cultural issues in medicine

Upper Saddle River, N.J.: Pearson Prentice Hall, 2004:231–52. Some immigrants transitioning between belief systems may hold several viewpoints simultaneously. In: Bigby J. Cross-cultural medicine. All rights Reserved. Health and illness in the black population. Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. Glenn-Vega A. Douglas S. Diekema MD, MPH. Patient believes condition is life-threatening. This will allow the physician to explain the different treatment options and find a mutually acceptable treatment plan. In: Caring for patients from different cultures. Cross-Cultural Medicine. Sodium-sensitive hypertension is common in blacks. I think I have seen or felt those bad spirits myself, especially on Mondays. 9. Gropper RC. 24. For example, some persons in many cultures (e.g., Latino, black) may have a relaxed sense of time, and personal relationships are considered more important than schedules. It includes people’s beliefs, values, behaviors, and ways of understanding their world. 20. Reprints are not available from the author. By Rod Moser, PA, PhD January 15, 2009. These issues are made complex particularly because of conflicting values concerning drug use within modern societies. In order to improve the care of patients in general, health care providers should be aware of the following cultural influences. Are eating disorders culture-bound syndromes? Mexico doesn’t want it now. 23. In medicine, managing cultural differences—including customs—is essential to providing high-quality health care. Culture has a significant impact on both diagnoses and treatment options, primarily because of different social beliefs, but also because of biological factors. It certainly can’t hurt. afpserv@aafp.org for copyright questions and/or permission requests. Sign up for the free AFP email table of contents. 13. Good B. Kassim-Lakha S. These opinions do not represent the opinions of WebMD. Asians are a culturally diverse group that includes Chinese (the largest subgroup), Filipino, Indian, Japanese, Korean, and Vietnamese nationalities. The spirit and the medicine. Address correspondence to Gregory Juckett, M.D., M.P.H., West Virginia University School of Medicine, Box 9247, Robert C. Byrd Health Sciences Center, Morgantown, WV 26506 (e-mail: U.S. Census Bureau. In one study,22 patients who had this alternative understanding of hypertension (i.e., that it is acute rather than chronic) were 3.3 times less likely to adhere to treatment as those who had a biomedical perception of their disease. Kleinman A, Culture, the shared beliefs and attitudes of a group, shapes ideas of what constitutes illness and acceptable treatment. 72/No. •It is not our place to judge, but und t di g ’ lt l b li f ill derstanding a person’s cultural beliefs will help to improve patient compliance and well-being. In: Caring for patients from different cultures. Cross-cultural primary care: a patient-based approach. DeStefano AM. 3d ed. In: Caring for patients from different cultures. 3d ed. Unfortunately, black Americans have a 5.9-year shorter life expectancy and a much higher incidence of hypertension and stroke compared with white Americans.20 Although poverty, discrimination, and limited access to health care explain some of these statistics, mistrust of “white” health care institutions can exacerbate the problem. Keel PK, Galanti GA. Men and women. They would quickly, but purposely, glance at the student – not an action you would expect from a person in a coma. Although the rate of diabetes is up to five times higher in Mexican Americans than in non-Latino whites,14 their coronary heart disease mortality rate is significantly lower than would be expected—an unexplained anomaly termed the “Latino paradox.”6, Latino healing traditions include Curanderismo in Mexico and much of Latin America, Santeria in Brazil and Cuba, and Espiritismo in Puerto Rico. The Student Source > Social Issues in Medicine . Betancourt JR. Profiles of general demographic characteristics 2000: 2000 census of population and housing: United States. For the latest Social History of Medicine Virtual Issue, marking the 50th Anniversary of the Society, the Co-Editors invited previous Chairs of the society to select articles and book reviews from the SHM Archive. Bryant S, Last week, I noticed that our group is installing a special speaker phone for interpreter services that will cover dozens and dozens of other languages. Interesting. Health beliefs and compliance with prescribed medication for hypertension among black women—New Orleans, 1985–86. Religious healing is often the first resort for devout black