11/5&11: Culture and PPC-Jenn

Question 1

A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Answer 1

Health

Question 2

Collective way in which a group of people share and interpret their experiences of the world.
A community of people who share a set of beliefs, values, and attitudes that may guide their behavior.

Answer 2

Culture

Question 3

_____ is defined by, reflects, and transmits culture.

Answer 3

Language

Question 4

We can’t and don’t know our culture unless we _____.

Answer 4

Talk about it and learn about it from others

Question 5

When interacting with others, it is through communication (verbal, nonverbal, written, spoken) that we learn _____.

Answer 5

How similar or different we are

Question 6

People who are similar are likely to understand each other better and _____.

Answer 6

Achieve shared meaning easier!

Question 7

_____ can mean differences in status, gender, sexual orientation, race, ethnicity, language, disabilities, age, political affiliation, religion, certain group memberships (voluntary or non-voluntary), etc.

Answer 7

Diversity

Question 8

For example, there is already a cultural difference between the patient (_____) and the provider (_____) when coming to this encounter.

Answer 8

Patient - lay person

Provider - medical culture

Question 9

4 Portions of Cultural Flow

Answer 9

Individual – the patient and provider bring his/her own cultural lens to the interaction.
Groups – family and other healthcare providers can influence decisions
Organizations – healthcare organizations, religious groups, political groups
Communities – flow of information within the community, culturally-appropriate

Question 10

Whether consciously or subconsciously, _____ exists.

Answer 10

Racism

Question 11

5 Cultural issues vs Structure of Healthcare

Answer 11

1. Ethnic/racial differences
2. Language (Translators vs. interpreters/Regional differences)
3. Fatalism (“Control” in health, disease, and cures)
4. Gender roles
5. Power

Question 12

A patient and provider may have two different views of reality, and both versions can coexist to shape the health-care interaction

Answer 12

Polymorphism

Question 13

The extent to which ethnic/cultural characteristics, experiences, norms, values, behavioral patterns, and beliefs of a target population as well as relevant historical, environmental, and social sources are incorporated in the design, delivery, and evaluation of targeted health promotion materials and programs.

Answer 13

Cultural sensitivity

Question 14

History of _____ in the U.S. healthcare system

Answer 14

discrimination

Question 15

Less likely to provide _____ for racial minorities

Answer 15

clinically necessary and routine procedures

Question 16

More likely to deliver _____ to racial minorities

Answer 16

low-quality health services

Question 17

Physicians exhibit less _____ toward racial minorities

Answer 17

empathy and emotion

Question 18

Racial minorities more likely to rate provider communication as _____ compared to whites

Answer 18

disrespectful

Question 19

Racial minorities ess likely to receive _____.

Answer 19

referrals

Question 20

Gordon et. al (2006) Racial Differences…

Doctors less likely to give _____ to black patients

Answer 20

information (e.g., prognoses, explanations, rationales, instructions, risks/benefits)

Question 21

Gordon et. al (2006) Racial Differences…

Black patients less likely to _____

Answer 21

participate (e.g., ask questions, expressing concerns)

Question 22

Gordon et. al (2006) Racial Differences…
Especially when companions/caregivers present.
Implication?

Answer 22

Racial variation in doctor-patient communication becomes an issue of concern especially when….research links patterns of communication to outcomes of care

Question 23

While not directly negating the possibility that racial disparities in care are due to doctor bias or patient preferences, they suggest that disparities in medical care are related in part to…

Answer 23

the communicative dynamics of the encounter, particularly the degree to which patients are actively involved.

Question 24

Improved communication can be the center of campaigns and interventions to possibly

Answer 24

Reduce health disparities based upon race.

Question 25

Describe the Tuskegee experiments

Answer 25

An infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to study the natural progression of untreated syphilis in rural African American men who thought they were receiving free health care from the U.S. government

Question 26

Describe the impact of the Tuskegee experiments

Answer 26

Grave impact on how blacks view and approach hc today
—distrust in medical community
—Bill Clinton apology on behalf of the federal gov for TE

Question 27

How might TE impact patient-provider communication?

Answer 27

• distrust hc providers

- avoid going to doctor

Question 28

Describe the Muai Risk Project

Answer 28

Prevalence of HIV Aids—beliefs in culture that condoms given to them are tainted with aids

Question 29

The Muai Risk Project implicates…

Answer 29

• shows distrust in medial community

- impact pp research, interaction, patient outcomes/prevention

Question 30

race plus nationality, ancestry (shared group history), language, and beliefs.

Answer 30

Ethnicity

“Upbringing”

Question 31

Describe Hmong culture (China, Laos, Thailand)

Answer 31

Clan family system – collectivistic culture
Spirituality – shamanism and connection to past ancestors
Link to Health – spirit and body are inextricably linked and there is a delicate balance between the two

Question 32

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____ disparities worsened by poor information about screening and treatment (reliance on informal networks)

Answer 32

Cancer

Question 33

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____: “deep-seated and economic dependence on tobacco growing and trading”

Answer 33

Tobacco use

Question 34

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____ – God’s will + medical care, “health professionals must understand the balance of these influences and integrate this understanding” in the care they deliver

Answer 34

Religion/fatalism

Question 35

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____ – geographic isolation, shortage of healthcare providers, lack of transportation

Answer 35

Low service availability

Question 36

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
Environmental risks –

Answer 36

occupations, toxic waste, unclean air, effluent from farms, mines and factories into water

Question 37

Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
Culture –

Answer 37

proud and private, unaccepting of charity

Question 38

Culture DOES make a difference in health. Links to:

Answer 38

Patient participation
Health literacy
Shared meaning**