Heath Care Cultural Influences on
Context
If you are not in tune with the universe, there is sickness in the heart and mind.
Navaho saying
We will focus on:• Beliefs about health care and treatment and
prevention of illness
We will also look at• Cross-cultural medical competence
• Language complications
Theories of health and disease causation
• Generally theories of health and disease/illness causation are based on prevailing worldview held by a group.
• These worldviews include a groups health-related attitudes, beliefs and practices.
• Are frequently referred to as health belief systems.
Theories of health and disease causation
• Generally theories of health and disease/illness causation are based on prevailing worldview held by a group.
• These worldviews include a groups health-related attitudes, beliefs and practices.
• Are frequently referred to as health belief systems.
Health Care Belief Systems
• Supernatural/magico/religious
• Holistic
• Scientitic/biomedical
Supernatural/Magico/Religious Tradition
• Comes from a belief system in which the world is perceived as an arena where supernatural forces predominate.
• Hold strong beliefs in sorcery, magic, and evil spirits.
Hmong of SE Asia
• Often attribute disease to spiritual forces such as malevolent spirits or ghosts.
• Believe an individual’s spirit is the guardian of the person’s well being
• If the spirit is happy, then the person is happy and well.
Phillipinos
• Some Phillipinos may believe that disease may be caused by a sorcerer who causes a poison to be introduced into the body.
Latinos and Phillipinos
• Among some Latinos and Phillipino’s health and disease is deemed to be consequences of God’s approval. Good health is by the grace of God.
The Evil Eye – Jealousy and Envy
• One of the oldest superstitions is the evil eye, the belief that someone can project harm by gazing or staring at another.
• The Nazar is thought to ward off the evil eye.
Treatments -- Shamanism
• Treatments are carried out by healer-practitioners known as shamans.
• In some cultures, known as medicine men, Kahunas, santeros, or spirit healers.
Shamanism
• Shamanism is neither a religion or a science but an activity that takes place in a world that is ordinary, yet spiritual – sacred.
• A healing or helping technology.
Shamanism
• Powers of a shaman may include hands-on power to heal by removing harmful spirit stuff from the body and restoring energy.
• Also, a visionary power to see into the body of a sick person and power to retrieve the lost soul or spirit of the sick.
Treatments: Korea
• “Hanyak,” which has its roots in ancient Chinese medicine.
• Diagnoses impalances in the body that are believed to cause illness and then prescribing herbal remedies.
• Balance of opposites – yin/yang.
Treatments: Korea
• Light complements dark; males complements female.
• Various organs are associated with the five elements of the world, fire water, wood, metal, and earth.
Treatments: Cuba, Haiti, Puerto Rico, Brazil
• “Santorini.” Santero is contracted who consultas a orisha deity to assist in the cure.
• AKA voodoo.
Holistic Tradition – Underlying Premises
• Holistic health is based on the principle that a whole is made up of interdependent, interacting parts.
• Holistic health is about more than just not being sick. It is an approach to life that focuses on connections of mind, body and spirit.
Holistic Tradition – Causes
• For people to be healthy, they must remain in harmony with nature’s laws and willingly adapt to changes in the environment.
• Do not believe they have the right to control nature. Many Asians possess a perspective where people must adjust to the physical world rather than controlling.
First Nations Peoples
• Although many First Nations tribes have different worldviews most consider the earth to be a living organism – the body of a higher individual with a desire to be well.
First Nations Peoples
• Believe that is the earth is harmed, humankind itself is harmed.
• Conversely, when humans harm themselves, they harm the earth.
• Cause and effect relationship with the earth creates an eternal chain.
Scientific/Biomedical Tradition -- Premises
• Evidence-based approach the relies on laboratory test.
• This system usually disavows the metaphysical and holistic.
Scientific/Biomedical Tradition
• Is geared to conquer disease by battling microorganisms and diseased cells.
• This Western biomedical ethnocentrism can often be a serious barrier to effecgtive health care communication and result in derisive response to alternative supernatural or holistic approaches.
Scientific/Biomedical Treatment
• Attempt to return the body to a normal state through surgery, medications, chemotherapy, radiation, antibiotics.
Intercultural Competence
• Cultural awareness
• Cultural knowledge
• Cultural understanding
• Cultural sensitivity
• Cultural skill
Intercultural Competence -- attributes
• Culturally diverse staff
• Interpreters who speak patients’ languages
• Training for providers about culture/language
• Multilingual signage and instructions
• Culturally specific health care settings.
Communication strategies, include
• Allow patients to be open and honest
• Do not discount effects of belief in supernatural
• Employ empathy
• Be restrained in relating bad news
• Follow patient’s lead in communication style