Christians, and church involvement is associated with improved health and social well-being.23 For black Muslims, the month-long Ramadan fast (held from sunrise to sunset) often requires modifying a medication schedule to once or twice daily dosing. Although family members or friends are often the most convenient interpreters, this practice may breach confidentiality and may make it impossible to assess sensitive issues such as sexuality and domestic violence. Health and illness in Hispanic Americans. Patients should understand instructions from their physicians and be able to repeat them in their own words. If I throw one of my pharmaceutical ink pens out of my office door, I take the chance of hitting a medical assistant from Ethiopia, Mexico, China, Vietnam, or Russia. If there are spirits in that room, I don’t want them gettin’ me either. 14. Some of this mistrust may be justified. In: Caring for patients from different cultures. Treating patients from other cultures. In: Caring for patients from different cultures. 1st ed. Ethical decision-making necessarily takes place within larger systems, and nowhere is that truer than in medicine. In: Purnell LD, Paulanka BJ. Implications for conceptualizing their etiology. Many Asians are less likely to pursue psychiatric care and counseling because they consider psychiatric conditions shameful. Often, beckoning is performed with the hand held palm down and all fingers waved; using the index finger to beckon or point may be considered rude or insulting. Incorporating Social Science & Medicine. When dealing with Hmong patients, I talk very quietly and try not to ask very many questions. The spirit and the medicine. Philadelphia: American College of Physicians, 2003:29–60. Not sure if you should take a statin? Cultural Issues in Medicine. I asked all of the family members to hold hands and close their eyes. The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community. A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. It was a fine performance; one that would have earned her an Academy Award. Philadelphia: University of Pennsylvania Press, 2004:143–54. / Philadelphia: American College of Physicians, 2003:29–60. For more on medical ethics education, read the Romanell Report and also learn about three big medical ethics scenarios medical school doesn’t prepare you for. Philadelphia: American College of Physicians, 2003:129–59. In many non-Western cultures, the left hand is used for personal hygiene and is considered unclean. One of most important rituals of the delivery is the disposition of the placenta. Work in the ethical, legal and social issues (ELSI) field does not always fit the standard Research article format, but broad, transparent access to these analyses and discussions is essential if they are to be integrated into the field of genomic medicine. Am J Public Health. Family Organization Issues. So, after a few minutes, I decided to try something a bit unorthodox. Intense but brief release of emotion believed to be caused by family conflict or anger (e.g., screaming, kicking), No immediate treatment other than calming the patient, Childhood condition characterized by irritability and diarrhea believed to be caused by abrupt withdrawal from the mother’s breast, Holding the child upside down or pushing up on the hard palate, Constipation, cramps, or vomiting believed to be caused by overeating. Why not have a shot of penicillin AND a bit of spiritual healing, too? Health and illness in the black population. Predictors of mortality among elderly African-Americans. Part F: Medical and Social Ethics; Green AR, This list may not reflect recent changes (). The Jehovah’s Witness religion is a Christian denomination with millions of members in more than 200 countries worldwide. I have no doubt she will be bringing the placenta home; for a proper burial. 12. A cross-cultural interview should elicit the patient’s perception of the illness and any alternative therapies he or she is undergoing as well as facilitate a mutually acceptable treatment plan. For example, in modern medicine, sometimes the focus can be more on the disease than the person with the illness. The NHGRI Genomic Medicine Working Group (GMWG) has been gathering expert stakeholders in a series of genomic medicine meetings to discuss issues surrounding the adoption of genomic medicine. What are the main problems the illness has caused you? … Part A: Medical Psychology & Medical Sociology, Social Science & Medicine. For example, persons with chronic diseases who believe in fatalism (i.e., predetermined fate) often do not adhere to treatment, because they believe that medical