Lecture 2 Flashcards
Which is better, boomed or alternative med?
As a healthcare professional, neither is better, need to use both to help your client at the end of the day
Other cultures have been using traditional meds for thousands of years so need to be mindful of that
What I biomed based on?
Based on principles of natural sciences:
Biochemistry
Biology
Physiology
Scientific findings through research (e.g., nutrition, exercise, smoking, mental health)
How is biomed diseases treated?
Disease treated through latest technology and medicine
Where is biomed commonly practiced?
In North America/Europe
What is CAM?
Complementary Alternative Medicine
Practices that may go against current research
May be difficult to prove efficacy
“Pseudomedicine”
What are examples of CAM?
Chiropractic Osteopath Massage Meditation Acupuncture Natural health products (NHPs) -Some of these are more common for other people
What do we have to be mindful of as HCPs in terms of CAM?
Some HC people are incorporating these into their care plans
Just because it isnt proven doesn’t mean it doesn’t work
If someone if finind relif and causing no harm can be use along side biomed
Has there been an increase in CAM?
Significant increase over recent decade
What is integrative medicine?
Combination of conventional medicine and CAM
Large trend towards this
“Holistic” approaches becoming extremely popular
In the eyes of some doctors, nutrition may be considered alternative medicine
What does holistic mean?
Holistic: embracing multiple aspects of health
Need to take back the meaning of the word and not disown it
Controversy If scientifically sound
How do cultures interpret health?
Each culture can define health differently
Treatment and definition of illness vary based on:
- Etiology of Illness, how it came about (personal, natural, social, or supernatural)
- Cures that are employed (therapeutic substances, physical forces, or magico-religious interventions)
What is the cultural worldview?
Cultural groups have unique outlooks on life
Vary based on ranking of values
Individuals may have their own spectrum of beliefs congruent or different from their culture’s beliefs
Westernized countries tend to have individualistic worldview
In Western cultures, what does the society value?
Personal control over the environment
Human equality
Youth
Directness/openness
In other cultures, what does the society value?
Fate
Hierarch/rank/status
Elders
Indirectness/ritual ‘face’
What do many cultures /religions belive is the root of illness?
Fate is the primary influence in health and illness
-“Will of God”
Interference not intended by God
What are the 2 main options for intervention when a culture/religion believe sit is fate or god for this illness?
Limited interventions for certain cultural groups
- Belief in reincarnation, afterlife
- Allow natural progression of death
Other cultures may belief in aggressive approach
- DNR viewed as murder
- Death is in God’s hands, therefore there is always hope
What is cultural imposition?
Tendency for health care practitioners to enforce personal beliefs, practices, and values upon clients
Ethnocentric viewpoint
Where biomed and CAM debate starts
What is the main goal of the biomed world view?
Mastery over nature
“Defeat” natural illnesses
Health by numbers
E.g., BMI, blood values, diagnostic tests
What happens when there are symptoms that cannot be linked to diagnosis in the biomes world view?
Symptoms that cannot be linked to diagnosis tend to be dismissed as psychosomatic
Belief in biomedical cause for every condition
-Fate rarely considered
What are the 3 main aspects of the biomed world view?
State of being
- Clients are expected to comply
- Change in lifestyle
- Biomedical emphasis of doing, not being
Role of the individual
- Confidentiality is essential – even from family
- Treatment rarely involves other members
Human Equality
-All patients deserve equal access to care
-Other societies may decide care based on rationality (i.e., chances of survival, age, SES)
Exception: Medical hierarchy
What is the biomed world view on aging?
Value of youthfulness
Goal to post-pone aging through natural and medical interventions (e.g., plastic surgery, Botox)
Other societies value honour and wisdom associated with aging
What is the biomed world view on time?
“What can be done today so the client will be better tomorrow”
Lateness is frowned upon – unless it’s from the healthcare professional
What is the biomed world view on formality/directness?
Limited small talk, to the point
Expectation of honestly, open communication to increase ability to diagnose and treat
What is the biomed world view on materialism?
Clinical significance dominates - social or emotional issues addressed by other professionals
-refer to different areas
Mind-body duality, rather than the whole (both separated vs connected)
What is the WHO definition of health?
“A state of complete physical, mental, and social well-being, not merely an absence of disease or infirmity”
Ignores natural, spiritual, and supernatural dimensions of health
How can ones health have an impact on others?
One’s health and its impact on others
- Fear of burdening children
- Pain is not masculine or for the weak
May change based on SES
-Low SES may “deal with it” in order to make ends meet
What are the characteristics associated with being healthy?
Weight maintenance Hair sheen Skin colour (i.e., pallor) Menstruation (pre-menopause) Regular BM Normotensive Motor skills Energized/Good sleep habits Infrequent colds/illness
How does health attributes vary form culture to culture?
