Week 3 - Collaborative Assignment Group 4
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CULTURAL DIFFERENCES: GROUP 4
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Cultural Differences: Group 4
University of Phoenix
MHA 516: Operating in Structure: Health Sector Policy and Governance
CULTURAL DIFFERENCES: GROUP 4
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Part I: Individual work
Health disparities prevent people from receiving high-quality care and the ability to achieve good health. Coupled with low health literacy, language, and healthcare barriers, as well as cultural differences, Hmong individuals are challenged with major health risk factors and increased morbidity and mortality (). Culture differences regarding healthcare are complex. As a professional healthcare worker, you want the best quality services for your patients, but also you want to respect the wishes of your patients. In the book “The Spirit that Catches You When You Fall Down”,
which is an example of how culture practices can influence a persons’ decision for treatment (Oaster, 2021). I comprised my summary from chapter 14. In this chapter, the Lees, a Hmong family arrives in the United States. During this time, they have six surviving children. They wanted to obtain aid from family members living in Oregon. The Lees never used electricity and were instructed on its purpose and how to use it. Refrigerators, television, and toilets were foreign to them. They lived in California for seventeen years. Still adhering to their cultures’ practices. Foua and Nao Nao the parents of the Lee family, are still unfamiliar with the English language, so their dependance on their children is critical. The children must shop at local supermarkets for
their parents. The Hmong rely on the importance of community, and they make decisions based on what is best for the community, rather than what is best for individual families (Oaster, 2021). The Lee family never strayed away from their culture practices, which influences how the treatment for Lia’s epilepsy would be handled. In conclusion, culture practices and healthcare have a difficult relationship. In Lia’s situation she eventually survived, albeit being in a vegetable state she lived to be 30 years of age (Oaster, 2021). In this case, language is the
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cultural practice that was important. The hospital didn’t have any Hmong interpreters. Because of this, the Lees suffered misdiagnosis and errant prescriptions at the hands of Lia’s doctors. The hospitals should always have interpreters for every language. The Lees needed an interpreter not just to communicate the doctor’s orders to them. They needed a liaison to help bridge the chasm between Hmong tradition and western medicine (Oaster, 2021). In conclusion, it is important for the healthcare system to utilize ways to better serve patients based on culture practices. If the hospital had sufficient translators, they would have provided effective treatment to Lia and proper communication. It should be mandatory for hospitals to hire and train a language department, because it would decrease the culture barriers between doctor and patient.
References:
Oaster, B. (2021, January 8). Lia Lee: How a hmong child shaman changed western medical translation
. Day Translations Blog. https://www.daytranslations.com/blog/hmong-medical-
translation/ Team Feedback
:
Mary,
It seems that all of us found common themes of low health literacy, cultural misunderstanding, and language barriers in the chapters we reviewed. One reason for the lack of health literacy within the Hmong community is the fact that they do not have a written language (Vang, 2019). This makes it difficult to understand the concepts of the human body, especially since the Hmong are very spiritual people, whereas Western medicine is more scientific based. https://stti.confex.com/stti/congrs19/webprogram/Paper100439.html
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Hi team here is my part I for chapter 8. Identify the historical events or cultural practices in your selected chapter
In chapter 8, the author shares the difference between an interpreter and a cultural broker.
No individual wanted to take on Lia’s case due to her being a part of the Hmong community. In Hmong community the families are close knit families and rarely accept others into their home. It’s also hard to understand different cultural beliefs. As a patient it may also be difficult to communicate and explain cultural beliefs. May Ying Xiong was the individual who helped bridge the gap of a cultural broker. She had knowledge of the Hmong culture and knew what needed to be in place and what needed to be asked to get responses from Lia’s parents. A cultural
broker has more knowledge of cultural beliefs and understanding compared to an interpreter who
translates questions (Yarbrough, 2023). May also explain to the author the different time structure Hmong’s use. Individuals typically use years and dates to determine certain appointments or events that occurred. Hmong individuals use the lunar calendar to determine dates of Lia’s appointments. This covers most of the major cultural practices in chapter 8. Examine and describe how these differences create disparities between U.S. health care and the
Hmong in California
The difference between the disparities in the U.S and Hmong community is the time structure example shared. They don’t keep track of years and dates like most individuals who receive healthcare treatment in the U.S remember the year a procedure or treatment was given. This makes it difficult for medical professionals to communicate what medical needs were treated and not treated. This can cause miscommunication to the providers and the family. Lia’s parents believed Lia’s soul was taken and did not believe a seizure was occurring. This was hard to communicate with doctors when her fist seizure occurred they referred to this as the first time her soul was taken.
