situations
What are health beliefs? A patients beliefs about his or her health
How do social and religious beliefs affect the administration and therapeutic plan of health care? Beliefs shape how a patient defines the illness, its cause, its treatment, and the qualifications of a healer. They may comply with the plan only to the level that it meets their beliefs.
Define acculturation Cultural modification of an individual, group by adapting to, or borrowing trats from another culture; a merging of cultures as a result of prolonged contact
What is Familismo? Collective family loyalty that outranks needs of 1 member (i.e. for medical decisions)
What is Hozhooji? Navajo: impt't to think & speak positively (i.e. makes HIPAA difficult)
What is the difference between illness & disease? illness = feel bad. disease = something wrong, but not necessarily associated w/feeling bad.
What is Fatalismo? impotency in the face of fate. i.e. quag dab peg (epilepsy of Hmong baby not treated)
What is Empacho? belief that all tummy troubles are caused by food/spit "stuck" in the stomach. treat w/starvation, tea, massage, lead
What is Mal ojo? evil eye, treat w/amulet, eggs, lemons, bay leaves, prayer
What is Moxibustion? therapeutic burning for jaundice, ankle/wrist/elbow/abdomen
What is Cao gio? Rub skin w/side of coin-> ecchymoses (bruises)
What is Cupping? Hot cup on forehead, cools & draws up skin & evil energy into cup-> bruise
What are Kleinman's Questions for Eliciting the Patient Perspective? What do you call the problem? What causes it? Why do you think it started when it did? How does it work? What kind of treatment do you think is best? How has this problem affected your life? what frightens you about this problem & treatment?
What are steps to cross-cultural negotiation? LEARN: Listen to patient's perspective, Explain your perspective, Acknowledge differences/similarities, Recommend treatment, Negotiate treatment plan.
What determines the need for interpretation? The patient or parent is LEP, or you are not fluent in the patient's language
Describe proper interviewing behaviors Introduce, position, look at patient, observe non-verbal, use first person, speak slowly one concept a time, back translate, questions, feedback
What is the most common error of translation? 1) Omission, 2) Addition, 3) Substitution, 4) Editorialization (interpreter inserts personal views), 5) False Fluency (interpreter not actually fluent)
What are the steps to providing translation? Fluent Health Care Provider > Medical Interpreter > 2-way Video Translator > Telephone Interpretor > Ad hoc Interpreter
How is using an ad hoc translator valued? Only in emergencies because poor quality, substitution, reluctance, confidentiality,
What impact do bias, stereotyping, discrimination, and racism hved on medical decision making and on disparities in healthcare? These may decrease the quality of care and decrease health outcomes
Identify how cultural and linguistic issues can impact quality of care, patient safety, communication, health care outcomes, health care costs, and patient satisfaction These may impact presentation, decisions, receptivity, healing, health seeking behavior, attitudes toward providers, pharmacologic efficacy
How is self awareness and understanding American medicine culture important in working with people from ther cultures? We have to understand how we communicate, percieve, and value things, so that we can accommodate with the way other cultures treat things.
Identify normative cultural values that can affect clinical care Authority , family (attitudes about discipline, parenting beliefs), gender roles, communication style (physical touch, eye contact, non-verbal behavior), interpersonal relationships, time.
How might you respond to a family's choice to purse complementary and alternative medicine? Show respect, maintain communication, encourage non-harmful CAM's
Created by: micah52