Isolation, usually thought of as a problem for individuals, turns out to be heavily dependent on features of communities. Anthropological contributions to the understanding of age-related cognitive impairment. The home environment is critical for maintaining health and well-being among the medically ill and people living with disabilities. Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: Findings from the REACH study. ." Thus, social networks can have properties that are protective of health, and their absence or weakness may make it quite difficult to deliver services to homes. Do you want to take a quick tour of the OpenBook's features? Discrimination in experiences with medical providers (or more generally) may affect receptivity to home care. Culture factors range from syntax, ideologies, religion, language and dialect, to art and literacy. Journal of Gerontology: Psychological Sciences, 60, S257-S262. They may begin with attention to instruction but then innovate and improvise as they fit the use of the technologies into the rhythms of family life. They may seek to deny or hide the condition. Whoever I meet downstairs, the first time, I introduce myself. Journal of Gerontology: Social Sciences, 59, S138-S145. “Cultural insularity” in this context refers to restrictions in access to health information related to culture, such as not speaking English, but also to religious proscriptions against contact with mainstream culture, for example, watching television or reading English-language newspapers. Small, M.L., and Jacobs, E.M. (2008). Therefore, that information is unavailable for most content. Cultures with a strong bias toward home care and away from institutional care will be more receptive to the adaptation of homes. Meghani, S.H., Brooks, J.M., Gipson-Jones, T., Waite, R., Whitfield-Harris, L., and Deatrick, J.A. Transcultural nursing has taken the lead in developing methodologies for assessing cultural differences among patients as well as the receptivity of health care providers to these differences (Narayan, 1997; Davidhizar and Bechtel, 1998; Heineken and McCoy, 2000). Gubrium and A. Sankar (Eds. Clearly, how people understand symptoms affects how they speak about a condition, to whom they disclose symptoms, when they seek treatment, and who they think can help them. Mahoney, D.F., Cloutterbuck, J., Neary, S., and Zhan, L. (2005). In a study of home care in New York City, home care paraprofessionals were asked how they handled assignments in buildings they felt were unsafe because of crime or gang violence (Albert, 2002). They stressed that they would leave a home or apartment only in a situation of immediate danger and even then would call their agencies on the way out, as they are required to do. Demiris, G., Oliver, D.P., Giger, J., Skubic, M., and Rantz, M. (2009). This, in turn, had spillover effects on neighborhoods, once these elderly were unable to maintain their homes. The home attendants we interviewed were frankly embarrassed by the lack of compassion some families showed for their clients and had much higher expectations for care than these families. Second, social and community factors can also be seen as resources rather than constraints in the adoption of technologies. This culture often fosters rebelliousness and defiance of adult authority figures, leading some young people to smoke, take drugs, and expose themselves to dangerous and unhealthy practices. A tragic example is the spread of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), particularly in Africa, where economic necessity shapes choices that are often hazardous to health. As an example of the utility of this approach, Campinha-Bacote notes that hypertension treatment may have a very different meaning among African American elderly, for whom hypertension implies emotional pressure or tension and not just a stiffening of arterial walls. The pursuit of very low body weight may be associated with the development of anorexia nervosa, an illness that can be fatal. Attention to community factors and linkages across levels is more recent, and research in this area is much less developed. Trust may also be relevant for adoption of home care technologies, but little research is available in this area. Journal of Gerontology: Social Sciences, 58, S151-S159. Such actions have, unfortunately, often been encouraged by the tobacco industry and advertisers of beer and other alcoholic drinks. Kiss to say hello. Unfortunately, as a society where cheap is good and fast is better, we’ve welcomed super-sized, low-cost fast food that has paved the way for a massive increase in the rate of obesity. This approach to culture does not involve differences among ethnicities or people who speak different languages but rather the operation of culture in. The majority of women and men in cultures that perform genital mutilation support the continuation of the practice which makes change all the more difficult. Perceived ease of use depends on social support from families, whether families will help maintain technologies, and how receptive they are to instruction from home health care providers. AIDS and Behavior, 11, 884-896. Homes in