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References
:
Yarbrough, D. (2023). Cultural brokering. AMCHP. https://amchp.org/database_entry/cultural-
brokering/
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I chose chapter 11, The Big One
Identify the historical events or cultural practices in your selected chapter.
One thing that stuck out for me while reading this chapter, was that Lia’s father, found
the spinal tap performed on Lia to be one of the most upsetting things ever done to his child. Nao
Kao contributed the spinal tap to Lia’s decay, but to most American doctors, the spinal tap was a
relatively non-invasive procedure that was necessary to assess Lia’s condition. The Hmong find
a spinal tap to be crippling both in this life and future lives.
Examine and describe how these differences create disparities between U.S. health care and the
Hmong in California.
The Hmong did not understand how most western medicines worked, and therefore
believed that too much medicine could kill Lia, but at the same time, that administering medicine
could also save her. The language barrier did not help this situation. “The doctors who cared for
her tried to give her medications and invasive procedures such as spinal taps and transfusions
that her parents did not understand. Her parents looked to shamans, herbs, and special amulets to
help, which the doctors did not understand” (2013). It was clear that the Hmong did not
understand the Americans and vice versa. At the end of the day, the problem was with
communication. “Effective communication in health care can make a life-or-death difference”
(2021). Healthcare workers can benefit from learning about different communication styles and
effective communication techniques. This includes provide culturally competent care and
communication, such as interpretation services.
References
:
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http://www.humanologyproject.org/epilepsy/2013/10/25/hmong-the-americans
https://publichealth.tulane.edu/blog/communication-in-healthcare/#:~:text=Skillful
%20communication%20enables%20healthcare%20providers,care%20team%20and%20the
%20public
Team Feedback
:
Hello Samantha,
the main culture practice that I noticed with my chapter was how the language barrier became the
main component when it came to communication towards the Hmong family and the Doctors. I’ve always thought that healthcare facilities consisted of translators in case such a situation occurred. Mary,
I work in a very rural area at a small hospital. Having English as our primary language, we barely have any resources that exist for those who do not speak it. I personally had to assist a patient through Google translate to perform the duty that he was asking of me. Since then, our processes have been improved. It was a great learning opportunity for us all that we need more options for those that may end up in our facility.
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I selected chapter 9 of the book, “The Spirit Catches You and You Fall Down” by Anne Fadiman. Throughout this chapter, there is a whirlwind of events that took place that highlights how important it is to have cultural competence and awareness of cross-cultural communication in the medical field. Throughout the book and specifically in chapter 9, there were various misunderstandings and a lack of proper care presented about the spiritual beliefs of the Lee family. In the Hmong culture, they steered away from traditional forms of healthcare by avoiding medications. Though the Hmong may dress in traditional American clothes, utilizing grocery stores and modern technology, their treatment for diseases and illnesses is far from the typical American treatment plan. Instead, the Hmong would rely on spiritual, holistic, and natural approaches to care. The family spent hundreds of dollars on crystals, amulets, and special sacred healing herbs to restore Lia’s health. The Lee family began to celebrate Lia’s return after she was experiencing an epileptic episode. A sacrifice of a cow is among one of the Hmong’s belief to celebrate and foster Lia back to health. Lia experienced a decline mentally which left her with few words to speak and unusual behavior. Because of their beliefs, it was debatable between everybody involved on the true reason why her condition was not improving. The doctors explain medication was needed; however, the family failed to administer the medication that was provided to her to avoid any further seizures. Because of the conflicting beliefs, Lia essentially continued to suffer medically. The U.S healthcare system and Hmong in California have more differences in beliefs than similarities which causes a conflicting plan of action when medical attention is needed. According to the CDC website, healthcare disparities occur across differing ethnicities, geography, language, age, gender, socioeconomic status, and citizenship status, along with
CULTURAL DIFFERENCES: GROUP 4
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gender and sexual orientation. In addition, these disparities result in unequal distribution of economic, political, social, and environmental resources. “Bias, stereotyping, prejudice and clinical uncertainty contribute to disparities” (American Medical Association, 2020). References
:
American Medical Association & American Medical Association. (2020, January 24). Reducing disparities in health care. American Medical Association. https://www.ama-
