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,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Respectful Communication,Certain topics are taboo in some cultures.E.g.,asking an older Latina/Hispanic unmarried woman about sex behavior can be considered offensive.,You may want to tell the patient that you realize that some things are not normally discussed,but that it is necessary so that the best care can be planned,Respectful CommunicationCertai,1,Alternative&Complementary Healing Systems/Techniques,Latino/Hispanic alternative and complementary healing systems or techniques include:Curanderismo,Espiritismo,and Santeria.,Healers include:,Curanderos(general practitioners of Mexican folk healing),Alternative&Complementary He,2,Alternative&Complementary Healing Systems/Techniques,Espiritistas(Puerto Rican faith healers),Santeros(Cuban faith healers),Yerbistas(herbalists),Sobadores(massage therapists),Folk healers often treat children for conditions such as:,Alternative&Complementary He,3,Alternative&Complementary Healing Systems/Techniques,Colico(colic),Empacho(locked bowels),Susto(fright),Mal de ojo(evil eye),Caida de la mollera(fallen fontanel),Alternative&Complementary He,4,Alternative&Complementary Healing Systems/Techniques,Healers also perform spiritual cleansing(barridas or limpias).,Insufficient data exists regarding the extent to which alternative and complementary healers and systems are used by Hispanics,Villa,M.L.,Cuellar,J.,Gamel,N.,&Yeo,G.(1993).Aging and Health:Hispanic American Elders(2nd edition),SGEC Working Paper Series,Number 5,Ethnogeriatric Reviews,Stanford Geriatric Education Center.,Alternative&Complementary He,5,Latino Health Care Gaps,Compared with non Latino whites,Latinos are three times as likely to be uninsured.,Many have no regular source of primary care,receive fewer check-ups,cancer screenings and other preventive services.They rely heavily on sporadic and emergency room care.,As a result of late diagnosis,breast cancer is the leading cause of cancer death among Latinas.,National Cancer Institute,Cancer Net,Breast Cancer Facts,1999,Latino Health Care GapsCompare,6,Hispanic/Latinos“Double burden”,Doty and Ives have extensively documented Latinos“Double burden”,1)Limited English proficiency(LEP),2)Lack of health insurance,Together,the“double burden”can be a death sentence,Doty,M.and Ives,B.“Quality of Health Care for Hispanic Populations:Findings from the Commonwealth Fund 2001 Health Care Quality Survey.”Commonwealth Fund(March 2002),Pub#526.,Hispanic/Latinos“Double burde,7,English-only Healthcare Providers,In the US,providers tend to be monolingual-English only.,And/or have insufficient knowledge of Spanish and lack awareness of medically relevant aspects of culture,Latino patient and Anglo provider have,communication gap,and different worldviews,English-only Healthcare Provid,8,Evaluating Effective Communication,Providers should evaluate whether questions or instructions given to LEP patients have been understood,To be polite,some Hispanic/Latino patients will nod“yes”but not really comprehend,.,Evaluating Effective Communica,9,Nonverbal Communication,Much of communication between people is nonverbal.One must learn it to be able to truly communicate,However,Nonverbal Communication is rarely a part of Foreign Language training in the higher education system,Nonverbal Communication,10,Nonverbal communication,Nonverbal communication is the sum of non-linguistic messages that are encoded and decoded through,Gestures,Facial expressions,Eye contact,Tone of voice,Pauses,silences,Nonverbal communicationNonverb,11,Communication gaps,Cultural,linguistic,and nonlinguistic gaps can lead to miscommunication and mistrust.,Health care personnel must be trained in cross cultural assessment and in both the verbal and nonverbal aspects of communication,Communication gapsCultural,li,12,Two-way communication:ethical imperative,To prevent poor health outcomes for Hispanic/Latinos and to lighten their“double burden”,Efforts to improve the quality of Anglo-Latino communicationin health care settings are ethical imperatives.,Two-way communication:ethical,13,Translation vs.Cultural Adaptation,Health messages and patient education documents should be not only linguistically translated but also,culturally adapted,.,Straight translation into Spanish has many limitations.,Cultural adaptation is a more effective method to achieve health promotion.,Translation vs.Cultural Adapt,14,Conceptual equivalence,In translation,conceptual equivalence is more important than linguistic equivalence,Health behavior modification approaches must be culturally appropriate to be effective,Conceptual equivalenceIn trans,15,Latinos in Columbus:Health gaps,Uninsured Latinos in Columbus report job-related injuries,trauma,diabetes,hypertension,allergies,need for birth control,skin rash and other conditions,Often they can not afford to take time away from work to go to a doctor during the day,Source:State of
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