OT 202 Flashcards
describe Josepha Camphina-Bacote’s 5 constructs of cultural competence
o Cultural Awareness: examination and exploration of one’s own cultural background.
o Cultural Knowledge: The process of seeking and obtaining educational foundation about diverse cultural groups.
o Cultural Skill: The ability to collect relevant data regarding the person’s problem in a healthcare setting.
o Cultural Encounters: Direct engagement with other cultures.
o Cultural Desire: Motivation to want to engage in the process in becoming culturally aware.
- Concepts to know regarding culturally competent healthcare
o The concept of “face”: Self-esteem/ respecting people while communicate with them.
o The concept of space: Personal bubble
o The concept of time
o The concept of non-verbal communication
o The “explanatory model”: every person and every culture has explanation that caused their illness
o Intergenerational Issues
Monochronic time:
• low context or individualistic culture. One thing at a time.
• Polychronic time
Many things or events happen at one time. People take precedents over events or activities
• Traditionalists
(born prior to 1946): they have been through depression, WW II, people are loyal, patriotic, fiscally frugal,
• Baby Boomers
(born 1946-1964): Vietnam war, water gates, human rights movements, questioning authority, competitiveness
• Generation X
(born 1965-1981): raised with computer, pop culture, AIDS scare, they are self reliant, resourceful and adaptable
• Millennial Generation Y
(born 1982-2000): technological advancements, natural disasters, they have computer literacy, environmental awareness,
- Socioeconomic factors
Education level: education can help a person view the world differently and contribute to society. Increase education = better life = better choices
- Income and Occupation: we are often judged by our job.
- Place of Residence: neighborhood, house etc
- Culture/Ethnicity: help shape our thoughts, attitude and belief systems
- Religion:
types of social injustices
o Unequal distribution of wealth: fewer opportunities, less resources, decreased food/housing/education/employment.
o Racism: discrimination based on your race.
o Sexism: discrimination based on your gender.
o Discrimination against disabled, gays, lesbians, bisexuals and transgender.
o Ethnocentrism
belief that your culture is better
o Personalismo
a client or family member will ask you personal question
o Somatization
person might report physical symptoms but they might actually have psychological disorder
o Customs
pattern of behavior common for many members of particular group.
o Traditions
inherited patterns or thoughts handed down through generations
o Superstitions
actions and practices done due to fear of unknown
o Bias
in favor of one thing over other
o Prejudice
preconceived disliked not necessary based on experience
o Stereotyping
belief that people who similar characteristics are the same
multiple barriers influencing the utilization of healthcare
o Language, Religion, culture, Money, transportation, complexity or understanding of process
primary characteristics of culture
the attributes that cannot be changed or if they are changed then it can cause a lot of problems. Ex: race, color, religion, gender
secondary characteristics of culture
educational status, political beliefs, and physical characteristics.
- What is culture shock?
o Stress experience when an individual cannot have their needs met.
o Have difficulty communicating
o Have difficulty making needs known
o Have difficulty understanding why “locals” are acting the way they are
o Have a sense of “loss” and “shock”
6 Universal Aspects of Healthcare
o 1. Healthcare specialist will apply a name to the problem.
o 2. Qualities of the healthcare specialist are important.
o 3. Healthcare specialist must establish credibility through use of symbols of status that are familiar in the culture.
o 4. Healthcare specialist will place the client’s problem in a familiar framework.
o 5. Healthcare specialist will apply a set of techniques to bring relief to the client.
o 6. Interactions with healthcare specialists occur at a certain time or place.
o Parochial Stage
narrow minded thinking, not acknowledging that other people exist.
o Ethnocentric Stage
you are aware but my way is the best way
o Synergistic Stage
aware of how other cultures are doing things and then chooses the best ways to do things
o Participatory Stage
variety of different cultures together to make a new culture of shared meetings
4 goals of managed care
To continue to provide some level of health care.
- To stop the cost of health care rising exponentially.
- To keep health care premiums low for employers.
- To make money
positive hanges that managed care did to therapy
- Therapists are forced to focus on the outcomes and function. This makes therapists more responsible for the patient’s outcome.
- It helped to streamline documentation and set standards that everyone must follow.
negative changes that managed care did to therapy
- Decreased # of treatments.
- Decreased # of treatment days.
- Physicians/Gatekeepers/Case Managers decide what treatments the therapist can do and for how long.
- Private practices have difficulties getting large managed care contracts.
- Decreased reimbursement amounts.
- Capitation: In 2013 Medicare cap on therapy is $1900 for OT. PT and ST are that amount combined.
types of Medicare fraud
o Medicare fraud occurs when a provider knowingly and willingly lies to get reimbursement.
• Making false claims for payment
• Making false statements for payment
• Billing for visits never made
• Billing for non face-to-face services
• Receiving kickbacks for goods and services
• Paying or receiving payment for patient referrals