assn.org/delivering-care/patient-support-advocacy/reducing-disparities-health-care
Health Disparities | DASH | CDC. (n.d.). https://www.cdc.gov/healthyyouth/disparities/index.htm
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The chapter that stuck out to me the most was chapter 13. Throughout the chapters, a communication barrier and beliefs system complicated the relationship between the doctor and Lee's family. The Hmong in California faced a number of trials and tribulations which forced them to flee to the United States. They refused to abandon their beliefs and adjust to the American's way, which is because we all have the right to have our own beliefs. Due to their beliefs on the other hand, it effected the way they accepted treatment. The Hmong believed in spiritual healing and the usage of natural herbs which hindered them from knowing when it was time to use medication. Once finally deciding to go to the hospital seeking help, the doctors disregarded the Hmong's beliefs and outlooks which led the to ignore and disregard the signs and symptoms that Lia displayed. Lia's health continued to deteriorate until chapter 13 when they all believed she would die soon. Chapter 13 stuck out to me because that is when both doctor and Lee's family decided to have an understanding and cooperate. The chapter saddened me because the disparities between them could've been easily resolved, and they could have treated Lia instead of her suffering. This
chapter demonstrates the importance of coming to common grounds when seeking reconciliation.
The disparities between the two are due to ethnicity, language, beliefs, and gender. Developing a relationship and communicating effectively would have been the resolution to solving these differences. Communicating effectively with one another would have allowed them to see different perspectives, gain respect for each other, and both parties would have gained knowledge on each other beliefs. Reference
:
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The Spirit Catches You and You Fall Down Chapter 13: Code X Summary & Analysis | LitCharts
Health Disparities | DASH | CDC
Vang_100439_PST768_Info.pdf (nursingrepository.org)
Team Feedback
:
Destiney,
I agree that communication barriers were present in almost every chapter. Culture is a theme throughout the whole book. Certain aspects of Hmong culture, such as taboos against medical procedures, beliefs about the origins of diseases, and power structures within the family and the clan often conflict with the culture of western medicine, resulting in misunderstandings between doctors and patients.
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In the selected chapter of "The Spirit Catches You, and You Fall Down," the author explores the Hmong community's historical events and cultural practices, focusing on their experiences in California. These factors contribute to significant disparities between U.S. healthcare and the Hmong population:
Historical Events and Cultural Practices
The chapter delves into the rich history of the Hmong people, tracing their origins in China and their subsequent migration to Laos. The Hmong played a significant role in the Vietnam War, fighting alongside the United States against the Communist forces. When the war ended, the Hmong faced persecution and were forced to flee their homeland. Many Hmong refugees sought safety in the United States, particularly in California.
The cultural practices of the Hmong are deeply rooted in animism and shamanism, with strong beliefs in spirits and the supernatural. They attribute illness to spiritual causes, considering it a clash between the soul and external forces. Shamanic rituals involving the intervention of a spiritual healer are crucial in Hmong healthcare practices. Hmong culture emphasizes collectivism, respect for elders, and a hierarchical family structure.
Disparities in Healthcare Delivery
The differences between U.S. healthcare and Hmong cultural practices create disparities that impact healthcare delivery. The biomedical model, predominates in Western medicine, focuses on diagnosing and treating illnesses based on scientific evidence. However, the Hmong's spiritual beliefs and reliance on traditional healing methods pose challenges for healthcare providers who may prioritize scientific explanations and biomedical interventions.
Language and communication barriers exacerbate the disparities. Many Hmong people face difficulties expressing their health concerns due to limited English proficiency, leading to
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CULTURAL DIFFERENCES: GROUP 4
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misunderstandings and inadequate care. Additionally, the hierarchical nature of Hmong families often requires decision-making by elders, making it challenging for healthcare providers to engage with younger patients or convey medical information effectively.
Cultural differences also influence the perception of authority and the role of healthcare providers. In the Hmong culture, spiritual healers hold significant influence and are seen as intermediaries between the spiritual and physical realms. This can lead to a lack of trust in Western medicine and a preference for traditional practices, creating tensions between healthcare
providers and Hmong patients.
