Culture and Medicine Flashcards
What does the cultural competence initiative from 1999 make VERY CLEAR?
Virtually every group has its own vulnerabilities and its own special needs.
What doe the cultural competence initiative from 1999 say about medical school training in regards to culture?
traditional training in medical school offers little guidance in how to treat individuals influenced by cultures of different groups
What is the cultural competence initiative from 1999 all about?
learning responsible ways to address these cultural differences in accord with our ethical values as physicians.
What does the institute of medicine report on health care disparities say?
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
What does the institute of medicine report on health care disparities say about physician role?
physicians need to take a leading role in protecting the health of all Americans.
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?
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
What is the difference between surface culture and deep culture?
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
What is cultural consciousness?
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
One cultural error that may lead to conflict is overgeneralization, describe what this means?
Individual variation exists within cultures
Culture descriptions will not apply to each individual within a culture
What are the official race classifications?
White Black American Indian Pacific Islander Asian
The next cultural error that may lead to conflict is ethnocentrism, describe what this means?
the tendency to assume that one’s own way of life (culture) is superior to the culture of others
our way vs their way
What are some aspects of life that are influenced by cultural background?
attitudes and practices regarding illness, pain and healing
concept of space and time
diet dress and body image
All societies have ethnomedical systems that address disease and death. These systems include what 3 elements?
1) A theory of etiology of illness
2) Techniques for diagnosing illness
3) Methods for appropriate therapy
What is the hot-cold theory of disease (latin america, morocco)?
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
What are some cultural variations in body image and self?
1) Beliefs about optimal body shape and size
2) Beliefs about the body’s boundaries and the sense of self
What is the main cultural variations in etiology and treatment?
Beliefs about the body’s inner structure and functioning
What is a culture-bound syndromes?
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)
In culture bound syndromes explain what these cultures think about the conditions they contract?
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
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
Brooding ,followed by intense hyperactive or violent behavior persecutory ideas, amnesia, and exhaustion.
(usually in Men)
An example of a culture bound syndrome is ATAQUE DE NERVIOS among the people of Latin America. Describe the symptoms associated with this syndrome
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.
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.
Sudden and intense anxiety that the penis is shrinking and will recede into the abdomen and cause death
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.
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.
The fifth example of culture bound syndrome is TAIJIN KYOFUSHO among the people of Japan. Describe the symptoms associated with this syndrome
Intense fear of one’s body displeases, embarrasses, or is offensive to others.
The sixth example of culture bound syndrome is ANOREXIA NERVOSA. What are the symptoms associated with this syndrome
Intense anxiety and pathological misperception about ones body image
Person engages in extreme, self-destructive behaviors to change one’s body, including self starvation
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
Shaman, herbalist, allopathic physician or nurse
mnemonic: Piman SHAN
2nd model: Allopathic …what is the practitioner –>
physician, nurse, rehabilitationist
3rd model: Curanderismo - what is the practitioner –>
Curandero, adapt, herbolaria, medica, herbalista, senora; parchera; espiritisa, medium.
mnemonic: Curanderismo chhammpes
4th model: chinese - what is the practitioner –.
Physician, apprentice, shaman; herbalist; masseur
mnemonic chinese HAMPS
What is the explanatory model of illness?
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.
Give some examples of questions for eliciting a patient’s explanatory model of illness (KLEINMAN)
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
What are some other tools that are used for the explanatory model of illness?
1) Ethnic Model
2) FIFE Model
3) Learn Model
What are the mandated national standards for culturally and linguistically appropriate services in health care?
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
What are the culturally competent care core competencies?
patient care medical knowledge practice based learning interpersonal and communication skills professionalism systems based practice
