chapter 3 Flashcards
worldview
overall perspective from which one sees and interprets the world
set of assumptions/beliefs that express how cultures see, interpret and explain their experience (time, personal space, individual autonomy, free will, fate)
closely linked to cultural/religious beliefs
culture built up worldviews
has profound health care implications
What are the three major facets of worldview?
time orientation
personal space
social organization
Describe time orientation in the east vs west?
West: time is logical, sequential and present focused, incremental certainty toward future
East: time feels like unlimited continuity, no defined boundary. Birth and death are not absolute ends because humans change form and continue as part of it
Polish are very timely, Latinos are less rigid and may be late
What is past oriented?
tend to value elders and honor traditions
ex: Asian culture
What is present oriented?
may see living in the moment as the priority and are less willing to forego immediate pleasures for future benefits
ex: American Indians and African Americans
What is future oriented?
understand that healthy behaviors in the present impact our health in the future, willing to make sacrifices now for future benefit
ex: Western culture
Describe personal space?
includes interpersonal space and boundaries
violating boundaries can be offensive
ex: North Americans prefer large amount of space, Europeans stand more closely together when talking and accustomed to smaller spaces
Describe social organization?
dominant patterns of social interaction
ex: how people interact and communicate, kinship system, marriage residency patterns, division of labor, who has access to specific goods and knowledge, social hierarchy
What are the four components of social organization that impact health care?
- individualism vs collectivism
- fate vs free will
- communication
- family relationships
What is individualism vs collectivism?
Individualists: see a person as a social unit, primary responsibility for him or herself, health decisions made indepedently (U.S, Germany, Canada ,Sweden)
Collectivists: part of a larger group such as a family, community, tribe and dependence and connections to group are valued. Decisions are based on what is good for the group instead of the individual, involve family in decision-making process (Amish, Chinese, Mexicans and Vietnamese)
What is fate vs free will?
free will: degree to which people believe that are masters of their own lives
fate: degree to which they believe that they are subject to events outside our control
also called “locus of control”
internal locus of control - they have control over their own health
external locus of control - health is outside of their control
What is interpersonal communication?
interactive process that involves sending and receiving info, emotions, thoughts and ideas through verbal/nonverbal means
- want to preserve mutual respect and minimize miscommunication and conflict
What can effective interpersonal communication lead to?
better health outcomes
higher patient satisfaction
continued care
better adherence to treatment recommendations
reduced conflict and errors, lost opportunities for encouraging health behavior changes, misinterpretation of treatment plans, etc
What are potential barriers in verbal communication?
varying connotative meanings of words
specialized biomedical jargon and vocab
culture-specific taboos against patient questioning healers
culture-specific taboos against discussing specific topics
What are modes of nonverbal communication?
gestures, posture, silence, spacial relationships, facial expressions, amount/location of touch, pace of speech, eye contact
What issues are included with different family relationships?
who makes decisions at home
family goals and priorities
child-rearing practices
family/community social status
marriage decisions
divorce acceptance
roles of elders and extended family
acceptance of alternative lifestyles
*health is related to the quality of social support from family
How does a culture’s worldview affect their medical decisions?
abortion
use of birth control
permission to allow blood transfusion
utilization of chemotherapy
advance directives
euthanasia
Describe views on birth control use?
prohibited by some religions
permitted with restrictions by other religions
Describe views on abortion?
the core question is about when life begins
many religions will approve of abortion under certain circumstances (health of mother will be at risk, child may be born with disability, pregnancy resulted from rape or incest)
Describe end of life decisions?
death is inevitable
Response to death varies in cultures: appropriateness of crying, sobbing and wailing while others conservatively control their grief in public
variations in the burial and grieving processes
Organ transplant
Euthanasia
What are some reasons for religious opposition to euthanasia?
concern for patients who may be in vulnerable positions because of their illness
fear that patients who cannot afford expensive treatment will be pressured to accept
concern about the moral nature of doctor’s professional self
karma and rebirth
murder/suicide similar in some cultures
What are advanced directives?
legal documents that enable a person to convey his or her decisions about end-of-life care ahead of time.
- living will and durable power of attorney
- patients communicate their wishes to avoid confusion
(twice as many whites as african americans completed advanced directives)
