The relation between somatic symptoms and depression.
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Cross-Cultural Comparison↗
Biomedical subjects
J E Carrillo
Publications and source records attributed to J E Carrillo.
The challenges of cross-cultural healthcare--diversity, ethics, and the medical encounter.
Difficulties in the provider-patient relationship arise from many sources, and pose various challenges to the integrity of the medical encounter. When these issues are especially sensitive or important to the patient's health and well-being, a complete breakdown in the therapeutic relationship may result. The goal of the emerging field of cross-cultural healthcare is to improve providers' ability to understand, communicate with, and care for patients from diverse backgrounds. We should weave the concepts of cross-cultural care into the ethics of caring if we truly hope to have a positive impact on the health status of diverse patient populations.
Aged↗
Cross-cultural primary care: a patient-based approach.
In today's multicultural society, assuring quality health care for all persons requires that physicians understand how each patient's sociocultural background affects his or her health beliefs and behaviors. Cross-cultural curricula have been developed to address these issues but are not widely used in medical education. Many curricula take a categorical and potentially stereotypic approach to "cultural competence" that weds patients of certain cultures to a set of specific, unifying characteristics. In addition, curricula frequently overlook the importance of social factors on the cross-cultural encounter. This paper discusses a patient-based cross-cultural curriculum for residents and medical students that teaches a framework for analysis of the individual patient's social context and cultural health beliefs and behaviors. The curriculum consists of five thematic units taught in four 2-hour sessions. The goal is to help physicians avoid cultural generalizations while improving their ability to understand, communicate with, and care for patients from diverse backgrounds.
Adult↗
Hypertension in multicultural and minority populations: linking communication to compliance.
Cardiovascular disease disproportionately affects minority populations, in part because of multiple sociocultural factors that directly affect compliance with antihypertensive medication regimens. Compliance is a complex health behavior determined by a variety of socioeconomic, individual, familial, and cultural factors. In general, provider-patient communication has been shown to be linked to patient satisfaction, compliance, and health outcomes. In multicultural and minority populations, the issue of communication may play an even larger role because of linguistic and contextual barriers that preclude effective provider-patient communication. These factors may further limit compliance. The ESFT Model for Communication and Compliance is an individual, patient-based communication tool that allows for screening for barriers to compliance and illustrates strategies for interventions that might improve outcomes for all hypertensive patients.
Communication Barriers↗
The Cambridge Hospital Latino Health Clinic: a model for interagency integration of health services for Latinos at the provider level.
Latinos who present for health services often suffer from a complex interaction of medical and mental health needs, requiring a multifaceted intervention. An essential element of this multilevel approach is cultural and linguistic sensitivity on the part of health providers. New, innovative models of health service organization are needed to address the unique needs of the Latino population. Some of the key characteristics these models need to focus on include interagency collaboration rather than competition for resources, interdisciplinary teams of primary-care providers that also involve other nonmedical professional members, centralized case coordination and decentralized service delivery, flexibility and adaptability to changing priorities, continuity of care for all patients, and mutual support among providers to minimize the effects of stress and burnout.
Community Health Centers↗
Sociocultural factors associated with smoking behavior by Puerto Rican adolescents in Boston.
This study examined cigarette smoking among Puerto Rican adolescents in the Boston area in its sociocultural context by describing who uses cigarettes, and by identifying factors that encourage or discourage cigarette use. The study, conducted from 1986-87, used two approaches. The first was to survey 605 Puerto Rican households with adolescents 11-20 years old. Households were identified from a random sample of census blocks in five neighborhoods. In each household, interviews were completed with one adolescent and his or her female caretaker. The second approach was to conduct ethnographic interviews with 40 adolescents selected through a purposive sample of survey respondents from three of the study neighborhoods. Bivariate and multivariate statistical analyses were used to examine the relationships between smoking behavior and characteristics of the adolescents. The results of these analyses were examined in light of the ethnographic data. Overall, 13.7% reported smoking in the month preceding the interview. Smoking was most prevalent among males 17-20. Patterns of smoking were associated with teens' social networks. The Puerto Rican adolescents in this study were more likely to smoke when their friends and household members smoked, if they participated in recreational activities such as sports or unsupervised games, and if they were not in school. These effects varied according to the gender of the respondent.
Adolescent↗