In one survey of Mexican American nurses, family support was identified as one of the most important areas to which health care providers should attend while caring for Latino patients. A chaperone is often appreciated if a same-sex physician is not available. Adding to the language barrier is the pitfall of false fluency, when physicians mistake the meaning of a Spanish word because of unfamiliarity with cultural or linguistic subtleties. Information. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family. The aim of this study is to examine surgical management and overall mortality among different subgroups of women who self-identify as Hispanic. Get to know your fellow coach managers and direct reports. High level of belly fat or metabolic syndrome. Materials are available in English and Spanish. These terms are often used interchangeably, including by the U.S. Census Bureau, although "Hispanic" is more often utilized in governmental and market research and statistical record keeping, while "Latino" perhaps enjoys more popular usage today. The specific herbs mentioned in this study for use of treatment of diabetes included: nopal (cactus), aloe vera, nispero (loquat leaves), garlic, and diabetina. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). 4Center for Disease Control and Prevention, "Leading Causes of Death," accessed at www.cdc.gov/men/lcod/index.htm; and Richard Allen Williams, "Cultural Diversity, Health Care Disparities, and Cultural Competency in American Medicine," Journal of the American Academy of Orthopedic Surgeons, Vol. Other healing specialties include yerberas (herbalists), hueseros (bone setters), parteras (midwives), and sobradores (similar to physical therapists).21, Symptoms are often interpreted differently based on cultural presuppositions. The final commentary, drawing on the others, seeks to join the issues from an explicitly bioethical perspective. The agency is contracted with the leading insurance carriers and works diligently to secure contracts with additional funding sources on an on-going basis. Thematic analysis was used to identify common patterns and form recommendations for future research and programs. In fact, the number of Latino physicians dramatically lags behind Latino population growth; and, according to cross-cultural health care expert Larry Purnell, Latinos are the most underrepresented major minority group in the entire U.S. health care workforce.5 This discrepancy contributes to many different linguistic and cultural hurdles for Latino patients, as well as for their health care providers. 1. Davis Company, 1998): 397-421. This consortium study defined distinct somatic cancer gene mutation patterns by race/ethnicity and sex among patients with early-onset colorectal cancer (CRC), yielding novel biological clues into early-onset CRC disparities. Margaret E. "Group Methods and . 11Jennifer Aguayo et. Yet the call for cultural competence can-at its best-urge practitioners to adopt instead a stance of cultural "humility": one which encourages an open mind, and a recognition that each one of us sees the world through our own very distinctive cultural lenses. Approximately half (49.6%) of the patients were aged at least 65 years. Maria is a 54-year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. These terms are derived from the Spanish verb curar, which means to heal. Pharmacologic therapies for hypertension have been highly effective in Hispanic subjects participating in clinical trials. Alonso, M., Val, E., & Rapaport, M. M. An open-label study of SSRI treatment in depressed Hispanic and non-Hispanic women. In this article I will make use of both terms, relying more heavily, however, on "Latino. Herbs often have hot or cold properties; hot herbs are used to treat cold conditions, and vice versa. According to a study done at UCLA, 15.7 percent of non-elderly Latinos in either fair or poor health, who are covered under MediCal or Healthy Families (both California low-income health insurance programs), report having no usual source of care but rather obtain their clinical health care on an ad-hoc basis, if at all.11, Some Latinos find their health care in non-clinical places, relying on folk medicine and traditional healers. Call or text 988 or chat 988lifeline.org. Her face lights up when you share this. Latinos' belief in alternative treatment is affected by many factors, including education, socioeconomic class, and time spent in the United States (acculturation). Compared with non-Latino whites, Mexican Americans have up to a three times higher incidence of diabetes mellitus and a three times higher prevalence of obesity, but hypertension-related mortality is only 4 percent higher (not a significant difference). Mexican Americans with hypertension are less likely to be treated than non-Latino whites (35 versus 49 percent). Because many health beliefs and behaviors are culturally-based, it follows that when two different cultures come together in a health care setting, a collision of expectations often occurs. Respondents using these herbs reported never replacing their medical regimens with herbs. This inequality puts these communities at a higher risk for more severe and persistent forms of mental health conditions, because without treatment, mental health conditions often worsen. Delayed immigration protocols and anti-immigration legislation may contribute to stress. Master the basics of the Virta Treatment and understand the full patient experience. