Chapter 2 Theories and models related to multicultural health

Question 1

Two Major Theories of Health and Illness

Answer 1

Personalistic and Naturalistic

Question 2

Health Theories are…

Answer 2

(beliefs) people hold about how to MAINTAIN
good health and what CAUSES illnesses.

Question 3

Personalistic explanations

Answer 3

[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

Question 4

Naturalistic explanations

Answer 4

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)

Question 5

Two Systems/Pathways to Care

Answer 5

BIOMEDICAL and HOLISTIC

Question 6

Care system selected based on…

Answer 6

CULTURE, ACCESS to care, health BELIEFS, AFFORDABILITY

Question 7

BIOMEDICAL/ALLOPATHIC APPROACH:

Answer 7

-OFEN VIEWED AS SCIENTIFIC

-FOCUSES ON (PHYSICAL) COMPONENTS OF ILLNESS

-CARE PROVIDED BY LICENSED PROFFESSIONALS SUCH AS;
DOCTORS, NURSES, PHYSICAL THERAPISTS

Question 8

Holistic Approach (Alternative or Complementary):

Answer 8

-viewed by some as UNSCIENTIFIC
-Based on a PSYCHOSOCIAL model of health care
-providers have vast levels of training
-FEW TRAINING and LICENSING standards

Question 9

Worldview

Answer 9

-overall PERSPECTIVE from which one sees and INTERPRETS THE WORLD
-closely LINKED to cultural and religious BELIEFS

Question 10

Facets of Worldview

Answer 10

-Time orientation (when to seek treatment)
-social organization
-belief in fate versus free will
-individualism versus collectivism

Question 11

Time Orientation

Answer 11

past, present, or future- prevention considered important.

Question 12

Personal Space

Answer 12

Violating boundaries can be offensive

Question 13

Social organization

Answer 13

DOMINANT patterns of SOCIAL INTERACTION

Question 14

Fate vs Free will

Answer 14

people can belief that the course of their life is either outside of their control or in their control.

Question 15

Individualism vs Collectivism

Answer 15

Affects how decision are made autonomy vs family made.

Question 16

Potential barriers in Verbal Communication

Answer 16

-varying connotative MEANINGS of words
-specialized BIOMEDICAL JARGON and vocabulary
-culture-specific taboos against patients QUESTIONING HEALERS
-culture specific taboos against discussing SPECIFIC TOPICS

Question 17

Non-Verbal Communication

Answer 17

-gestures
-posture
-silence
-spatial relationships
-facial expressions
-amount and location of touch
-pace of speech
-eyes contact

Question 18

ESSENTIALS of cultural competence

Answer 18

-understanding ONE’S own WORLD VIEW,
-understanding the worldview of ANOTHER or community
-AVOIDING stereotyping, judging, and misapplication of scientific knowledge

Question 19

Cultural competence models

Answer 19

-Campinha-Bacote’s** Process of Cultural
Competence in the Delivery of Healthcare Services

-Purnell’ s** Model for Cultural Competence

Question 20

Campinha-Bacote model

Answer 20

• 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

Question 21

Purnell model

Answer 21

• The individual PERSON
• That person’s FAMILY
• That person’s COMMUNITY
• Global SOCIETY

Question 22

Naturalist ex 1; Humoral

Answer 22

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.

Question 23

Naturalistic ex 2; Ayurvedic

Answer 23

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

Question 24

Naturalistic ex 3; Vitalistic

Answer 24

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.

Question 25

Biomedical approach elaborated

Answer 25

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.

Question 26

biomedical ex 1; Allopathic medicine

Answer 26

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.

Question 27

Biomedical example 2; Germ Theory–> part of Allopathic medicine.

Answer 27

germ theory- the micro-organism is the cause of many diseases.

Question 28

Cultural Competence….

Answer 28

Occurs pon a continuum.