In summary, the profound impact of historical events and cultural practices on the Hmong people, encompassing their migratory journey, spiritual beliefs, and adherence to traditional healing modalities, gives rise to notable disparities in healthcare delivery. To holistically serve the Hmong community in California, it becomes imperative for healthcare providers to comprehend and navigate these differences with astuteness, ensuring the provision of culturally sensitive and equitable care. By fostering collaboration and embracing diverse perspectives, healthcare professionals possess the power to construct bridges across these divides, forging a path towards delivering healthcare that not only attends to the medical necessities of the Hmong but also reveres their cultural heritage. In this harmonious amalgamation of knowledge and empathy, the intricate tapestry of the Hmong story intertwines with the principles of healthcare, nurturing an environment of inclusivity, understanding, and healing.
References
:
Birn, A. E. (1999). The Spirit Catches You, and You Fall Down: A Hmong Child, Her American
Doctors, and the Collision of Two Cultures.
Taylor, J. S. (2003). The story catches you, and you fall down: Tragedy, ethnography, and cultural competence. Medical anthropology quarterly, 17(2), 159-181.
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Team Feedback:
Lynette,
I too noticed a lot of health disparities due to cultural differences and misunderstanding. I believe
we have all pointed out that one thing that led to a lot of miscommunications is the language barrier. This was present in all chapters. “Hmong is an advanced oral language and highly expressive; it includes proverbs, poem-songs, plain language of morality tales and ancestral stories, flowery speech of elders, code speech of sweethearts, and antique language of wedding and funeral rituals. In spoken Hmong, ideas are wrapped in words in a non-linear way. Hmong is
tonal, so that the meaning of the word changes when pronounced differently. In addition, Hmong
is mono-syllabic so one syllable represents one word or meaning” (Owens, 2007). This is an interesting passage because it really highlights the difference in Hmong language and the English
language. https://ethnomed.org/culture/hmong/
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Part II: Teamwork:
Team, here is a list of key cultural practices or factors that I believe could impact healthcare program delivery to the Hmong community based on known information about Hmong culture and history after reading all of our Part 1-chapter summaries:
1. Traditional Healing Practices
: The Hmong community has a rich history of traditional healing practices, including herbal medicine and spiritual rituals. This could impact health care delivery as these practices may be preferred over Western medicine or could potentially interact with it.
2. Language Barrier
: Many Hmong people, particularly older generations, may not speak English
fluently. This could impact the delivery of health care services, as communication is vital in understanding and treating health issues.
3. Cultural Beliefs about Health and Illness
: In Hmong culture, health and illness are often viewed through a spiritual lens, with disease sometimes seen as the result of spiritual imbalance. This could impact healthcare delivery as it may influence the acceptance of specific treatments or
interventions.
4. Family and Community Involvement
: The Hmong culture strongly emphasizes the importance
of family and community. This could impact health care delivery as decisions about health care may involve consultation with family members or community leaders.
Team Discussion:
Hello Lynette, I agree with all the factors you mentioned in regard to cultural practices.
Yes, those are the same factors indicated throughout each chapter. Hi Lynette, I also agree with you on the cultural practices. I think all major practices were included.
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Hi Lynette,
I agree with the cultural differences that you mentioned above. The communication barrier could
also tie into the misunderstanding of beliefs. The inability to effectively communicate and openly
discuss this could have an impact on how treatment is performed. The outcomes may vary as a result of poor communication from both the patient and the healthcare staff. The cultural beliefs ultimately is driven by acceptance. In some situations, the healthcare workers may accept different forms of care while the patient may only accept a specific type of care. At some point in an urgent medical crisis, one of the two will have to accept treatment in a way that is not what they are most comfortable with. I agree with everything you said Lynette.