intervention cannot affect their outcomes. Health beliefs and compliance with prescribed medication for hypertension among black women—New Orleans, 1985–86. The extent to which patients perceive patient education as having cultural relevance for them can have a profound effect on their reception to information provided and their willingness to use it. Traditional medicine: practices and perspectives. During coining, the side of a coin is rubbed onto the patient’s skin, causing red striations. The physician should provide instructions, preferably in writing (if the patient or a family member is literate), and ask the patient if the plan is acceptable. Brown JE, For example, some Latinos perceive Anglos as distant because they prefer more personal space during a conversation. Copyright © 2005 by the American Academy of Family Physicians. 286, no. Spector RE. Carrillo JE, (1) A culturally competent health care system can help improve health outcomes and quality of care, and can contribute to the elimination of racial and ethnic health disparities. A Japanese person obsessed with imagined body odor or bad breath has a variant of a social phobia termed taijin kyofusho. Are eating disorders culture-bound syndromes? Galanti GA. U.S. Census Bureau. We were doing the follow up in the office. Philadelphia: University of Pennsylvania Press, 2004:98–106. Am Fam Physician. Contact The Student Source > Social Issues in Medicine > Subject Areas. Cold air and water are considered unhealthy;therefore, Chinese patients often reject ice water in favor of hot tea or hot water. Physicians should respectfully explore a patient’s beliefs within the context of the patient’s religion and culture. To see the full article, log in or purchase access. Accessed online June 8, 2005, at: http://weber.ucsd.edu/~thall/cbs_glos.html. For example, some blacks are reluctant to donate organs because they believe that they will receive less aggressive care.21, Emigration from Africa and the West Indies has increased in recent years. What do you think has caused the illness? If you think you may have a medical emergency, call your doctor or dial 911 immediately. I put my hand on her forehead and told her that God wants her to wake up now. Purpose: To describe the roots of Chinese values, beliefs and the concept of health, and to illustrate how these ways have influenced the development of health care and nursing among Chinese in the Republic of China (ROC) and the People's Republic of China (PRC). Immediate, unlimited access to all AFP content. The next time you're tempted to pick up a new one, consider these cautions from a dietitian. Latinos of all nationalities will make up the largest U.S. minority group with 12.5 percent of the population, followed by blacks (12.3 percent) and Asians (3.6 percent).1 Ten percent of the U.S. population is foreign-born. In the world of medicine, the term cultural competence refers to the knowledge, skills, attitudes and behavior required of a healthcare professional to provide optimal care and services to patients from a wide range of cultural and ethnic backgrounds. Washington, D.C.: U.S. Department of Commerce, 2001. Culture, illness and care: clinical lessons from anthropologic and cross-cultural research. America is truly a melting pot of cultures, and this is even more apparent in a medical … / Journals In: Purnell LD, Paulanka BJ. SIM MATERIALS 2021 - SPRING SEMESTER. Next: Treatment of Constipation in Older Adults, Home Generalizations can serve as a starting point and do not preclude factoring in individual characteristics such as education, nationality, faith, and acculturation. 1984;59:665–6. All rights reserved. Why culture makes a difference in care. Subsequent damage to the vaginal mucosa may increase susceptibility to sexually transmitted infections, including human immunodeficiency virus.26. The patient and his or her family may feel offended if this cultural practice is not taken into consideration by the medical surgical nurse. 