186. Multiculturalism

Question 1

Higher levels of acculturation and lower levels of perceived dis- crimination are associated with ___levels of trust in health care pro- viders.

Answer 1

higher

Question 2

Patients with limited English proficiency are more likely to have which issues in care? Name 3

Answer 2

defer needed health services, leave against medical advice, miss appointments, fail to adhere to treatment regimens, lack a regular provider, and report poor health status.

Limited English proficiency include risk of increased medication errors, decreases in understand- ing medical conditions, and misdiagnosis resulting from the lack of physician understanding of complaints or patients’ ability to effectively convey their symptoms.

Question 3

Name 3 Pitfalls in Language Communication Standards

Answer 3

• Use of family members, friends, or children
• Failure to translate documents such as consent forms and discharge
  instructions
• Lack of documentation of a patient’s need for an interpreter or English lan-
  guage limitations
• Lack of documentation of the use of an interpreter and background and
  qualifications of the interpreter

Question 4

National Association of the Deaf Communication Guidelines for Health Care Providers - list at last 4 guidelines

Answer 4

• Clearly identify at-risk individuals for poor communication.
• Provide visual medical aids.
• Providers who know basic sign language can be beneficial but be aware of
  limitations.
• Establish an effective communication policy for the office or institution.
• Provide qualified sign language interpreters.
• Ineffective methods of communication are discouraged, including lip-
  reading or written notes.
• Be aware of effective communication approaches and resources.
• Make health care providers and staff aware of relevant laws and mandates
  that provide equal access and communication for deaf patients.

Question 5

Which patient groups may be consisdered for specail accomodations and or bias checks in aprticular per Rosen’s chapers

Answer 5

communication and use of interpretor for those in which english is not their first language
hearing impaired
unhouse patients
undocumented patients
prisoners

Question 6

what is the difference between disease and illness?

Answer 6

Physicians are experts in diagnosis and treatment of disease, the abnormal structures or func- tions of the human body (the pathophysiology of disease states). Patients, on the other hand, experience illness, a subjective feeling state that is interpreted through the lens of culture and has a personal and social meaning.

Question 7

Name Six Principles for Cultural Competence Standards and Expectations

Answer 7

1. Community representation and feedback at all stages of implementation
2. Cultural competency integrated into all systems of the health care organi-
   zation, particularly quality improvement efforts
3. Ensuring that changes made are manageable, measurable, and sustainable
4. Making the business case for implementation of cultural competency poli-
   cies
5. Commitment from leadership
6. Staff training on an ongoing basis

Question 8

Which of the following factors has not been identified as a health care disparity for minorities?
a. High rates of no insurance or underinsurance
b. Lack of prenatal care
c. Likelihood of living in an area with adequate physician concen- tration
d. Lower life expectancy when compared to white populations
e. Relatively low number of minority providers

Answer 8

c

Question 9

Patients’ cultural perceptions can have a significant impact on how
they perceive their provider and the care they are receiving. Which of the following methods can be used by providers to approach dif- ferent cultural perceptions so as to enhance the provider-patient relationship?
a. Being aware of one’s own cultural values
b. Developing assumptions of cultural perceptions base on patients’
ethnicity or race
c. Limiting participation of alternative therapies and folk medicine
in the patient’s care plan
d. Maintaining the role of the physician as the decision maker, even
when it may conflict with the patient’s autonomy

Answer 9

a

Question 10

Which method of communicating is adequate to utilize with a deaf
or hard-of-hearing patient? a. Certifiedinterpreter
b. Family member
c. Lipreading
d. Written communication on notepad

Answer 10

a

Question 11

A helpful language translator can be essential in communication
with a patient who is facing a language barrier. Which of the below methods are recommended for using an interpreter during a medi- cal examination?
a. Asking the patient to have friends or family translate discharge
instructions for them
b. Only obtaining an interpreter if the patient requests one
c. Using a family member is appropriate as long as they are older
than 18 years
d. Using a trained medical interpreter
e. Using health care staff members who are fluent in the patient’s
language

Answer 11

d

Question 12

Which of the following organizations have suggested guidelines to
address cultural competence in educational standards? a. American Association of Medical Colleges
b. Liaison Committee on Medical Education
c. Accreditation Council on Graduate Education
d. All of the above

Answer 12

d