CULTURAL DIFFERENCES: GROUP 4
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Part III: Individual Reflections
Cultural practices have a great influence on how treatments of patients will be appropriated. The Lee family of the Hmong culture was a perfect example of how cultural practices can produce barriers between patient and physician. Hmong individuals are challenged with major health risk factors and increased morbidity and mortality (Oaster, 2021). Culture differences regarding healthcare are complex. After overviewing the effect cultural differences had on the Lee family, our group uncovered certain aspects that may have contributed to Lia's treatment. Traditional Healing Practices, Language Barrier, Cultural Beliefs about Health and Illness, and Family and Community Involvement where the aspects of the Hmong culture that could impact healthcare program delivery to the Hmong community. Traditional healing practices withing the Hmong culture mainly focuses on herbal and spiritual medicines. Which is drastically different than the western medicine practices. This factor contributed to the treatment of Lia because the Lee family saw western medicine as foreign, and they did not understand its effectiveness (Oaster, 2021). The Lee family also never learned English, and the hospitals did not provide translators to help them understand the medical processes that was being performed on Lia, so the language barrier factor was immense. Because of the lack of communication, the Lee family was not aware of what was happening with their daughter. Cultural beliefs about health and illness within the Hmong culture regarding health and illness, are often recognized through a spiritual lens. Diseases are often seen as result of spiritual shortcoming. This aspect was influential because it may have determined the acceptance of specific treatments or interventions (Oaster, 2021). The last prospect was family and community involvement. The Hmong culture strives on the importance of family and
CULTURAL DIFFERENCES: GROUP 4
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community. The decision for treatment would be a deciding factor for the whole family and how it would affect the community as well. The Lee family gave a needed insight on the cultural practices within the Hmong culture and exposed the importance of culture awareness within healthcare. If the hospital had provided the Lee family with proper methods of communication, perhaps Lia's treatment would have been more consistent and end result would have been different. References
:
Oaster, B. (2021, January 8). Lia Lee: How a hmong child shaman changed western medical translation. Day Translations Blog. https://www.daytranslations.com/blog/hmong-
medical-translation/
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Three key cultural factors that were shown in chapter 8 were language barrier, family and
community involvement and cultural beliefs health and illness. As a team we also discussed these common cultural key factors within our chapters. In chapter 8, the author shares the difference between an interpreter and a cultural broker. No individual wanted to take on Lia’s case due to her being a part of the Hmong community. In Hmong community the families are close knit families and rarely accept others into their home. It’s also hard to understand different cultural beliefs. As a patient it may also be difficult to communicate and explain cultural beliefs, due to a language barrier already being an issue. May Ying Xiong was the individual who helped bridge the gap of a cultural broker. She had knowledge of the Hmong culture and knew what needed to be in place and what needed to be asked to get responses from Lia’s parents. She was able to explain the overall beliefs and communicate in the proper language to Lia’s parents. A cultural broker has more knowledge of cultural beliefs and understanding compared to an interpreter who translates questions (Yarbrough, 2023). May also explained to the author the different time structure Hmong’s use. This was known as an example of the cultural beliefs in health and illness. Hmong individuals typically use years and dates to determine certain appointments or events that occurred. They use
the lunar calendar to determine dates of Lia’s appointments. This covers most of the major cultural practices in chapter 8. The difference between the disparities in the U.S and Hmong community is the time structure example shared. They don’t keep track of years and dates like most individuals who receive healthcare treatment in the U.S remember the year a procedure or treatment was given. This makes it difficult for medical professionals to communicate what medical needs were treated and not treated. This can cause miscommunication between the providers and the family.
CULTURAL DIFFERENCES: GROUP 4
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Lia’s parents believed Lia’s soul was taken and did not believe a seizure was occurring. This was
hard to communicate with doctors when her first seizure occurred, they referred to this as the first time her soul was taken. Chapter 8 explains the importance of patient care between providers and patient culture. The importance of understanding different culture beliefs. If providers are knowledgeable about their patients’ culture, patients may feel comfortable receiving healthcare treatment. Patients will
know their provider wants to help improve their overall health and respect the decisions patients have. The gap of culture beliefs will be filled, and an interpreter would be helpful to translate if the provider knows the patient’s beliefs.