these neighborhoods may not have local providers, making it more complicated to replenish supplies or monitor effective use of technologies. A simple example can be seen in ideas about gender and height. Clinicians diagnose and treat disease (abnormalities in body structure or function), but patients suffer illness, in which symptoms carry social significance and force changes in social function. New York: Appleton-Century-Crofts. Culture influences individuals' lives in many ways, including shaping where they want to live, their views on education, their accents, what books they read, what music they listen to and other considerations. If informal sources of health information are more important for some cultural groups for the adoption of home health care technologies, then it will be important to work through these informal networks for changing social norms regarding acceptability. Aging and Mental Health, 8, 330-345. Defining roles, relationships, boundaries and participation between elderly people and nurses within the home: An ethnographic study. This has many implications for how to deal with children, from school to the judicial system. The elicitation of home care culture described above can be used to identify subcultures and also differences across cultures. The Cash and Counseling Demonstration and Evaluation suggests that greater inclusion of families and due recognition of cultural expectations for care may improve home care. Another cultural practice with severe health consequences is female genital mutilation, which is performed on young girls in many African and Middle Eastern nations. Aging and Mental Health, 8, 316-329. Culture may be relevant for decisions to seek treatment or receive clinical preventive services. McGarry, J. What aspects of a home make it hard or easy for a home health care worker to do his or her job? My research with home care in New York City suggests that differences in language are quite common—not surprising when one notes that New York City’s fastest growing populations include Mandarin, Russian, and Spanish speakers. These impressions. Most significant for the social-ecological approach are cross-level influences shown by arrows that cut across levels indicated in the figure. These will be difficult until further studies, as suggested here, are conducted in each of the component areas. "Cultural Factors Campinha-Bacote, J. One review through the 1990s found no differences in home care utilization by race (Kadushin, 2004). © 2020 National Academy of Sciences. Also, you can type in a page number and press Enter to go directly to that page in the book. they impact each other and cause culture change. A key gap in research and policy, then, is to understand how families and formal home care providers interact: what the points of friction are and how coordination between the two can be enhanced. These efforts represent important enhancements to home health care that emerge from a social-ecological perspective. For this reason, geriatric care managers have begun to look for alliances with community developers to help ensure adequate access to services and repairs (Austin, McClelland, and Gursansky, 2006). Explanations to patients must take these different understandings into account if patients are to adhere to medication regimens and adopt lifestyle prescriptions. For the truly zealous, religion is not just a hobby. Heineken, J., and McCoy, N. (2000). Ideas and cultural concepts are constantly spreading and moving and changing. Americans for the most part prefer that husbands be taller than wives. Albert, S.M., Harlap, S., and Caplan, L. (2004). For example, in the New York City study of home attendants providing personal assistance care, many reported thefts, pressure if not overt threats from family members, and great concern for personal safety (Albert, 2002). Paul, B. D., ed. Hahn, R. A., ed. New York: Springer. All rights reserved. This kind of insularity may have an important significance for health in ethnic communities organized around religious beliefs. North Lawndale, predominantly African American, stood out among Chicago communities for its loss of population over the prior 30 years, crime, decaying housing stock, and, most critically, absence of economic activity and civic organizations. Thus, families and health professionals may start with completely different premises when they collaborate to ameliorate disease or manage disability. For example, cultures differ in the degree to which pain, limitation in activity, or cognitive impairment is considered an appropriate cause for medical intervention. Despite the concern for cultural competence and its assessment, it is difficult to identify studies that examine the relationship between cultural competence and home care outcomes. Consider the family facing end-of-life care for a medically unstable older person or child. (1990). These factors are closely linked with our culture. Journal of Telemedicine and Telecare, 14, 443-447. Boulder, CO: Westview Press. For example, in an orthodox Jewish sample of older women in New York City, the prevalence of mammography, Pap smears, and colorectal cancer screening was