Clpr Q2 Post Midterm Part Ii

Front 1

Re: cultural factors: Details on the Twelve Domains?

Back 1

Localities, topography, politics, education; Communication; Family roles and organization; Workforce issues; Bio-cultural ecology; High risk behaviors; Nutrition; Pregnancy and childbearing practices; Death rituals; Spirituality; Health-care practices; Healthcare practitioners

Front 2

Re: cultural factors: Localities, topography, politics and education

Back 2

o Relates to the country of origin and current residence
o Where you live can isolate, insulate or preserve culture
o Economic and political conditions
o Value placed on formal education
• Educational styles differ among countries.
o Immigrants try same job in a new country but struggle to assimilate
o Immigrant jobs have health risks.

Front 3

Re: cultural factors: Communication?

Back 3

Communication includes verbal language skills in the dominant language, dialects, context, voice, tone, intonations reflections willingness to share, eye contact, facial expression, use of touch and body language, sense of time; Degree of formality and use of names, Spatial distance practices and acceptable greetings, Hierarchical, gender/religious beliefs, Clock versus social time, Languages, How to greet patient, What form of touch is ok not OK, Eye contact, Facial expressions, emotions; sense of time, punctuality.

Front 4

What does PARQ stand for?

Back 4

Procedures, Alternatives, Risks, Questions

Front 5

Re: cultural factors,What does family roles and generations include?

Back 5

includes Head of household, gender roles, family goals, children, social status, alternative lifestyles, childlessness/divorce.
• Decision-maker in family, gender roles
• Identify prescriptive, restrictive, and taboo behaviors, caste system
• Grey’s Anatomy clip, “Hmong Healing” – pt’s father permits to daughter’s surgery after shamanic healing ritual

Front 6

Re: cultural factors,workforce issues?

Back 6

o Differences and conflicts intensity in multicultural workforce.
o Language barriers, assimilation/acculturation, hours, healthcare.

Front 7

Re: cultural factors,what is bio-cultural ecology?

Back 7

specific physical, biological, physiological variation in ethnic/racial origins:
o skin color/physical/biological variations, geographical risk factors, hereditary/genetic diseases; specific variations in drug metabolism, drug interactions, dosages and related side effects.
Video: Due to Tuskeegee experiment, African-American man mistrusts & feels marginalized by medical community

Front 8

Re: cultural factors, What are high-risk behaviors?

Back 8

o e.g. tobacco, alcohol, recreational drugs, lack of physical activity, increased calorie consumption, unsafe driving practices, failure to use seat belts and helmets, failure to take precautions against HIV, STIs and high risk recreational activities.
o Identify specific high-risk behaviors, e.g. domestic violence, unsafe home situations, safe sex, health-seeking behaviors, physical activity

Front 9

what are cultural factors of high risk nutrition?

Back 9

: adequate food to satisfy hunger/needed calories and meaning of food in culture, rituals, prohibited foods
o How does weight reflect health, especially in babies and children?
o enzyme deficiencies, food intolerances, native food uses/difficulties when access limited.

Front 10

What are cultural issues re: Pregnancy and Child Bearing?

Back 10

sanctioned/unsanctioned fertility practices/taboos related to pregnancy, birthing/postpartum health of mother/child.

Front 11

What are prescriptive practices?

Back 11

what mother should do for healthy pregnancy/ child.

Front 12

What are restrictive practices?

Back 12

practices to avoid in pregnancy or in first years of childhood.

Front 13

What are cultural factors re: death rituals?

Back 13

views towards euthanasia, rituals, death preparations, specific burial practices, death/grief, meaning of death/dying/afterlife.

Front 14

What are cultural factors re: spirituality?

Back 14

o Religion strong influence over nutrition practices, health-care practices and other cultural domains.
o relationship between spiritual beliefs & health practices.
o Behaviors give meaning to life & provide strength to individual:
prayer, meditation, ritual, iconography to help individuals reach fulfillment.

Front 15

What are cultural factors re: healthcare practices?

Back 15

o traditional, magioreligious and biomedical beliefs.
o Individual responsibility for health, self-medication practices.
o Views toward mental illness, chronicity, rehabilitation, organ donation and transplant.
o Response to pain & sick roles as shaped by ethnocultural beliefs.
o Barriers, role of health insurance, responsibilities; Identify predominant beliefs, Describe health promotion & prevention practices.
o Focus of acute-care; i.e. curative or fatalistic.
o Use of OTC medications, prescription medications and herbal medicines.
o Identify barriers, i.e. language, economics, accessibility, geography.

Front 16

B-E-L-I-E-F mnemonics Instrument to Elicit Patients Health Beliefs

Back 16

• B-Beliefs-What caused your illness?
• E-Explanation–Why did it happen at this time?
• L-Learn-Help me understand your belief-opinion.
• I-Impact-How is this illness impacting your life?
• E-Empathy-This must be very difficult for you.
• F-Feelings-How are you feeling about it?
-Dobbie, Medrano, Tysinger, Olney.

Front 17

L-E-A-R-N Model of Cross Cultural Encounter Guidelines for Clinical Practitioners

Back 17

• L-Listen with sympathy and understanding to the patient's perception of the problem
• E-Explain your perceptions of the problem
• A-Acknowledge and discuss the differences and similarities
• R-Recommend treatment
• N-Negotiate agreement

Front 18

E-T-H-N-I-C Clinical model for culturally competent practice

Back 18

• Explanation-How do you explain your illness?
• Treatment-What Treatments have you tried?
• Healers-Have you sought advice from folk healers?
• Negotiate-Discuss mutually acceptable options.
• Agree on an Intervention
• Collaboration-with patient, family and healers.

Front 19

B-A-T-H-E Model for psychosocial interview

Back 19

• Background-What is going on in your life?
• Affect-How do you feel about what is going on?
• Trouble-What troubles you most?
• Handling-How are you handling that?
• Empathy-This must be very difficult for you.

Front 20

Standard Mexican Diet

Back 20

SMD (lard, tortillas, milk)

Front 21

Standard American Diet

Back 21

this type of diet gets imposed on immigrants

Front 22

Mexican Cultural Health Beliefs

Back 22

hex/god causes illness
cold illnesses externally caused
hot illnesses internally caused
good health is macho;