What strain the clinical health care encounter for Latino patients?
Apart from these language and socioeconomic disparities and variation in the way health care is envisioned and sought out, differences in the way values are ordered and articulated can also strain the clinical health care encounter for Latino patients.
What do Mexican American Nurses need to know about family-centric decision-making?
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. Additionally, within this family-centric decision making structure, there may be particular gender-based roles.
Do Latinos have a difficult time talking to doctors?
In fact, compared to both white Americans and African-Americans, Latinos generally report feeling less listened to and understood by their doctors, as well as less able themselves to understand their doctors; and they are twice as likely to leave a doctor's office with unasked questions.
Where do Latinos get their health care?
Some Latinos find their health care in non-clinical places, relying on folk medicine and traditional healers. This reliance does not necessarily replace modern biomedicine; rather, herbal remedies and other non-allopathic treatments often are utilized in conjunction with Western medical care.
What is a depressive disorder marked by chronicity?
Dysthymia is a depressive disorder marked by chronicity. The depression must have been present more than 50% of the time for at least 2 years. The other options describe major depression and psychotic depression.
What is a c. allergy?
c. Allergies to dust, pollen, and mold
Does melancholia cause anhedonia?
Individuals with the depressive variant of melancholia often display anhedonia, depression worse in the morning, early-morning awakening, anorexia and/or weight loss, and inappropriate guilt. It is appropriate to monitor sleep patterns to ascertain if sleep disturbance is present. Homeostasis is contingent on adequate sleep. The distracters are seen in depression with catatonic features, atypical depression, and seasonal affective disorder.
How often should a patient lie down?
Direct the patient to lie down every 2 hours.
What to do when a patient is too difficult to talk?
encourage the patient to nod if speaking is too difficult.
Does melancholia cause anhedonia?
Individuals with the depressive variant of melancholia often display anhedonia, depression worse in the morning, early morning awakening, anorexia and/or weight loss, and inappropriate guilt. It is appropriate to monitor sleep patterns to ascertain if sleep disturbance is present. Homeostasis is contingent on adequate sleep. The distracters are seen in depression with catatonic features, atypical depression, and seasonal affective disorder.
The Hispanic Population
Latinos/as/ or Hispanics in the United States are a fast growing population, expanding from a small, regionally concentrated group of fewer than 6 million in 1960 to a now widely dispersed population of well more than 50 million (or 16 percent of the nation’s population).
Significant History – Events which influenced the community and contextualize assessment and treatment
Mexican Americans represent the largest Latino group in the US. Technically, the first significant influx of Latino immigrants to the U.S. occurred just after most of the modern boundary between the U.S.
Culture-Bound Syndromes in Hispanic Patients
Culture has an impact on symptom presentation. For example, Ataques de nervios or attack of the nerves is a cultural bound syndrome of distress which includes such symptoms as uncontrollable screaming or shouting, crying, trembling, sensations of heat rising in the chest and head, dissociative experiences, and verbal or physical aggression.
Future Needs
Despite the challenges, Latinos are a growing academic, political and financial force in the US. One-in-four newborns is Latino. Never before in this country’s history has a minority ethnic group made up so large a share of the youngest Americans.
What is it called when you feel a sudden sensation of fear and anxiety?
Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations).
What is the term for a sudden feeling of fear and anxiety?
Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time.
What is a specific phobia?
Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
Is anxiety a medical condition?
For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.
What is a nervous breakdown?
The term "nervous breakdown" is sometimes used by people to describe a stressful situation in which they're temporarily unable to function normally in day-to-day life. It's commonly understood to occur when life's demands become physically and emotionally overwhelming.
Is nervous breakdown a medical term?
The term was frequently used in the past to cover a variety of mental disorders, but it's no longer used by mental health professionals today. Nervous breakdown isn't a medical term, nor does it indicate a specific mental illness. But that doesn't mean it's a normal or a healthy response to stress.
What do Latinos use for health care?
Some Latinos find their health care in non-clinical places, relying on folk medicine and traditional healers. This reliance does not necessarily replace modern biomedicine; rather, herbal remedies and other non-allopathic treatments often are utilized in conjunction with Western medical care.
Why are Latinos better off than other ethnic groups?
3 Latinos are less likely than non-Hispanic whites and African-Americans to suffer from heart disease (which is nevertheless the leading cause of death in all three groups). Yet Latinos are at particular risk for diabetes mellitus, tuberculosis, hypertension, HIV/AIDS, alcoholism, cirrhosis, and death from violence. 4 There is also a disproportionately high prevalence of acute care in the treatment of Latinos; that is, too often patients delay medical care until their conditions worsen and necessitate immediate attention. There are likely many possible reasons for this, including poverty and lack of health insurance, and thus at best irregular access to health care; cultural factors that might cause patients to delay seeing a doctor, for example, the expectation that one should tolerate pain without complaint; and a belief that certain conditions (such as pregnancy) are natural and do not require medical attention.
