Chapter 2 Theories and models related to multicultural health Flashcards
Two Major Theories of Health and Illness
Personalistic and Naturalistic
Health Theories are…
(beliefs) people hold about how to MAINTAIN
good health and what CAUSES illnesses.
Personalistic explanations
[not talked about ignore them low-key]
- Health/illness seen as RESULTING from a
PERSON’S BEHAVIOR
- Often invokes normative ideas of spirituality
and/or morality
• Shamanistic/animistic
• Susto
•”Evil eye,” witchcraft/sorcery, voodoo
Naturalistic explanations
See health as reflecting a state of harmony
between a person AND his/her ENVIRONMENT
- Examples:
• Ayurvedic medicine (links energy centers
associated with organs to primal force such as
the breath of life)
• Chinese medicine (balance of polar energies
i.e. yin-yang)
• Humoral pathology (Hippocrates, four fluids or
humors cause illness when out of balance)
• Germ theory (microorganisms cause disease)
Two Systems/Pathways to Care
BIOMEDICAL and HOLISTIC
Care system selected based on…
CULTURE, ACCESS to care, health BELIEFS, AFFORDABILITY
BIOMEDICAL/ALLOPATHIC APPROACH:
-OFEN VIEWED AS SCIENTIFIC
-FOCUSES ON (PHYSICAL) COMPONENTS OF ILLNESS
-CARE PROVIDED BY LICENSED PROFFESSIONALS SUCH AS;
DOCTORS, NURSES, PHYSICAL THERAPISTS
Holistic Approach (Alternative or Complementary):
-viewed by some as UNSCIENTIFIC
-Based on a PSYCHOSOCIAL model of health care
-providers have vast levels of training
-FEW TRAINING and LICENSING standards
Worldview
-overall PERSPECTIVE from which one sees and INTERPRETS THE WORLD
-closely LINKED to cultural and religious BELIEFS
Facets of Worldview
-Time orientation (when to seek treatment)
-social organization
-belief in fate versus free will
-individualism versus collectivism
Time Orientation
past, present, or future- prevention considered important.
Personal Space
Violating boundaries can be offensive
Social organization
DOMINANT patterns of SOCIAL INTERACTION
Fate vs Free will
people can belief that the course of their life is either outside of their control or in their control.
Individualism vs Collectivism
Affects how decision are made autonomy vs family made.
Potential barriers in Verbal Communication
-varying connotative MEANINGS of words
-specialized BIOMEDICAL JARGON and vocabulary
-culture-specific taboos against patients QUESTIONING HEALERS
-culture specific taboos against discussing SPECIFIC TOPICS
Non-Verbal Communication
-gestures
-posture
-silence
-spatial relationships
-facial expressions
-amount and location of touch
-pace of speech
-eyes contact
ESSENTIALS of cultural competence
-understanding ONE’S own WORLD VIEW,
-understanding the worldview of ANOTHER or community
-AVOIDING stereotyping, judging, and misapplication of scientific knowledge
Cultural competence models
-Campinha-Bacote’s** Process of Cultural
Competence in the Delivery of Healthcare Services
-Purnell’ s** Model for Cultural Competence
Campinha-Bacote model
- Cultural AWARENESS; recognizing cultural differences
- Cultural KNOWLEDGE; aware of cultural beliefs
- Cultural SKILLS; ability to relate and build bonds
- Cultural ENCOUNTER; introduction to different cultures
- Cultural DESIRE; wanting to engage with other cultures
Purnell model
- The individual PERSON
- That person’s FAMILY
- That person’s COMMUNITY
- Global SOCIETY
Naturalist ex 1; Humoral
bodies have four important fluids:
1) Blood (arteries, veins, liver)
2) Phlegm (brain)
3) Black Bile (Spleen)
4) Yellow Bile (liver)
The fluids are related to the seasons, internal organs, physical qualities, (hot/cold; wet/dry), and human temperaments.
Curing an Illness involves finding the IMBALANCE behind it.
Naturalistic ex 2; Ayurvedic
Ayurvedic explanation believes that disease is the result of an IMBALANCE IN VITAL ENERGIES, living/non-living.
vital force is (prana).
(ayus) means life, and (veda) means science/knowledge*
(chakras)- are energy centers that are associated with ORGANS of the body
Three doshas; based on five elements, space, air, fire, water, earth
Naturalistic ex 3; Vitalistic
bodily functions are due to a vital principle or “life force” distinct from psychical forces which are measurable and explainable by science. An ILLNESS is caused when there is an imbalance or a disruption of the vital energy. Imbalances related to yin-yang (polar opposites)
one combines these energies with body fluids and energy channels or meridians.
Biomedical approach elaborated
in this approach health and spirituality are kept separate.
mental health problems are viewed as disorders to be treated with pharmaceuticals, and counseling for behavior modification.
biomedical ex 1; Allopathic medicine
most common in the west. in allopathic medicine diagnosis and treatment should be based on scientific data.
health professions like nurses, pharmacists, and therapists treat symptoms using, drugs radiation, or surgery.
Biomedical example 2; Germ Theory–> part of Allopathic medicine.
germ theory- the micro-organism is the cause of many diseases.
Cultural Competence….
Occurs pon a continuum.