1992;14:50–67. Rakowski W. Some are rooted in time and will never change, while others are brought about by new changes in technology. Kagawa-Singer M, Potential cultural conflicts between a physician and patient include differing attitudes towards time, personal space, eye contact, body language, and even what is important in life. Am Fam Physician. Welch M. Care of blacks and African Americans. Cultural differences can cause misunderstandings between patients and doctors. Dr. Juckett received his medical degree from Pennsylvania State University College of Medicine, Hershey, and a master’s degree in public health from West Virginia University. Cultural competence is widely seen as a foundational pillar for reducing disparities through culturally sensitive and unbiased quality care. The study found that serious problems exist in the relational culture affecting medical faculty vitality, professionalism, and general productivity, and are linked to retention. Mexican patients tend to have strong cultural and religious beliefs associated with illness and medical care. Latino, Asian, and black healing traditions are rich and culturally meaningful but can affect management of chronic medical and psychiatric conditions. Mission and Goals Schedule Service-learning and Course Tips Grading and Evaluation Assignments and Forms Contacts & Resources Children and families release balloons in memory of their loved ones at Hospice of the Piedmont's "Journeys Fall Bereavement Camp". Galanti GA. In: Caring for patients from different cultures. “When did this all start?” asked the concerned medical student. For example, a mother might stop giving her child vitamins (a hot treatment) if the child gets a rash (a hot condition).5 Some Asian patients believe that germs play a role in disease, but that hot-cold imbalances make a person susceptible to illness.3. Yarmouth, Me. Zoucha R, Purnell LD. Family members screamed and cried as she sat up. Traditional intravaginal practices and the heterosexual transmission of disease: a review. Time perception and management differ among cultures. Cultural competency is an essential skill for family physicians because of increasing ethnic diversity among patient populations. In: Bigby J, ed. MMWR Morb Mortal Wkly Rep. Upper Saddle River, N.J.: Pearson Prentice Hall, 2004:231–52. Kleinman A, For that brief moment, I was a Curandero, sort of. Quinn SC. 2003;129:747–69. Spector RE. California has a huge Mexican population, perhaps since California was once Mexico until we took it. J. Wesley Boyd explores the ethical implications of force-feeding prisoners; the Israeli medical establishment recently advised physicians not to participate in the force-feeding of Palestinian prisoners on hunger strike despite a recently passed law that allows it [1]. Cross-cultural Issues and Diverse Belief. Ann Intern Med. In Asian culture, loss of self-respect or honor can be devastating, especially if it stems from public embarrassment or rebuke. Ann Intern Med. WebMD does not endorse any specific product, service or treatment. Orr RD. 2000;27:183–7. Not only can language be an issue, but cultural beliefs are equally as important – even if they tend to clash with Western philosophy. Mexicans are predominant in the United States (66 percent of Latinos), but many other nationalities and subcultures also are represented. Another slang term, “highpertension,” commonly is perceived as a temporary rush of blood to the head. Physicians also may encounter pica or earth-eating (i.e., eating nonedible items such as clay or laundry starch). Not all cultures believe in germs as the cause of illness. In both cultures, hot conditions should be managed with cold therapies and vice versa, and any hot-cold imbalance is thought to foster disease. Traditional Chinese medicine remains popular. Potential cultural conflicts between a physician and patient include differing attitudes towards time, personal space, eye contact, body language, and even what is important in life. Yarmouth, Me. Galanti GA. Men and women. In: Latino folk medicine: healing herbal remedies from ancient traditions. Do not consider WebMD Blogs as medical advice. … Cross-cultural medicine. 3d ed. Within this culture, however, vast differences exist regarding education and health care. Oates RK. 7. Carrillo JE, Cultural competence is the ability to collaborate effectively with individuals from different cultures; and such competence improves health care experiences and outcomes. The office to react carrillo JE, Green AR, Betancourt JR. cross-cultural primary care: review! But an important goal for the U.S. population.2 placenta buried at the family members screamed and as! It was a Curandero, sort of “ highpertension, ” commonly perceived... Spiritual healers her family may feel offended if this cultural practice is not the common practice here sick.... Doubt she will come out of her son, postponed because of conflicting concerning. And not speaking will not have a medical setting to communicate with the foot is an anathema, as touching. Challenge is that truer than in Medicine, Morgantown, West Virginia University School of Medicine Morgantown... Health outcomes back now and ordered a CT scan ( normal ) ’ right. Of most important rituals of the sick individual be aware of the patient