Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Latinos Things to keep in mind while servicing Latino families Involve family members: Hispanic/Latino families traditionally emphasize interdependence over independence and cooperation over competition. Family members are more likely to be involved in the treatment and decision-making process for a consumer of services. Allow for several family and friends to participate in a consultation, and communicate with the group. The consumer may not be the key decision-maker for describing symptoms, deciding among treatment options, or complying with recommended treatment. Determine the matriarch and patriarch, and notice if the acculturated children or non-family members are the spokespeople. Show respect: Always be respectful, and explain without condescending. Health providers, as authority figures, need to take seriously the responsibility and respeto conferred on them by many Hispanic/Latino patients. One way Hispanic/Latinos show respect is to avoid eye contact with authority figures. Do not misinterpret this respectful behavior as a sign of disinterest. Address elders in traditional ways (such as below eye level if you are younger than they are), and be mindful of parents and elders when an acculturated child or a health mediator is the spokesperson. The older Hispanic/Latino adult patient may terminate treatment if he or she perceives that respect is not being shown. Get personal: Hispanic/Latinos typically prefer being closer to each other in space than non-Hispanic/Latino whites do. When non-Hispanic/Latino providers place themselves two feet or more distance away from their Hispanic/Latino patients, they may be perceived as not only physically distant but also uninterested and detached. Overcome such perceptions by sitting closer, leaning forward, giving a comforting pat on the shoulder, or other gestures that indicate an interest in the patient. Encourage the asking of questions: Out of a sense of respeto, many Hispanic/Latino patients will avoid disagreeing with or expressing doubts to their health care provider about the treatment they are receiving. They may be reluctant to ask questions or admit they are confused about instructions or treatment. There is a cultural taboo against expressing negative feelings directly. This taboo may manifest itself in a patient's withholding information, not following treatment orders, or terminating medical care. Respect traditional healing approaches: Some Hispanic/Latino people believe that disease is caused by an imbalance between hot and cold principles. Health is maintained by avoiding exposure to extreme temperatures and by consuming appropriate foods and beverages. Examples of "hot" diseases or states are pregnancy, hypertension, diabetes, and indigestion. "Cold" disease examples include menstrual cramps, pneumonia, and colic. The goal of treatment is to restore balance. "Cold" diseases are treated with "hot" remedies, and vice versa. Inter- and intra-group variations exist with regard to beliefs about the hot and cold theory of disease. Traditional medicine in most Hispanic/Latino countries has an extensive list of folk remedies. Examples include using garlic to treat hypertension and cough; chamomile to treat nausea, gas, colic, and anxiety; a purgative tea combined with stomach massage to cure lack of appetite, stomach pains, or diarrhea; and peppermint to treat dyspepsia and gas. Providers may encounter the concept of a bilongo or hex, for which the proper diagnosis and treatment require consulting a santero/santera or healer. The evil eye (mal de ojo) appears in several Hispanic/Latino cultures. In children, it is thought to cause vomiting, fever, crying, and restlessness. It is believed to be brought on by an admiring look from a person with a strong eye. It can be diagnosed and treated with a barrida (Puerto Rico) or limpia (Mexico)—a sweeping of the body with eggs, lemons, and bay leaves, accompanied by prayer. Familia : Hispanic/Latino families traditionally emphasize interdependence over independence and cooperation over competition. Therefore family members are likely to be involved in the treatment and decision-making process for a patient. Including family members in the consultation is often critical to the care of the patient and may contribute to a patient ability to adhere to the recommended treatment. Hispanic/Latinos include many people in their extended families, not only parents and siblings, but grandparents, aunts, uncles, cousins and compadres, close friends, and godparents (padrinos) of the family's children. When ill or injured, Hispanic/Latino people frequently consult with other family members and often ask them to come along to medical visits. Hispanic/Latino extended families and the support role they play for patients may run counter to certain institutional rules, such as hospital policies that limit patients to two visitors. Respeto (respect): For Hispanic/Latinos the intimate confines of extended families, close-knit Hispanic/Latino communities, and traditional patriarchal networks are mediated by respeto (respect). Respeto implies a mutual and reciprocal deference. Respeto dictates appropriate deferential behavior towards others based on age, sex, social position, economic status, and authority. Older adults expect respect from those younger, men from women, adults from children, teachers from students, employers from employees, and so on. Personalismo: Hispanic/Latinos tend to stress the importance of personal relationships, which is why so many Hispanic/Latinos continue to rely on community-based organizations and clinics for their primary care. Warm, friendly, and personal providers who take an active interest in the patient life are more likely to earn the loyalty, respect, and confidence of their clients. How are you doing today? How did your daughter's graduation go?" Such a greeting implies personalismo, conveying to the patient that the provider is interested in her/him as a person . Confianza (trust): Over time, by respecting the patient's culture and showing personal interest, a health care provider can expect to win confianza (trust). When there is confianza, Hispanic/Latinos will value the time they spend talking with their health care providers and believe what they say. Confianza means that the provider will have their best interests at heart. Espiritu- (spirit), body, and mind: Health care professionals often work within the structures of mainstream medicine, which provides separate physical and mental health care. Hispanic/Latino culture, on the other hand, tends to view health from a more synergistic point of view. This view is expressed as the continuum of body, mind, and espiritu(spirit). Traditional Medicine -Within the Hispanic/Latino community there is an extensive practice of traditional medicine carried out by curanderas, espiritistas, or healers. In urbanized barrios this tradition has been carried on in part by Hispanic/Latino pharmacists, familiar with both traditional treatments like TE de manzanilla (chamomile tea) as well as modern prescription medicines such as antibiotics. Many Hispanic/Latinos will use traditional medicine in combination with other approaches. Distance from family and inter-generational family conflict Migration and separation from family may cause stress in Hispanic/Latino patients who are used to making decisions in collaboration with other family members. The values of young immigrant workers or couples newly arrived in the United States may clash with those of other family members. Similarly, teenagers who quickly acculturate to the United States and the manners of their peers may demand to be treated as individuals and show signs of typical adolescent conflict with their parents and other relatives who maintain traditional values and customs. The desire for personalismo in the provider-patient relationship Hispanic/Latino loyalty to the individual provider has significant implications for continuity of care. If a health care professional leaves a health center for another in close proximity, their Hispanic/Latino patients may follow him/her to the new setting. If the health professional leaves the area however, their Hispanic/Latino patients may stop treatment, unless the provider has made introductions to the new health care provider and established a transitional relationship between them based on personalismo. Unfortunately, personalismo tends to conflict with the health system trend towards managed care, the eight-minute visit, and physician rotations in public clinics. Resource Consulted: Management Sciences for Health