Why is family centered decision making important in Latino culture?
The value of familismo perhaps deserves to be emphasized for the important role it plays for many Latino patients. Generally speaking, Latino cultures include a more family-centered decision making model than the more individualistic or autonomy-based model embraced by modern mainstream biomedical culture in the United States. Rather than operating on the ideal of an informed, active individual who makes decisions based on his or her own personal good, many Latino cultures consider as paramount the individual's obligation to the family and broader community. Hence, the individual's good cannot be neatly separated from his or her community. Moreover, the family itself can play an enormously important role in supporting and empowering the patient within the medical setting. 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. Additionally, within this family-centric decision making structure, there may be particular gender-based roles. For instance, Latino mothers may determine when medical care is warranted for a family member, though a male head of household may formally make the decision to send the family member to a medical center. 16
What percentage of Latinos speak Spanish?
First among these, of course, is a language barrier. Although most Latinos living in the U.S. do speak at least some English, 60 percent of Latino adults speak primarily Spanish at home. 6 According to the U.S. Census, more than half of U.S. Latino residents age 5 and older speak English "very well," but a nevertheless significant number of Latino adults speak English "not well" or "not at all." 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. In fact, compared to both white Americans and African-Americans, Latinos generally report feeling less listened to and understood by their doctors, as well as less able themselves to understand their doctors; and they are twice as likely to leave a doctor's office with unasked questions. They are also far more likely than whites to feel that they are treated unfairly by providers or by the medical system. 8
Do people in Brazil speak Spanish?
1 The term does not refer only to Spanish speakers, however; many people usually thought of as "Hispanic"-the people of Brazil, for instance, or those from indigenous Mexican communities-often do not speak Spanish at all, or at least not as their primary language.
Can Latino mothers decide when medical care is warranted for a family member?
For instance, Latino mothers may determine when medical care is warranted for a family member, though a male head of household may formally make the decision to send the family member to a medical center. 16. These broad generalizations are just that: broad generalizations.
Do Latinos understand doctors?
In fact, compared to both white Americans and African-Americans, Latinos generally report feeling less listened to and understood by their doctors, as well as less able themselves to understand their doctors; and they are twice as likely to leave a doctor's office with unasked questions.
SPECIAL MEDICAL CONCERNS
Latinos have disproportionately higher rates of obesity and diabetes mellitus ( Table 1). 9 – 14 Approximately 43 percent of Mexican Americans older than 20 years are obese, compared with 33 percent of the non-Latino white population.
HEALTH CARE BELIEFS AND FOLK ILLNESSES
Non-Latino physicians may be perplexed by references to folk healing and illness in Latino patients. Latino healing traditions include curanderismo in Mexico and much of Latin America, Santeria in Brazil and Cuba, and espiritismo in Puerto Rico.
CULTURAL VALUES
Latino culture has several normative values that must be recognized in clinical settings. These include simpatía (kindness), personalismo (friendliness), and respeto (respect). 25 Simpatía emphasizes politeness and conflict avoidance. Personalismo, a personal connection, can be achieved by asking about the patient and his or her family.
CROSS-CULTURAL INTERVIEW
Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians.
TEACH BACK AND PATIENT ACTIVATION
Conveying medical instructions to patients with limited English skills can be frustrating. For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. These instructions can be studied by the patient or translated when time permits. Spanish language handouts are a better option.
A CARING ENVIRONMENT
Medical practices and hospitals should strive to create an environment that is warm and welcoming to Latino patients. Bilingual posters and medical literature are an important starting point. Spanish language handouts are available from several Internet sources.
The Hispanic Population
Culture-Bound Syndromes in Hispanic Patients
- Culture has an impact on symptom presentation. For example, Ataques de nervios or attack of the nerves is a cultural bound syndrome of distress which includes such symptoms as uncontrollable screaming or shouting, crying, trembling, sensations of heat rising in the chest and head, dissociative experiences, and verbal or physical aggression. Ataques...
A Few Cultural Differences Between Anglo Americans and Latinos
- For Latinos, having a mental illness or even receiving counseling can be stigmatizing. Poor access to care due to low rates of insurance, immigration status, language and cultural barriers in healthcare which can include differences between provider-patient in explanatory models of illness and families as the gate keepers can limit entry into treatment (Cortes et al, 2008). Availa…
Best Practices
- A few best practices for working with Latinos 1. Use a bio-psycho-social-cultural model of evaluation and treatment. 2. Take the time to develop a cultural formulation, which includes a consideration for acculturation, community and family connection, immigration status/ history, education. 3. Supporting collaborative care with Latinos is important for retention and success o…
Future Needs
- Despite the challenges, Latinos are a growing academic, political and financial force in the US. One-in-four newborns is Latino. Never before in this country’s history has a minority ethnic group made up so large a share of the youngest Americans. By force of numbers alone, the kinds of adults these young Latinos become will help shape the kind of society America becomes in the …