In North American societies, “healthy” hair is clean, free of dandruff, and soft
In other societies, oily hair and dandruff are normal and not an indication of poor health
North American societies view pregnancy as a medical condition, warranting regular doctors appointments and exams
Other societies have limited prenatal care
What is the thin ideal?
Westernized countries prefer thinness, although this is changing
Other cultures believe thinness is an indication of sickness/disease
Views may change based on geographical relocation
Is there a word for min-body unity in NA?
Physical and emotional/psychological health is so distant in North American culture that there is no word for mind-body unity
-So we associate the 2 of them separately
What are generally accepted health habits?
Healthy diet, rest, and cleanliness defined as good health practices worldwide
The definition of these practices vary
What are the health promoting food habits?
Usually defined as the most important way to maintain health
Almost all cultures define certain foods as “health-promoting” (but vary depending on the food)
Food May provide mind-body balance and benefits to both
In Canada what is used ass a guideline for good health?
Canadas food guide
-Heavily criticized for lack of cultural representation, influence from industry
What does the western “ideal” diet look like?
Diet high in V/F
Protein-rich
Limited sugar, fat, salt, alcohol
Dietary supplements
What is the Yin and Yang diet based on?
Mainly practice in China and surrounding countries
Balance of foods classified as Yin (raw, soothing, cooked at low temperatures, white/light green) and Yang (high kcal, high heat, spicy, red-orange-yellow in colour)
Believe to avoid extremes
Staple foods (e.g., rice) are believe to be neutral
What can be vied as a sign of good health?
eating large volumes of food
What is the sympathetic quality of food?
food that looks like a human organ or body part
What is an illness?
weakness, pain/discomfort, emotional distress, or physical debilitation that may prevent a person from fulfilling responsibilities to family or society
Perceptions or and reaction to physical or psychological condition
Caused by disease, malfunctioning body organs and systems
What is a sickness?
The entire disease-illness process; cultural consensus of definition may vary
How the person became sick, whole process from tart to finish
Symptoms experienced
How it is cured
In some cultures how is the seriousness of an illness determined?
by elder (e.g., mother, grandmother, knowledgeable family member)
Decision to seek help from medical professional
-Based on the consultation with this fam member you go to the professional
What is the role of a sick person?
Social legitimization of sickness
New role as the ‘sick person’
Sick person is usually excused from daily roles, social activities, and religious duties
Temporary respite from physical and psychological burdens of life to allow for healing
What is the explanatory model?
Unexpected events warrant reason and explanation of origin/cause
Sickness : Cause of disease, perception of symptoms, healing treatments, why others do not get sick
According to biomed, what are the 3 main causes of sickness?
Immediate causes (toxins, tumors, physical injury, bacterial/viral infection)
Underlying causes (smoking, hypercholesterolemia, glucose intolerance, nutritional deficiencies)- more chronic
Ultimate causes (genetic predisposition, obesity, environmental stresses)
What are the 4 aspects of the ethology of sickness (4 ways to get sick?
The patient The natural world The social world The supernatural world -these etiologies may not be embraced by every culture
What is meant by the sickness due to the patient?
Genetic or lifestyle-related
Genetic Examples:
BRCA1 > Breast cancer susceptibility
Crohn’s disease > Ashkenazi Jews
Lifestyle Examples:
Overeating > Obesity
Smoking > Lung cancer
Not wearing a seatbelt > Injury from car accident
Blame often placed on the patient, without appreciation of external causes (e.g., obesogenic environment)
What is meant by the sickness due to the natural world?
Involves environmental elements: Weather Allergens Pollution Smoke Toxins Viruses/bacteria Wind or bad air > through pores, orifices, wounds -all to cause illness
What is meant by the sickness due to the social world?
Sickness due to interpersonal conflict
Blaming an enemy for pain
The Evil Eye:
- When a person stares at another person with envy, resulting in harm
- Widely believed in Asia, Europe, Africa, Greece, Middle East
- Children believed to be vulnerable (colic, crying, hiccups)
- Adults experience headaches, malaise, impotency, birth complications, etc.
Conjury
-Ability to invoke supernatural forces
E.g., voodoo, witchcraft
What is meant by the sickness due to the supernatural world?
Sickness caused by gods, spirits, or ghosts of ancestors
Will of God
-Judaism, Christians, Muslims
Sickness may be considered a form of punishment
Malevolent spirits may attack a person
Spiritual possession
- Evil spirit inhabits a body
- Catholics believe in exorcisms
- Which causes them pain or to act out in certain ways
Loss of soul
-Usually due to emotional distress or spirit possession
In the 4 ways of how to get sick, where does traditional med and biomed start to separate?
Sickness due to social world
What is a folk illness?