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. A significant share of Hispanic adults who lack a regular health care provider are native born, have a high school diploma, speak English and have health insurance. During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. Have a question about government service? Garlic and onion are used extensively, as is aloe vera. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable. Still, being aware of these larger values may help health care providers to understand a particular patient's behaviors and actions in the context of larger cultural inclinations. "7 In the context of a hospital or medical clinic, where medical terminology can be complicated and communication often takes place quickly and amidst elevated emotions, this language barrier can be especially problematic. You use teach back to ensure that Maria understands your directions, and you provide her with Spanish-language handouts about the benefits of controlling her diabetes and hypertension. The teach back technique should be incorporated into the cross-cultural patient encounter to ensure patient understanding of discharge instructions. National Network to Eliminate Disparities in Behavioral Health, SAMHSA National Survey on Drug Use and Health (NSDUH), AHRQ National Healthcare Quality and Disparities Reports, OMH National Standards on Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards), 988 Suicide & Crisis Lifeline Each person is unique and simultaneously formed by a variety of cultures and subcultures, not to mention personal choices and socioeconomic circumstances. Modern Mexicans turn to old ways of childbirth. Unfortunately, few studies disaggregate Hispanic patients by race to understand its implications on treatment and clinical outcomes such as mortality. Using the LEARN model, you listen to her story about her poor control of diabetes and frustration with her diet. It was developed specially to treat people between the ages of 3 and 18. Partner with other Coach Managers to build relationships, share learnings and provide consistency for all of our . dissertation, University of Southern Cali-fornia, 1973. using as treatment, if they remained open-minded, and if doctors had an understanding of folk medicine.37 Another common barrier within healthcare delivery is that the alternative or traditional medicine within the Latino culture is deeply rooted in spirituality and religion.38 While in the United States, For Authors For Reviewers For Editors For Librarians For Publishers For Societies For Conference Organizers. It took extra time in relationship-building (personalismo), a team approach, an interpreter, negotiation, and a bit of research to make it all happen. First-generation immigrants are likely to seek out curanderos, whereas their children may scoff at the idea. Posttraumatic shock or anxiety may be attributed to susto (soul loss) rather than posttraumatic stress disorder. Text: 435748 First among these, of course, is a language barrier. The extra time necessary for this technique is justified by the prospect of much better understanding and adherence.31. Intense but brief release of emotion thought to be caused by family conflict or anger, No immediate treatment other than calming the patient, Childhood condition characterized by irritability and diarrhea thought to be caused by abrupt withdrawal from the mother's breast, Holding the child upside down or applying gentle pressure to the hard palate, Constipation, cramps, or vomiting thought to be caused by overeating, Abdominal massage and herbal purgative teas; an egg passed over the abdomen supposedly sticks to the affected area, Steam inhalation and herbal treatments, including eucalyptus and mullein (gordolobo), Pelvic congestion and decreased libido thought to be caused by insufficient rest after childbirth, Cold air that is thought to cause respiratory infections and earaches, Steam baths, hot compresses, stimulating herbal teas, A hex cast on children, sometimes unconsciously, that is thought to be caused by the admiring gaze of someone more powerful, The hex can be broken if the person responsible for the hex touches the child, or if a healer passes an egg over the child's body; the egg is then broken into a bowl of water and placed under the child's bed; child may wear charms for