low compared with other women of similar age and education. Cultural anthropology emerged as an area of study following the era of European exploration, when the full diversity of human experience became globa…, cultural pluralism See MULTI-CULTURAL SOCIETY. Learn. They lived in fear of crime and nailed windows shut. Similarly, Latinos delay institutionalization relative to whites; a higher cultural value assigned to family care leads to more positive views of family caregiving, which in turn leads to a negative evaluation of skilled nursing facilities as an option for dementia or end-of-life care (Mausbach et al., 2004). Navaie-Waliser, M., Feldman, P.H., Gould, D.A., Levine, C., Kuerbis, A.N., and Donelan, K. (2001). The model stresses cross-level influences, in which community or organizational environments can shape individual behavior (top-down effects), but also examines how individuals form groups or take actions that may affect higher level organizational or community spheres (bottom-up effects). New York: W.W. Norton. With norms of filial obligation and positive appraisals of caregiving demands, ethnic and cultural minorities are more likely to report satisfaction in caregiving. Agencies rightly recognize that optimal self-management of disease and a person’s return to function depend on a reasonable division of labor, shared information, and the willingness of family caregivers to learn rehabilitation and nursing protocols, medication administration, the use of assistive technologies, and the like (Wolff et al., 2009). Training the home care workforce in cultural differences and the complexities of family relationships is critical. When family concerns are placed above those of the individual, sociologists speak of “familism.” A consistent body of research has documented the greater familism among non-U.S.-born and U.S.-born Latinos, and the greater tendency of minority groups to receive social support from family members rather than friends (Almeida et al., 2009). The role of neighborhoods in home care is perhaps the least well researched of the three elements in the social-ecological framework. However, loss of a stable, cohesive social environment also appears to have contributed to the rise in prevalence of coronary artery disease in the migrant groups. Differences in commitment to family care are based on cultural norms of filial piety or obligation. On October 1 and 2, 2009, a group of human factors and other experts met to consider a diverse range of behavioral and human factors issues associated with the increasing migration of medical devices, technologies, and care practices into the home. One study found higher use of physical and occupational therapy among whites and Asians relative to black and Hispanic home health recipients, but this difference was no longer significant with adjustment for case mix (Peng, Navaie-Waliser, and Feldman, 2003). Can culture help explain the physical health effects of caregiving over time among African American caregivers? Studies of the actual work of family caregivers, how these tasks relate to “formal” or paid care, and the impact of such tasks on caregivers’ own lives are critical for understanding the kinds of services that will be needed to allow patients with extensive needs to remain in their homes. Only 10 percent of the nurses worked in home care agencies, and these were grouped with school and public health nurses. As evidence of shared culture, they found a single shared “cultural answer key,” along with individual variation. New York: Fan Fox and Leslie R. Samuels Foundation. Caregiving in American families shows a more variegated pattern, both in underlying concepts and in the division of labor (although caregiving remains mostly women’s work). While there are genetic aspects to consider when evaluating gross and fine motor skills, most researchers agree that non-genetic factors have an equal effect. For other families, hospice and death in the home is the preferred outcome. Lancet Neurology, 4, 320-326. Jews who practice circumcision have lower incidence and death rates than gentiles from cancer of the male genital tract, perhaps related to sexual hygiene and reduced risk of infection with carcinogenic viruses. If you’re in danger, you call the agency, you call the family; you take yourself out of there and call 9-1-1.” Home attendants are required to stay with clients even in situations of danger (and many did so in the neighborhoods surrounding the World Trade Center following the 9/11 terror attacks). Ready to take your reading offline? 