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Week 5 Notes

by: Kara Pemberton

Week 5 Notes ANTH 3540

Kara Pemberton
GPA 3.9
Multicultural Healthcare
Dr. Susan Tanner

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About this Document

Notes for September 14th-18th. We discussed how anthropology comes into Western Biomedicine and how it can help the doctor/patient relationship. Additionally we examined the Placebo/Nocebo phenomenon
Multicultural Healthcare
Dr. Susan Tanner
Class Notes
25 ?




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This 6 page Class Notes was uploaded by Kara Pemberton on Sunday September 20, 2015. The Class Notes belongs to ANTH 3540 at University of Georgia taught by Dr. Susan Tanner in Summer 2015. Since its upload, it has received 28 views. For similar materials see Multicultural Healthcare in anthropology, evolution, sphr at University of Georgia.

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Popular in anthropology, evolution, sphr


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Date Created: 09/20/15
Multicultural Healthcare Week 5 91415 0 Healing o Placebo and Nocebo 0 Cultural Competency Wed 0 Reader Berlin and Fowkes 31 amp Kleinman and Benson 33 0 Continue reading Fadiman Anthropology in the World of Physicians 0 Medical practitioner or not 0 Tribe of medicine 0 Ethos of positivism provides certainty amp control 0 Diagnosis based on affective neutrality 0 Separate well from sick 0 Focused on explaining not understanding I Understanding is more academic pursuit Healers and Healing 0 What makes a good doctor 0 Knowledgeable o Able to explain complicated things 0 Caring o Personable o A good listener o Experienced The Illness Experience 0 Healer Listen to illness experience obtain solution 0 Healing Therapeutic relationship between healer and client Disease and Illness Experience 0 Illness experience includes Diagnosis and Treatment 0 Healer must listen to illness experience and obtain solution Failure may challenge power and authority of healer andor medical system 0 In many societies healing is integrated with relationships Biomedicine tends to be secular How do we know it works 0 Evidencebased medicine conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients recognizes individual patient s predicaments rights and preferences in making clinical decisions about their care 0 Requires millions of tests and interpretation 0 Efficacy Quantitative measures of how a treatment increasesdecreases the frequency of an outcome 0 Effect Overall healing experience Belief in Healing 0 Healing process requires belief and trust at 3 levels C LeviStrauss o Healer Believetrust their power 0 Patient Believetrust power of healer 0 Social Group Believetrust in power of healer and system Belief kills belief heals Hahn and Kleinman 1983 o 1 minute essay The Power of Belief 0 Placebos and Nocebos o For treatment to be effective it must improve a condition beyond that of a sugar pill placebo 0 Both treatment and placebos can be effective 0 Why Doctors and Patients Morman 0 Nature character personality behavior and style of doctor can in uence their patient s response to both inert and active medicines Nocebo Phenomenon Hahn o The imagined itch Brain circuitry supporting noceboinduced itch in atopic dermatitis patients 0 Looked at brains during itch afterwards Nocebo Effect Walter Cannon 1942 0 Voodoo death Death when death is expected 0 Mass hysteria Usually among highly vulnerablemarginalized community 9 16 15 Cultural Competency o Increasingly relevant Healers Patients and Culture 0 Culture in CrossCultural Health Care 0 What is this 0 Why is it needed 0 How is it done Culture in Biomedicine 0 Cultural Competence Making practitioners aware of and sensitive to the cultural beliefs and values of their patient Culture 1 Pragmatic View Culture is what one must know and do to function in a given society 2 Learning Perspective Defines culture as norms values beliefs and behaviors that are socially transmitted 3 Statistical Terms Norms values beliefs and behaviors that are common in a population How to Study Culture 0 Ethnography Living among them 0 Long indepth interviews 0 Looking into ritual religion music art laws Culture is 0 Shared 0 Contested 0 Dynamic and exible Folk Medical Models among Mexican Migrants in Nashville Ross et al 2011 0 Four main groups they were grouped into 1 Respiratory 2 Gastrointestinal 3 Chronic 4 Other 0 Asked which are the most important diseases Why is culture important Health Disparities 0 363 of US population is ethnic minority 0 Infants of African American women in 2008 had largest death rate more than twice the rate among infants of white women 0 AsianAmericans and Hispanics in 20062008 had greatest percentage of populations residing in countries whose air quality didn t meet EPA standards for particulate matter and ozone 0 American IndiansAlaska Natives in 2009 had highest motor vehiclerelated death rates 25 times rates of other racesethnicities 0 Many factors contribute to this Racial Disparities in Pain Management of Children with Appendicitis in Emergency Departments Goyal et al 2015 JAMA 0 Moderate pain Black patients less likely than white patients to receive any pain medications 0 Severe pain Black patients less likely than white patients to receive opiods o Likely that threshold treatments differ Vulnerable and At Risk Populations Resource Guide How do we address these health disparities Berlin amp Fowkes L Listen With sympathy and understanding to patients perception of problem E Explain your perceptions of the problem A Acknowledge and discuss differences and similarities R Recommend treatment N Negotiate agreement Kleinman and Benson Cultural Formation O O 0 Step 1 Ethnic Identity What is it is it important Step 2 What is at stake with illness Step 3 The illness narrative Step 4 Psychological stresses Step 5 In uence of culture on clinical relationships Step 6 The Problems of Cultural Competency Approach be critical


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