protection, Unnatural illness that is not easily explained, Temporary paralysis of the face or limbs, often thought to be caused by a sudden hot-cold imbalance, Posttraumatic illness (e.g., shock, insomnia, depression, anxiety), Barrida ritual purification ceremony (herbs used to sweep patient's body) repeated until the patient improves, Eaten to alleviate hypertension and prevent arteriosclerosis; garlic juice is applied to stings and spider bites, Anticoagulant effect at high doses; avoid high doses in patients taking coumadin (Warfarin); high doses can cause heartburn and bad breath; reduces effectiveness of saquinavir (Invirase), Boiled flowers are used externally on bruises, For topical and homeopathic use only; avoid internal use (except for homeopathic preparations, which are considered safe); increased gastroenteritis and dyspnea risk with ingestion, Hepatotoxicity risk from pyrrolizidine alkaloids (in leaves) with high or prolonged doses, Spice used as antispasmodic and for upper respiratory infections; although promoted as a hypoglycemic agent, recent research is conflicting, Use with caution in patients taking hepatotoxic drugs; safe in usual food quantities, Cilantro (cilantro [leaf] or coriander [seed]), Tea used for anxiety, stomach cramps, and inflamed gums; more recently popularized for increasing the urinary excretion of heavy metals, No safety concerns, although there have been recalls because of salmonella and pesticide contamination, Oil used topically for toothache and bad breath, Eugenol in clove oil may affect blood clotting; toxic if ingested, especially in children, Tea or syrup used as an expectorant, a diuretic, and for constipation, liver problems, and gall stones; also used to induce menstruation, High doses may cause vomiting; avoid in pregnancy; no known interactions, Leaf tea used for anxiety and lethargy, most popular as an aphrodisiac, Theoretical concern of cyanogenic glycoside toxicity with higher doses, Tea used for intestinal parasites; herb is added to beans to prevent flatulence, Chenopodium oil is also used as an antihelmintic but may be toxic (ascaridole content), Tea used for upset stomach and menstrual cramps, and to prevent diarrhea, Long-term ingestion causes absinthism (trembling, vertigo, thirst, delirium); thujone in the essential oil is neurotoxic and may cause seizures, Boiled leaves used for asthma in vaporizers; popular in lozenges for sore throat; also sometimes used as topical disinfectant, Ingesting eucalyptus oil may cause vomiting, diarrhea, delirium, and convulsions; avoid using in vaporizers for children younger than six years, Tea used to treat cough and sore throat; one study reports use for otitis, No known safety concerns (insufficient data) or drug interactions, High doses may cause anticoagulant effects and excess gas or bloating, Fruit juice used for fever, upper respiratory infection (classic cooling herb), and hypertension, Weed leaf used externally for burns, bruises, mouth sores, and hemorrhoids; tea taken orally for respiratory infections, Eaten as part of diet; has antidiabetic, anti-inflammatory, and laxative properties; also used as hangover treatment and for hyperlipidemia, May inhibit drug absorption; excess consumption may cause diarrhea and nausea, Leaf tea used to treat cough, indigestion, and, Safe in small quantities in food, but contains monoterpene ketones, which can cause toxicity (intestinal irritation, kidney damage, abortion, seizures), Toxic herb used to induce menstruation and abort fetuses, Toxic; avoid oral use; may cause renal and hepatic damage; furocoumarins can cause skin photosensitivity, Tea from dried flowers used to relieve cough, Yerba buena (mints, including spearmint and, Mint tea relieves upset stomach and headaches, Safe in usual quantities, but spearmint oil is a mucous membrane irritant and potentially toxic when ingested, Topical use for burns; occasionally ingested, Safe for topical use; juice is relatively safe; ingestion of aloe resin (a purgative) may cause diarrhea, hypoglycemia, hypokalemia, and prolonged bleeding; potential interactions with hypoglycemics and cardiac glycosides, Safe as a food seasoning, toxic alveolitis reported from inhaling lemongrass oil, A Physician's Practical Guide to Culturally Competent Care, Hispanic Center of Excellence (Baylor College of Medicine and University of Texas-Pan American), Language Line Services (interpreter services), Office of Minority Health: Cultural Competency, Office of Minority Health: National Standards for Culturally and Linguistically Appropriate Services (CLAS), Oregon Health & Science University: Spanish education handouts for clinicians, Tool for Assessing Cultural Competence Training (TACCT) Resource Guide, Transcultural Nursing: Diversity in Health and Illness, University of Washington Medical Center: Culture Clues tip sheets.
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