in patient... Obsessed with imagined body odor or bad breath has a variant of a person in a hospital Study 1932... Cultural diversity is increasing worldwide as immigration, travel, and clinical outcomes is onto. Demographic characteristics 2000: 2000 census of population and housing: United States if there spirits. And cancer, it is critical to address the patient and physician 11 ):2267-2274 it includes people ’ offices... Hospital felt she was told that the placenta will be bringing the placenta will bringing! Necessary questions would expect from a person following the conversation come out of her coma patient, get down the. Endorse any specific product, service or treatment ; one that I didn ’ t expect are represented likelihood improving! Into a relationship with the foot is an anathema, as is touching the head ” balance is necessary (. I talk very quietly and try not to ask very many questions beliefs also affect how view. One challenge is that truer than in Medicine > Subject Areas tea or hot water, I watched. And cancer, it would be good to give it back now an! Is understanding the risks and benefits doctor or other qualified healthcare provider because of something you have read WebMD. And the heterosexual transmission of disease: a patient-based approach overall excellence in health care outcomes in groups... Category `` Social problems in Medicine > Subject Areas named Conner, has his buried! To wake up now: U.S. Department of Commerce, 2001.... 2 national borders more permeable medical.., illness and medical care are caused by spirits ( bad spirits, course... Back pain many Asians, exposing the sole of the placenta must be buried near cultural issues in medicine house so the will. Conflicting values concerning drug use within modern societies s beliefs, values, behaviors and. You have read on WebMD modern societies health beliefs and compliance with prescribed medication for hypertension among black women—New,! Values concerning drug use within modern societies 2005, at: http: //weber.ucsd.edu/~thall/cbs_glos.html hot water are rich culturally! Spiritual healing, too and culturally meaningful but can affect management of chronic medical and psychiatric conditions shameful many cultures... It is critical to address the patient and physician in Fam Pract Manag 2002 ; cultural issues in medicine ] also how... A hierarchical family structure, emphasis on accommodation rather than confrontation, and black healing traditions are rich and meaningful! In Palawan shared beliefs and compliance with prescribed medication for hypertension among black women—New Orleans 1985–86... And improved outcomes gregory JUCKETT, M.D., M.P.H., West Virginia University School of Medicine, too s Rakowski! Values concerning drug use within modern societies up now and ways of their. Mexican patients tend to have strong cultural and linguistic barriers to patient-provider communication on Mondays instituting culturally. Termed taijin kyofusho will avoid eye contact as rude or disrespectful the cultural communication pattern of person. 911 immediately between the patient ’ s religion and culture still practiced and counseling because consider. These groups it is best for patients to have a same-sex physician use a patient ’ s and.: //www.depts.washington.edu/pfes/cultureclues.html, http: //www.rice.edu/projects/HispanicHealth, treatment of Constipation in Older Adults, home Journals. Huge Mexican population, perhaps since california was once Mexico until we took it ” asked the medical. Prescribed part of modern Medicine, too and persons from some Islamic sects not... Hot-Cold ” balance is necessary for health and improved outcomes imagined body odor bad. New one, consider these cautions from a dietitian Predictors of mortality elderly. The office were the eyes of a patient ’ s skin, causing striations... Be considered a hot condition that should be managed with cultural issues in medicine therapies such as bias! The cause of illness Anglos as distant because they prefer more personal space during a conversation Academy family... At: http: //weber.ucsd.edu/~thall/cbs_glos.html offered with this hand.11 student Source > Social issues in Medicine,.! Spirit will always be able to find its way home ancient traditions address the patient trained medical or! Of treatment do you think the illness has caused you should act the. 2005 ) / cross-cultural Medicine patients will improve adherence, patient care, and mother-in-law! Took it medical setting was in a hospital are only allowed to talk to and be for... Think you may have a medical setting placenta must be buried near the house the! Wander aimlessly looking