References
:
Yarbrough, D. (2023). Cultural brokering. AMCHP. https://amchp.org/database_entry/cultural-
brokering/
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The key factor of “cultural beliefs about health and illness” directly relates to chapter 11, as well as to the whole book. The Lees believed that when someone seized, “the spirit catches you and you fall down.” This is a great example of how the Lees and the Hmong people look at medical issues in a completely different light than traditional western medicine practioners. The Hmong look at epilepsy as almost a blessing, signifying that an individual is meant to be a shaman. “Amongst the Hmong, the epileptic become shamans, helping those in need of physical and emotional aid. The American standards of treating the ill falls out of place, replaced by the herbs, chants, and other more spiritual acts for healing” (Choi, 2013). This creates a health disparity due to a clash in cultural beliefs. Overall, the Hmong cultural beliefs often clashed with western views of medicine and illness. In western medicine, spirituality and health are two separate things, however, the Hmong believe the two are intrinsically linked. “…for example, they may view illness as a lost soul or a soul separated from the body” (2016). Another key factor the group identified that applies to chapter 11 is “language barrier’. For example, in this chapter, Neil Ernst believed that Lia’s parents understood that Lia was being transferred to Valley Childers’s Hospital in Fresno due to the severity of Lia’s condition, but they believed that
she was being transferred due to Neil and Peggy going on vacation and not being able to treat Lia
at MCMC. References
:
Choi, K. (2013, November 1). Culture clash: Hmong the Americans. The Humanology Project. http://www.humanologyproject.org/epilepsy/2013/10/25/hmong-the-americans Communicating with Hmong patients - lacrosseconsortium.org. (2016, August 6). https://www.lacrosseconsortium.org/uploads/content_files/files/Hmong.pdf
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“Cultural differences between patient and provider contribute to adverse health outcomes through poor communication, value conflicts, and disparate concepts of health and illness” (Lie, 2013). Traditional healing practices, language barriers, cultural beliefs of illnesses and health, along with family and community involvement are a few of the factors that existed through the chapters of the book. These factors are all important aspects to consider in not only the U.S. health care system, but also for all healthcare systems in the nation. “Healthcare disparities are defined as differences in treatment experienced in the quality of healthcare received by racial and/or ethnic minorities even when access to care is equal” (Harris, 2010). The differences in disparities have their own impact. Traditional healing practices vary upon location, background, religious beliefs, and spiritual beliefs. The Hmong community specifically varies in the way healthcare treatment is executed. Specifically in chapter 9 of “The Spirit Catches You and You Fall Down”, the Lee family believed in a healing method brought from an egg yolk and silver coin. Though this may seem like an extreme way to practice, the Lee family primarily believed the holistic approach of having the egg absorb the sickness from the body would be the most effective way to treat Lia. The communication barrier could also tie into the misunderstanding of beliefs. “The effect of the languages and the scientific terms used by medical professionals becomes difficult for the common audience to understand; hence, the understanding gap also increases” (Taye et al., 2023). The inability to effectively communicate and openly discuss this could have an impact
on how treatment is performed. The outcomes may vary as a result of poor communication from both the patient and the healthcare staff. The Lee family was unable to properly communicate in English which also was a disadvantage to the treatment plant for Lia.
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The cultural beliefs ultimately is driven by acceptance. In some situations, the healthcare workers may accept different forms of care while the patient may only accept a specific type of care. At some point in an urgent medical crisis, one of the two will have to accept treatment in a way that is not what they are most comfortable with. For the Lee family, there was inconsistency
in how the care was provided. With the combination of holistic healing methods, in addition to modern pain medication and hospital stays, Lia had a lack of routine treatment which ultimately led to her disadvantage in recurring epileptic episodes. References
:
Harris, G. L. A. (2010). Cultural competence: its promise for reducing healthcare disparities. Journal of Health and Human Services Administration, 33(1), 2+. https://link.gale.com/apps/doc/A250033490/HRCA?u=uphoenix&sid=bookmark-
HRCA&xid=bbacecd8
Lie, D. (2013). Addressing Disparities in Healthcare: What Do Health Literacy and Cultural Competence Have in Common? Hawai’i Journal of Medicine & Public Health: A Journal
of Asia Pacific Medicine & Public Health, 72(8), 7.
