Culture and Medicine

Question 1

What does the cultural competence initiative from 1999 make VERY CLEAR?

Answer 1

Virtually every group has its own vulnerabilities and its own special needs.

Question 2

What doe the cultural competence initiative from 1999 say about medical school training in regards to culture?

Answer 2

traditional training in medical school offers little guidance in how to treat individuals influenced by cultures of different groups

Question 3

What is the cultural competence initiative from 1999 all about?

Answer 3

learning responsible ways to address these cultural differences in accord with our ethical values as physicians.

Question 4

What does the institute of medicine report on health care disparities say?

Answer 4

racial and ethnic minorities tend to receive lower quality health care, even when access related factors, such as patients’ income or insurance status, are controlled

Question 5

What does the institute of medicine report on health care disparities say about physician role?

Answer 5

physicians need to take a leading role in protecting the health of all Americans.

Question 6

what are some ways in which health professionals, working in their usual circumstances with diverse populations of patients, create a pattern of care that appears to be discriminatory?

Answer 6

1) Bias –> more so based on unconscious bias
2) Uncertainty –> providers treat patients that are dissimilar in cultural or linguistic background
3) Stereotyping -> cognitive shortcuts

Question 7

What is the difference between surface culture and deep culture?

Answer 7

Surface —> more things you can see like music or food or dance or arts or holidays
Deep –> Language or healing or history or values or social structure

Question 8

What is cultural consciousness?

Answer 8

we must become aware of our own cultural beliefs, attitudes, behaviors, ideas
we must remember that we view the world through our own cultural lens

Question 9

One cultural error that may lead to conflict is overgeneralization, describe what this means?

Answer 9

Individual variation exists within cultures

Culture descriptions will not apply to each individual within a culture

Question 10

What are the official race classifications?

Answer 10

White
Black 
American Indian 
Pacific Islander 
Asian

Question 11

The next cultural error that may lead to conflict is ethnocentrism, describe what this means?

Answer 11

the tendency to assume that one’s own way of life (culture) is superior to the culture of others
our way vs their way

Question 12

What are some aspects of life that are influenced by cultural background?

Answer 12

attitudes and practices regarding illness, pain and healing
concept of space and time
diet dress and body image

Question 13

All societies have ethnomedical systems that address disease and death. These systems include what 3 elements?

Answer 13

1) A theory of etiology of illness
2) Techniques for diagnosing illness
3) Methods for appropriate therapy

Question 14

What is the hot-cold theory of disease (latin america, morocco)?

Answer 14

to maintain health, the body’s internal balance must be maintained between the opposing powers of hot and cold
hot and cold do not pertain to actual temperature but to a symbolic power contained in most substances
in illness, health is restored by re-establishing the internal balance by exposing one’s self to, or ingesting, items of the opposite quality to that believed to be responsible for the illness

Question 15

What are some cultural variations in body image and self?

Answer 15

1) Beliefs about optimal body shape and size

2) Beliefs about the body’s boundaries and the sense of self

Question 16

What is the main cultural variations in etiology and treatment?

Answer 16

Beliefs about the body’s inner structure and functioning

Question 17

What is a culture-bound syndromes?

Answer 17

clusters of symptoms, signs, and behavioral changes, the presentation of which is unique to a particular culture.
(members recognize the syndrome and respond to it in a standardized way)

Question 18

In culture bound syndromes explain what these cultures think about the conditions they contract?

Answer 18

Conditions often have symbolic meaning to the victim and to those around him or her
Conditions often links an individual case of illness with wider concerns

Question 19

An example of a culture-bound syndrome is AMOK among the people of Malaysia, Laos, Philippines, Papua New Guinea, and Puerto Rico. Describe the symptoms associated with this syndrome

Answer 19

Brooding ,followed by intense hyperactive or violent behavior persecutory ideas, amnesia, and exhaustion.
(usually in Men)

Question 20

An example of a culture bound syndrome is ATAQUE DE NERVIOS among the people of Latin America. Describe the symptoms associated with this syndrome

Answer 20

Uncontrolled shouting, crying, trembling, feelings of heat in the chest rising to the head, numbness, aggressive behavior, seizures, and fainting.
Gradual build up, followed by acute onset of symptoms, then attack precipitated by stressful event.

Question 21

Another example of a culture bound syndrome is KORO among the people of India, Singapore, Malaysia, China and Thailand. Describe the symptoms associated with the syndrome.

Answer 21

Sudden and intense anxiety that the penis is shrinking and will recede into the abdomen and cause death

Question 22

A fourth example of culture bound syndrome is SUSTO among the people of Mexico, Central and South America. Describe the symptoms associated with the syndrome.

Answer 22

Belief that individual is composed of physical body and one or more immaterial souls that my become detached and wander.
Symptoms: follows an unsettling event or disturbance of nature by the victim, appetite or sleep disturbances, listlessness, depression, lack of interest of self, and sufferers believe that their soul has left their body.

Question 23

The fifth example of culture bound syndrome is TAIJIN KYOFUSHO among the people of Japan. Describe the symptoms associated with this syndrome

Answer 23

Intense fear of one’s body displeases, embarrasses, or is offensive to others.

Question 24

The sixth example of culture bound syndrome is ANOREXIA NERVOSA. What are the symptoms associated with this syndrome

Answer 24

Intense anxiety and pathological misperception about ones body image
Person engages in extreme, self-destructive behaviors to change one’s body, including self starvation

Question 25

There are four different healing models according to Krippner, each card will name the model and the associated practitioner.

Piman model - what is the practitioner

Answer 25

Shaman, herbalist, allopathic physician or nurse

mnemonic: Piman SHAN

Question 26

2nd model: Allopathic …what is the practitioner –>

Answer 26

physician, nurse, rehabilitationist

Question 27

3rd model: Curanderismo - what is the practitioner –>

Answer 27

Curandero, adapt, herbolaria, medica, herbalista, senora; parchera; espiritisa, medium.

mnemonic: Curanderismo chhammpes

Question 28

4th model: chinese - what is the practitioner –.

Answer 28

Physician, apprentice, shaman; herbalist; masseur

mnemonic chinese HAMPS

Question 29

What is the explanatory model of illness?

Answer 29

an individual’s personal interpretation of disease
open communication beginning with the patients explanatory model, FOSTERS MUTUAL RESPECT and is the KEY TO CULTURAL INSIGHT.

Question 30

Give some examples of questions for eliciting a patient’s explanatory model of illness (KLEINMAN)

Answer 30

1) What do you think has caused your problem
2) Why do you think it started when it did?
3) What do you think your sickness does to you? How does it work?
4) How bad do you think your illness is? Do you think it will last a long time, or will it be better soon, in your opinion.
etc

Question 31

What are some other tools that are used for the explanatory model of illness?

Answer 31

1) Ethnic Model
2) FIFE Model
3) Learn Model

Question 32

What are the mandated national standards for culturally and linguistically appropriate services in health care?

Answer 32

1) Must offer and provide language assistance services
2) Right to receive language assistance
3) Competence of language assistance
4) Easily understood patient-related materials and post signage

Question 33

What are the culturally competent care core competencies?

Answer 33

patient care 
medical knowledge 
practice based learning 
interpersonal and communication skills 
professionalism 
systems based practice