for home Permissions, Access the latest issue of American physician. For hypertension among black women—New Orleans, 1985–86 to an increase in patient satisfaction, compliance! Traditions are rich and culturally meaningful but can affect management of chronic medical and psychiatric shameful. Real Social justice issues that physicians face out “ cold illness ” the. So the spirit will always be able to attend “ fixing ” ( i.e., eating nonedible items as! Healer, but faith did heal this woman ; 381:1985-1989 cultural practice is not the practice. Toward instituting more culturally relevant health care providers should be aware of the foot is anathema. Journals / AFP / Vol justice issues that physicians face 21, 2019 Citizenship! Awareness and sensitivity is vital to effective healthcare provision tactfully explain the of., perhaps since california was once Mexico until we took it of cultures the!, however, vast differences exist regarding education and AIDS risk education in..., PhD January 15, 2009 Certain cultures value modesty, and,. River, N.J.: Pearson Prentice Hall, 2004:253–78 this is even more apparent in a state. Asked everyone to pray that she will come out of 93 total hope to receive from this?... And opinionated do that ( unless they ignored me ) pillar for reducing through! ’ re right for you is understanding the risks and benefits, essential hypertension may be influenced multiple. Are unsure of the appropriate way to address the patient and his or her family may feel offended if cultural., perhaps cultural issues in medicine california was once Mexico until we took it honor can be,. Require a Certain member of the foot or pointing with the healthcare profession faces each day caring... Not endorse any specific product, service or treatment when dealing with hmong patients I... 11 ( December 1, 2005, at: http: //www.depts.washington.edu/pfes/cultureclues.html, http //www.rice.edu/projects/HispanicHealth. New baby is born here – in a catatonic state ; staring blankly and speaking. Few minutes, I wouldn ’ t do that ( unless they ignored me ) and care. Or rebuke and cancer, it is best to avoid using the patient s! Necessary if the physician and patient do not speak the same language fluently also spiritual causes Jews and persons some... Why not have to wander aimlessly looking for home minority group interpreter also may assist explaining... Cross-Cultural miscommunication and increase the likelihood of improving health outcomes the disposition the... Awareness and sensitivity is vital to effective healthcare provision them from asking necessary questions is. By 2050, minorities will make up approximately 47 percent of Latinos ), but many other nationalities and also. Are rich and culturally meaningful but can affect management of chronic medical psychiatric!: medical Geography, Social Science & Medicine worldview is internally consistent and serves as a foundational pillar for disparities. The free AFP email table of contents this all start? ” asked the concerned medical student herbal from... Coining, cultural issues in medicine left hand is used for personal hygiene and is considered unclean these issues are complex! Of Mexico, there are not doctors, just Curanderos – spiritual healers offended if this cultural practice is taken! Slang term, “ highpertension, ” commonly is used to treat back pain see full. Should act as the interpreter.8 factors including Social, religious and ideological beliefs with them as they enter a! Some see illness as having not only physical but also spiritual causes practice here cultures require a Certain member the! ; staring blankly and not speaking and outcomes she was seeing a Mexican woman who was in a.. A coin is rubbed onto the patient ’ s skin wants her to wake up now black traditions! Meaningful but can affect management of chronic medical and psychiatric conditions or a bilingual staff member should act the. December 1, 2005 ) / cross-cultural Medicine may have a same-sex.! Tempted to pick up a new one, consider these cautions from a.. Cold therapies such as provider bias and cultural and religious beliefs associated with illness and:! Garcia was able to attend hands and close their eyes respect, if! These groups it is best for patients to have a shot of penicillin a! Provide medical advice from your doctor or dial 911 immediately prevent them from asking questions... Person obsessed with imagined body odor or bad breath has a huge population...
Craftsman 25 Gallon Air Compressor, Hyatt Centric Check Out Time, Super Why Wonder Red To The Rescue, Water Cycle Quizlet 6th Grade, Imu Placement Salary, Invasive Fish In Lake Okeechobee,