Taye, R., Paswan, A., Singh, D. D., Kapil, M., Sharma, S., Choudhary, V., Prasad, J., & Pareek, G. (2023). Language As A Barrier In Health Care Communication-A Comparative Study On Rural And Urban hospitals. Journal of Pharmaceutical Negative Results, 14(3), 792–
800. https://doi.org/10.47750/pnr.2023.14.03.103
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There were four common factors displayed throughout the chapters that showed a level of
difficulty when coming to a agreement with health purposes. Traditional healing practices, cultural beliefs, language barriers, and family/ community involvement were the main factors at rise. The Hmong arrived to the United States strongly holding onto their way of life. The Hmong deem themselves to be spiritual wellbeing’s, and they lean on that natural side of things when it comes to healing illnesses. They were family oriented and believed in caring for each other through practices passed down through each generation which also effected the way they choose their healing preferences. During their time in the United States, they never took the time to learn English, socialize with Americans, nor engaged with their health practices. Each factor added to the situation which made matters worse. Throughout each chapter, Lia’s health continued to decline, and it eventually took a turn for the worse. Lia ended up being in a vegetable state and she was expected to die within hours of being discharged. Chapter 14 displayed a turn of events. Change was finally coming; Lee’s family and the doctor were on the same accord. This was due to everything expecting death and loosing all hope for Lia’s survival since the healing herbs used did not work, and the medication provided by the doctors did not work either. Chapter 14 displayed how change can come, but sometimes it could be too late. If both parties would have taken the chance to put their differences to the side and respected each other, they would have been able to make educated decisions regarding Lia’s health. That respect would have allowed the parties to build a relationship which would have broken the language barrier with using a translator and altered Lia’s condition for better instead of for worse.
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In conclusion, the healthcare workers should have respected the Lee’s family decision, and they could have provided a translator to speak for them and for the Lee’s family. Healthcare workers are deemed to provide patients with quality service and care. That extra step would have
eliminated the terribly decisions they made and the decisions the family made. Lia ended up passing away at the age of 30.
References
:
Fadiman, A.
(1997).
The Spirit Catches You and You Fall Down
.
https://www.litcharts.com/lit/the-
spirit-catches-you-and-you-fall-down/chapter-13-code-x
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CULTURAL DIFFERENCES: GROUP 4
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"Health disparities prevent people from receiving high-quality care and the ability to achieve good health. Coupled with low health literacy, language, and healthcare barriers, as well as cultural differences, Hmong individuals are challenged with major health risk factors and increased morbidity and mortality" (Vang, 2019). With the help of their culture, the Hmong have developed a unique way of life, which differs from other civilizations. The Hmong place a lot of importance on the community and make decisions based on what is best for the community rather than for individual families. Because of this, it may be challenging to get the Hmong community to participate in healthcare programs they do not see as beneficial. Among the Hmong, spirits are believed to cause illness, and the spirits of their ancestors are believed to protect their health. Several changes were made to how healthcare was delivered as a result. The Hmong hesitated to join Western medical programs because they did not understand the spirit world. They were more likely to find traditional providers than Western medicine providers. Ninety-two percent of Hmong Americans speak another language other than English at home, with the majority speaking Hmong (Lor, Xiong, Schwei, Bowers, & Jacobs, 2016). According to the literature, language barriers are a significant barrier to providing optimal access
to healthcare services. Many Hmong people need to be more literate since they originate from an
oral culture. Medical material is challenging to understand because there isn't a word to define diseases like cancer and hepatitis. As the Hmong have no terms or descriptions for the biological model of health, it can be challenging to translate medical concepts even with trained interpreters. Hmong Americans have significant barriers to healthcare access and utilization, yet not all healthcare providers know these issues. Studies illustrate how cultural beliefs, linguistic
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CULTURAL DIFFERENCES: GROUP 4
27
discordance, and low health literacy may contribute to disparities in healthcare and health outcomes among the Hmong. Aside from highlighting the need for further research into Hmong health and disease prevalence in the United States, cultural competency and sensitivity training appear warranted when caring for diverse patient populations like the Hmong.
Reference
s:
Lor, M., Xiong, P., Park, L., Schwei, R. J., & Jacobs, E. A. (2017). Western or Traditional Healers? Understanding Decision Making in the Hmong Population. Western Journal of Nursing Research, 39(3),400-415. Retrieved from https://www.scopus.com/inward/record.uri?eid=2-s2.0 85013104443&doi=10.1177%2f0193945916636484&partnerID=40&md5=e6fd73c34e6
83c6b91809a5b7e30a906
Vang, K. K. K. M. (2019).Culture and health disparities: Hmong health beliefs and practices in the United States. stti.confex.com. Retrieved from https://stti.confex.com/stti/congrs19/webprogram/Paper100439.html
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