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Mental Health in Lifestyle Medicine
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Culture is a term that refers to a set of shared beliefs, norms, and values shared by a group of people. It is critically important that healthcare professionals recognize that significant diversity exists among people from the same culture, depending on age, income, level of acculturation, health status, and other factors. Healthcare providers must avoid stereotyping individuals based on their appearance, racial or ethnic background, socioeconomic status, religion, political affiliation, or other factors. Cultural misunderstandings between patients and healthcare providers can lead to clinician bias and fragmentation of care, which can deter people from accessing, utilizing, and receiving appropriate healthcare services. Not receiving appropriate treatment can have disastrous consequences, including disability in one or more life domains, extreme psychological or emotional distress, self- or other-directed violence, or suicide.
Cultural Competency and Cultural Adjustment of Services
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Michael Knipper, Diane Duclos, Miriam Orcutt, Bernd Hanewald, Karl Blanchet
A major challenge of a culturally sensitive approach to health, suffering, disease and care is, however, practical: How can this kind of nuanced, differentiated and non-stereotyping cross-cultural understanding be achieved? What has to be concretely done, and how – especially in day-to-day health services and humanitarian assistance? The anthropological response is to do ethnography yet in a practical way, suitable for health professionals.5,11 Generally spoken, ethnography consists of systematically combining long-term participant observation with qualitative interviews, guided by a genuine respectful and non-judgemental interest in the peoples’ perspectives and perceptions. The objective is not to produce generic information about different ‘cultures’ but to find clues for interpreting the meaning and rationale behind health-related beliefs, practices, choices and behaviours of real individuals in the real world. Empathy, reservation against generalising statements about people, cultures and social groups and the systematic reflection of one owns’ preconceived assumptions about ‘the other’ are essential to this approach.
Complexity: Cloud 9, Caryl Churchill (1979)
Published in Ewan Jeffrey, David Jeffrey, Enhancing Compassion in End-of-Life Care Through Drama, 2021
Assumptions and pattern recognition may be an integral part of reaching a clinical diagnosis, but they can lead to mistakes if extended to the other (arguably more important) parts of a patient’s life. When assumptions are made about a patient on the basis of a doctor’s prejudices and values then stereotyping becomes likely.
Cultural competency education in the medical curriculum to overcome health care disparities
Published in Baylor University Medical Center Proceedings, 2023
Rachaita Lakra, Shahzeem Bhayani, Karina Sulaiman
The workshop coordinators included internal medicine attendings and residents, and each coordinator underwent a pretraining session that comprised three modulator training sessions, 1 hour each, by a senior faculty member. A total of 106 fourth-year medical students and 19 internal medicine residents underwent the training, including the lecture followed by breakout rooms for workshops. The theme of the training was building skills in cultural competence; the training session included a 30-minute lecture introducing cultural and structural competency, patterns of health care disparities, and barriers to recognizing and eliminating disparities followed by three breakout sessions (Figure 1). Each cohort attended both the lecture and one of the three workshops through random allocation. The participants were given Post-It labels with the number 1, 2, or 3 as they entered the session; these labels were later used to assign the participants to a workshop. Workshops were based on three TACCT domains: key aspects of cultural competence, understanding the impact of stereotyping on medical decision-making, and cross-cultural clinical skills. Each workshop was moderated by two facilitators, a medicine resident supervised by an internal medicine faculty member. The workshop was designed to include a case that was a hypothetical scenario formulated on the basis of the TAACT domains, followed by an extensive interactive discussion. The 30-minute workshop was broken down into a case review (5 minutes), questions and discussion (15 minutes), and debrief, including take-home points (10 minutes).
Health Disparities, Systemic Racism, and Failures of Cultural Competence
Published in The American Journal of Bioethics, 2021
Jeffrey T. Berger, Dana Ribeiro Miller
Although the AAMC’s overarching objective to reduce health disparities through education is laudable, its choice to prioritize culture over all other considerations is curious. In light of its ethnocentric foundations, cultural competence as organized medicine’s approach to disparities appears as a contemporary reverberation of cultural imperialism, which itself is a historical societal pillar of the United States from early contacts between power-wielding Europeans and indigenous peoples. The notion of competence relative to other-than-Western cultures and to peoples of color reflects ethnocentrism and reinforces systemic bias in health care (Pon 2009) and gives rise to various ethical concerns including the promotion of cultural reductionism and reinforcement of stereotyping (American Society for Bioethics and Humanities Clinical Ethics Task Force 2009).
The Challenge of Coming Out to Providers by Gay and Bisexual Men With Prostate Cancer: Qualitative Results from the Restore Study
Published in International Journal of Sexual Health, 2021
William West, Maria Beatriz Torres, Darryl Mitteldorf, Benjamin D. Capistrant, Badrinath R. Konety, Elizabeth Polter, B. R. Simon Rosser
Given the unique characteristics of the GBM prostate cancer population which includes distrust of the medical community while facing treatment outcomes that impact core elements of identity, it is worth exploring their communication patterns. Studies of prostate cancer providers show doctors give little attention to eliciting patients’ reactions particularly during new cancer diagnosis and explaining the decision making process before describing treatment options (Denis et al., 2012; Henry et al., 2015). Studies of prostate cancer patients show that while many respondents felt satisfied with their communication with their doctors, nearly 40% reported being less than satisfied and adequately informed about prostate cancer and treatment options (Cegala et al., 2008; Denis et al., 2012; Sloan & Knowles, 2013). Other patients experienced stereotyping and insensitivity from some staff (Denis et al., 2012; Nanton & Dale, 2011). The complexity of prostate cancer doctor-patient communication is augmented with gay, bisexual and other men who have sex with men (GBM) patients.