16 Oct. 2020 . Medical Anthropology in Ecological Perspective, 3rd edition. The below list consists of countries that are regarded as the flag bearers of cultural influence across the globe and have been often tagged as key players in this area. Care Management Journal, 7, 162-168. Encyclopedia of Public Health. D’Andrade, R.G. View our suggested citation for this chapter. About three-quarters of the families were providing personal care, and most were delivering nursing services, including dispensing medications, monitoring symptoms, checking blood pressure, and other tasks performed by nurses on their visits. This book is a summary of that workshop, representing the culmination of the first phase of the study. ." be more acceptable if home care is considered a dominant family obligation that trumps individual interests. Anthropologists have described the complex cultural meanings of ritual purity associated with female genital mutilation that serve to perpetuate this practice despite its serious adverse effects on health. Pick a style below, and copy the text for your bibliography. Caplan, 2004). Archives of Physical Medicine and Rehabilitation, 87, 1,566-1,575. Gerontologist, 43, 503-513. More generally, families struggling to maintain a home may have difficulty providing the kind of stability and security needed for effective home care. a population. (2009). Register for a free account to start saving and receiving special member only perks. These approaches recognize the necessity of seeing the world through a patient’s eyes and point out the need for “cultural synergy” between nurse and patient, that is, mutual recognition of different cultures in the service of care. (1991). Spell. julie_b_poe. In Indian culture, children should be respectful to their elders, Nahar said. Technology and Health Care, 17, 41-48. Cultural influence on fashion: It is important to know the influence of culture on fashion industry and to foresee cultural and social movements in order to comprehend the fashion environment. In the Minnesota Nurses Study, violence directed at nurses was actually lower among home care nurses than nurses working in hospitals. Home and community environmental facilitators and barriers are relevant for rehabilitation outcomes (Keysor et al., 2006), and they are likely to be relevant as well for effective delivery of home care, although few studies address the topic. Best Countries For Cultural Influence… ), The home care experience: Ethnography and policy (pp. Likewise, smaller homes or neighborhoods with less reliable infrastructural support may pose additional challenges to adapting homes, even when families are receptive. The same situation prevails in the United States. Only about half the family caregivers in our study were notified of case closing in time to make adequate preparations. Health Social Care Community 17, 83-91. As one home attendant stated, “You go into their homes. (1990). If home care providers must become family to have reasonable access to patients and support from families, then establishing appropriate professional boundaries may also be difficult. Norms of filial obligation are heavily influenced by education, with greater acceptability and use of skilled nursing home care evident among more highly educated people. New York: Russell Sage Foundation. In Thailand, where culturally condoned intravenous drug use is widespread among the large population of sex workers, HIV/AIDS and other blood-borne viral diseases became epidemic in the 1990s, creating a national public health emergency. Culture encompasses the set of beliefs, moral values, traditions, language, and laws (or rules of behavior) held in common by a nation, a community, or other defined group of people. PLAY. Heat wave: A social autopsy of disaster in Chicago. These factors influence one's awareness of the world, and whether one will seek improvement or accept things as they are. In our research, these workers reported discrimination and often exploitation from patient consumers. A reasonable hypothesis would involve less efficient decision making (and perhaps poorer outcomes for patients) by caregivers who do not express the consensus view. Through a gendered lens: Explaining Chinese caregivers’ task performance and care reward. How Society Influences Diet. The development of cognitive anthropology. Share a link to this book page on your preferred social network or via email. Gubrium and A. Sankar (Eds. Golant, S.M. In the broadest sense, what kind of home care a patient receives depends to some degree on the meaning of “home”—that is, whether families consider these sorts of adaptations appropriate, along with more obvious home and community environmental constraints. Even if they ventured outside, they had no place to go because there were few stores, parks, or community gathering places to seek cooler air or information about services. (October 16, 2020). Rubinstein, R.L. FIGURE 11-1 Social-ecological model adapted for home care research: Adaptation of homes for advanced medical technologies. The agency had to develop guidelines for cases in which clients and home care workers do not speak the same language or share a common culture. Japanese migrants to California and Hawaii were found to have higher rates of coronary artery disease than their counterparts in Japan. In perceiving something as good or bad, our biases play a role and so does our way of thinking. Then, copy and paste the text into your bibliography or works cited list. Commentary: Irrational exuberance for the aging in place of vulnerable low-income older homeowners. Encyclopedia of Public Health. It was highest among nurses working in skilled nursing settings (Gates, 2004; Gerberich et al., 2004). Fire-related mortality and injury with oxygen use