Deck 5 Flashcards
Culture
Values and behaviors shared by a group of individuals.
People may belong to more than one cultural group.
Examples include race, socioeconomic status, sexual orientation, physical abilities (so a culture can be pretty much anything)
Cultural competence
A set of congruent behaviors/attitudes/policies that enable you to work effectively in cross-cultural situations
You’re not just being unbiased, you’re also valuing how culture can be a positive factor in someone’s health.
Cultural humility
Ongoing effort to make sure you’re not being biased when interacting with someone from another culture
Cultural competence is considered to be a ____, not all or nothing
continuum
The goal of cultural competence is to build
build honest and trustworthy relationships
Implicit/unconscious bias is
exactly what it sounds like
How does implicit bias among healthcare workers compare to implicit bias among the general public
it’s the same
The most widely used study to measure unconscious bias is the
Implicit Association Test
Cultural syndrome
A cluster of symptoms that occur in a specific cultural group. May not be seen as an illness within the culture, but outsiders may recognize it as such
Ataque de nervios
A syndrome in Latin America that includes shouting/crying/aggression/dissociation in response to a stressful situation.
Cultural idiom of distress
A way of expressing features of distress of a way of talking about suffering that is commonly used among people of a cultural group.
Kufungisisa
“Thinking too much”
An idiom of psychosocial and interpersonal distress among the Shona of Zimbabwe.
Associated with anxiety, headache, and dizziness
Cultural explanation or perceived cause
a label of explanatory model used to provide an etiology or cause for symptoms, disease or distress
Susto
“Fright”
Among Latino, it’s an explanation for distress/misfortune.
Susto happens after a frightening experience that causes the soul to leave the body.
It causes unhappiness and somatic complaints.
General health disparities for black and hispanics
they receive less care even after controlling for income and other factors
Black psych patients are more likely than white patients to be
hospitalized, involuntarily hospitalized, placed in seclusion, diagnosed as schizophrenic
Black psych patients are less likely than white patients to be diagnosed with
affective disorders
The highest suicide rate is among which ethnicity
Native Americans and Alaskan Indian
Implicit/unconscious bias negatively affects providers’ willingness to
Engage in patient-centered care
Provide referrals to specialized treatment
Adhere to evidence-based guidelines
When it comes to implicit/unconscious bias, mental health facilities are
particularly at risk
Strategies to mitigate unconscious bias include 4 broad categories. The categories are,
Organizational
Individual
We all have biases
Remembering
Strategies to mitigate unconscious bias: Organizational
Commitment to culture of inclusion
Diversity training
Recruit diverse staff
Strategies to mitigate unconscious bias: Individual
Reflection and cultural humility
Strategies to mitigate unconscious bias: We all have biases
Be aware- How biases may appear as “intuition”
Be systematic- Use concrete guidelines and be transparent in decision-making
Be open to learning new things
Strategies to mitigate unconscious bias: Remembering
There is a difference between intent and impact; Consider other’s past experience.
Acknowledge your actions and own the consequences.
What percent of LGBTQ experience discrimination
more than 50%
Transgender/GNC people postponing medical care
more than 25% have postponed
LGBTQ and suicide
2 to 3 times more likely to commit suicide
Transgender woman of color
average age of death is 31
Transgender people and suicide
40% attempt suicide
Transgender people and provider knowledge
More than 50% of transgender people encounter significant lack of provider knowledge.
LGBTQ: PMHNP responsibilities:
Ne nonjudgemental and open to learning
Use inclusive language and avoid heterosexual bias (asking “are you married” is not really inclusive because gays might not be able to marry)
Provide diagnosis of gender dysphoria
Assess other psych disorders
Assess the patient’s informed consent to hormonal and surgical options
Provide support for exploration of gender identity etc
Gender dysphoria
Incongruence of experienced gender and the gender assigned at birth, demonstrated by at least 2 of the following:
- wants to be another gender
- wants to be treated as another gender
- wants the sexual characteristics of another gender
- wanting to get rid of the current sex characteristics
- believing that you have the feelings/emotions of the other gender
Best practices for working with an interpreter
Don’t use family
Use the culturally appropriate type (the right gender, age, etc)
Meet with the interpreter first
Short phrases, no jargon
Ask the same question in different ways
Seat the interpreter behind or next to you
Listen to them even though you don’t understand the language
Remember it takes 2 to 3 times as long to work with an interpreter
Cross-dresser
Person wears clothes of the opposite sex for erotic arousal or other psychological reasons. It’s a form of gender expression. Transvestite is no longer used.
Misgendering
when someone purposely or accidentally uses the wrong term.
Agender
a person who doesn’t identify as having a gender