Culture-bound illnesses
Susto/Espanto
- Soul loss according to Latinos
- Asians, Indigenous people, Pacific Islanders, South Asians commonly believe in loss of soul
Sudden Unexpected Nocturnal Syndrome (SUNDS)
-Death caused by evil spirits (Cambodia)
Burning of soles of feet
-Experience of severe stress (India)
Empacho
-Feeling of food stuck in stomach (Mexico)
Anorexia Nervosa and Bulimia Nervosa
-Some believe these conditions to be culture-based in Westernized societies due to drive for thinness, control over body, body image
What is heal thing?
“Addresses the illness, alleviating the infirmities of the sick patient even when the disease is not evident”
Responds to personal, familial, and social issues
Biomedicine:
Focuses more on diagnosing and treating the disease
How do most people seek care?
Route of care may depend on patient’s perception of severity
Home remedies are usually first step of care
Once ineffective, further care may be sought out
“Healing” dependent on several factors
What is healing dependent on?
Price Availability Accessibility Previous experiences Referrals by friends/family members How the patient perceives the problem Type of healing required -Type of illness would have to go to the appropriate illness s they believe they have. -Having musltiple healters is common
What are home remedies?
herbal teas, vitamins, meditation, relaxation, essential oils
What are popular therapies?
Chiropractic, homeopathy, hypnosis, massage, IV therapy
-not all backed by science
What are professional practices?
Requires extensive academic training in conventionally recognized medical systems, such as biomedicine, traditional Chinese medicine, and ayurvedic medicine
-some May be approached and appreciated more tan others
Which 3 categories do all healing therapies fall under?
Administration of therapeutic substances
Application of physical forces or devices
Magico-religious intervention
What kinds of therapeutic substances can be administered?
Biomed medication and diet perscriptions
Botanical med
Homeopathy
Naturopathic medicine
What are botanical meds?
Often used by health professionals outside of biomedicine
Focus on whole plants, herbs, and parts of animals (e.g., organs, mineralized powders)
Chinese medicine or ayurvedic medicine
What is homeopathy?
Belief that symptoms of an illness are evidence that the body is curing itself
Exaggeration of symptoms speeds healing; “like cures like”
Widely debated and criticized
What is naturopathic medicine?
Helping the body heal itself using non-invasive natural treatments and physical manipulations
Nutritional therapy is the foundation of naturopathic health maintenance and healing
Growing in popularity
Taking over nutrition and claiming they are experts
What re kinds of applications of physical force/devices?
Chiropractic Osteopathic Asian Healing practices Physio Hydrotherapy
What is the theory behind chiropractic?
The misalignments of the spine interfere with the nervous system, interrupting the natural intelligence that regulates the body, resulting in disease and disorder”
What is osteopathic medicine?
Blood, lymph, and nerve function improve through manipulation of musculoskeletal system
What are Asian heathen practices?
used to release vital energy flow
Massage therapy, acupuncture, pinching/scratching techniques, cupping – common among athletes
What is physiotherapy?
Use of electrotherapy for injury
May be used by other professionals for alleviating GI upset, chronic pain, insomnia, etc.
What is hydrotherapy?
Use of bath, shower, saunas, hot tubs, steam rooms, etc. to relieve discomfort, asthma, hypertension, clear pores, etc.
What are the 2 categories of magic-religious interventions?
Action by the individual
Action by the sacred healer
What are the differences in magic-religious interventions between western and eastern religions?
Western religions (Judaism, Christianity, Islam):
God has control over life and death
Life according to God’s will
E.g., Catholics make appeals to saints for specific ailments (St. Joseph for terminal illness)
Eastern religions (Buddhism, Hinduism)
Correct conduct in this and past lives
Religious offerings
Healing occurs through restoration of balance
What are individual healing practices from magic-relisous interventions?
Meditation:Finding focus within the mind, deep breathing
Yoga:Calms the mind, control of breathing and use ot systematic poses to promote mind and body being one
Visualization/guided imagery:Induced relaxation and targeting away of health problems
What are sacred healing practices?
Prayers Blessings Chanting, singing Charms Conjuring Use of therapeutic substances Application of physical cures -done by a sacred healer
What is medical pluralism?
“Consecutive or concurrent use of multiple health care systems”
Low SES and high SES have been found to rely on this
-Increasingly popular among high SES
What are many patients doing in terms of their healing?
In many cases, patients are using more than one route of healing
-Underreporting is a massive issue
Health care practitioners must be open to alternative practices :
- Avoid offending the client
- Develop trusting relationship
- Awareness of drug-nutrient/drug-drug/nutrient-nutrient interactions
Issue with contradictory information
-Patient may be left confused on which treatment is “right”
What are the 3 aspects of transcultural during theorys?
Cultural care preservation and/or maintenance
Cultural care accommodation and/or negotiation
Cultural care repatterning or restructuring