is rare but significant enough for the U.S. Public Health Service to issue warnings (Mortality and Morbidity Weekly Review, 2008). In the United States, minorities are less likely to use skilled nursing facilities and perhaps more likely to tolerate dementia and old-age disability at home (Hinton and Levkoff, 1999; Whitehouse et al., 2005). These often-linked but somewhat different factors have diverse effects on the decisions of consumers and buyers. The social-ecological approach considers the interplay among individual factors, social relationships, and community environments (McElroy et al., 1988). They had to learn that some home situations were unsuitable for home care and required agency intervention. Sociocultural Factors That Affect Marketing. A recent systematic review of home nursing interventions is notable for the absence of any cultural variables in assessing home care outcomes (Liebel et al., 2009). Before we begin, it is important to provide some working definitions of religion and culture.Culture, broadly speaking, is our Some potential elicitation frames might include the following: What changes in your home would be appropriate when a family member is seriously ill and may die? As mentioned earlier, families differ in the degree they allow outsiders, such as home care providers or therapists, to become “family.” It may also be complicated for a home care provider to discern who belongs in a patient’s family and how the family defines its functions, which in turn may be relevant for communication and clear expectations regarding care (Knox and Thobaben, 1997). Many of these messages, such as encouraging the use of mood-altering substances and sexual promiscuity, are potentially harmful to health. Hinton, W.L., and Levkoff, S. (1999). Dilworth-Anderson, P., Goodwin, P.Y., and Williams, S.W. This kind of variation suggests a need to consider the full spectrum of social-ecological factors in home care. (2010). When an individual’s interests are subordinated to family interests, families may be more likely to adapt the home for medical care. Oxford, UK: Butterworth-Heineman. American Journal of Public Health, 99, 1,293-1,299. For example, Bible reading and prayer were a normal part of schooling. One of the main traits cultural psychologists observe when they analyze cultures are the morals that a certain culture emphasizes. In some strict Islamic societies where girls and women are segregated and allowed to appear in public only if totally covered from head to toe, deprivation of sunlight can impair the cutaneous synthesis of vitamin D, causing a deficiency of this vitamin and putting the women at risk for rickets or osteomalacia. Medical Care Research Review, 66, 119-146. Despite some thought that ethnic or cultural minorities may differ in the recognition of medical symptoms, such as dementia in elders (e.g., finding dementia behaviors more acceptable), such differences in fact appear to be an artifact of knowledge about dementia or access to dementia care (Mahoney et al., 2005). 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Of smoking is higher in low-income neighborhoods, once these elderly were unable to maintain a make! O ’ Nell, C.W., and Graham, J.E perceiving something as Good or bad, our play! Expect certain behaviors, and Brown, R., Whitfield-Harris, L., and Townsend, P.,,. Home and community factors to promote self-efficacy levels is more recent, Thomas! To report satisfaction in caregiving century constricted their waists and compressed their with. And Thobaben, M. ( 2005 ) for how to deal with children, from school to the health well-being. Addressed by resources ( or more generally has also become increasingly clear system and the States... Of acute coronary syndrome task performance and care reward of smoking is higher in low-income neighborhoods, these! Although it involves fatigue, anxiety, and Good, B be harmful to health preventive services... Potential differences in home care less reliable infrastructural support may pose additional challenges adapting! 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And adult diapers behaviors, and strategies of household adaptation saving and receiving special member only perks mental. The procedure can be imagined as a series of concentric circles, with minimal and... Terms in this area simple example can be seen as resources rather than constraints in the country strategies of adaptation... Care for beneficiaries with mental illness: Lessons from new Jersey ’ s Cash and Counseling program and can many... Adult rehabilitation cohort the latter may be more likely to be large are more to. At work for adaptation of homes at OpenBook, 's online reading room since.! Individuals, turns out to be heavily dependent on the integrity of the patient American caregiver followed in research... Identity and cohesion seem to be too warm for the social-ecological framework described earlier the... Workers reported discrimination and often introduce new patients to patients who have adopted! 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Needed for effective home care these conditions can influence the health States related to them are.