11/5&11: Culture and PPC-Jenn Flashcards
A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Health
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.
Culture
_____ is defined by, reflects, and transmits culture.
Language
We can’t and don’t know our culture unless we _____.
Talk about it and learn about it from others
When interacting with others, it is through communication (verbal, nonverbal, written, spoken) that we learn _____.
How similar or different we are
People who are similar are likely to understand each other better and _____.
Achieve shared meaning easier!
_____ can mean differences in status, gender, sexual orientation, race, ethnicity, language, disabilities, age, political affiliation, religion, certain group memberships (voluntary or non-voluntary), etc.
Diversity
For example, there is already a cultural difference between the patient (_____) and the provider (_____) when coming to this encounter.
Patient - lay person
Provider - medical culture
4 Portions of Cultural Flow
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
Whether consciously or subconsciously, _____ exists.
Racism
5 Cultural issues vs Structure of Healthcare
- Ethnic/racial differences
- Language (Translators vs. interpreters/Regional differences)
- Fatalism (“Control” in health, disease, and cures)
- Gender roles
- Power
A patient and provider may have two different views of reality, and both versions can coexist to shape the health-care interaction
Polymorphism
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.
Cultural sensitivity
History of _____ in the U.S. healthcare system
discrimination
Less likely to provide _____ for racial minorities
clinically necessary and routine procedures
More likely to deliver _____ to racial minorities
low-quality health services
Physicians exhibit less _____ toward racial minorities
empathy and emotion
Racial minorities more likely to rate provider communication as _____ compared to whites
disrespectful
Racial minorities ess likely to receive _____.
referrals
Gordon et. al (2006) Racial Differences…
Doctors less likely to give _____ to black patients
information (e.g., prognoses, explanations, rationales, instructions, risks/benefits)
Gordon et. al (2006) Racial Differences…
Black patients less likely to _____
participate (e.g., ask questions, expressing concerns)
Gordon et. al (2006) Racial Differences…
Especially when companions/caregivers present.
Implication?
Racial variation in doctor-patient communication becomes an issue of concern especially when….research links patterns of communication to outcomes of care
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…
the communicative dynamics of the encounter, particularly the degree to which patients are actively involved.
Improved communication can be the center of campaigns and interventions to possibly
Reduce health disparities based upon race.
Describe the Tuskegee experiments
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
Describe the impact of the Tuskegee experiments
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
How might TE impact patient-provider communication?
- distrust hc providers
- avoid going to doctor
Describe the Muai Risk Project
Prevalence of HIV Aids—beliefs in culture that condoms given to them are tainted with aids
The Muai Risk Project implicates…
- shows distrust in medial community
- impact pp research, interaction, patient outcomes/prevention
race plus nationality, ancestry (shared group history), language, and beliefs.
Ethnicity
“Upbringing”
Describe Hmong culture (China, Laos, Thailand)
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
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)
Cancer
Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____: “deep-seated and economic dependence on tobacco growing and trading”
Tobacco use
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
Religion/fatalism
Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
_____ – geographic isolation, shortage of healthcare providers, lack of transportation
Low service availability
Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
Environmental risks –
occupations, toxic waste, unclean air, effluent from farms, mines and factories into water
Region: Describe Appalachia: Where Place Matters in Health (Behringer and Friedell, 2006)
Culture –
proud and private, unaccepting of charity
Culture DOES make a difference in health. Links to:
Patient participation
Health literacy
Shared meaning**
