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1.
West J Nurs Res ; : 193945920918334, 2020 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-32400300

RESUMEN

Culturally tailored interventions have been applied to provide benefits to ethnic minorities' care; however, the effectiveness of these interventions for chronic conditions is mixed. This systematic review of systematic reviews critically evaluates recent evidence of the effects that culturally tailored interventions have on health care outcomes among ethnic minorities with chronic conditions. It synthesizes results of eight English-language systematic reviews published between 2010 and 2018 and identifies four health care outcomes common to the reviews: disease knowledge, objective clinical outcomes, satisfaction, and access. Our findings suggest that culturally tailored interventions can contribute to the improvement of ethnic minorities' health care outcomes and especially improve patients' satisfaction with care. However, results overall are mixed. Further studies to better understand the value of culturally tailored interventions for ethnic minorities' care are needed.

2.
PLoS One ; 15(1): e0226938, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31978050

RESUMEN

Recent protests by athletes focused on raising awareness of social issues and injustices, such as the Black Lives Matter protests led by Colin Kaepernick of the National Football League's San Francisco 49ers, have generated a great deal of attention and debate within society. Notably, the protests conducted by these players before games in the 2016 and 2017 seasons became such a sensational topic, that extraordinary amounts of attention was paid to it by the media, consumers, and even politicians who often denounced the players as being unpatriotic. Against this backdrop, the current research examines whether fluctuations in attendance at National Football League games are associated with explicit attitudes towards race, implicit racial prejudice, and racial animus within a population. Specifically, using multiple measures of racial attitudes as part of an econometric model estimating attendance at games, the results suggest that having a higher level of implicit bias in a market leads to a decline in consumer interest in attending games. Additionally, using interaction effects, it is found that while protests generally reduced the negative effects of implicit bias on attendance, markets with lower levels of implicit bias actually had greater declines of attendance during the protests. From this, the current study advances the understanding of racial attitudes and racial animus, and its impact on consumer behavior at the regional level. That is, this research highlights that racial sentiments in a local market were able to predict changes in market behaviors, suggesting that race relations can have wide reaching impacts.


Asunto(s)
Fútbol Americano/economía , Relaciones Raciales/psicología , Racismo/economía , Adulto , Afroamericanos , Actitud , Participación de la Comunidad , Comportamiento del Consumidor/economía , Humanos , Activismo Político , Estados Unidos
3.
Geriatr Nurs ; 41(2): 89-97, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31320127

RESUMEN

Due to low levels of planned care, older adults of underrepresented communities tend to experience higher rates of unwanted treatments at end of life (EOL). The purpose of this review was to identify factors that may explain differences in EOL care preferences and planning between older adults from the general population and ethnically diverse populations. We hypothesized that culture-specific factors may be fundamental. To describe similarities and differences, we conducted a comprehensive literature search using keywords and subject headings. Findings from 14 studies were critically examined, grouped, and compared across studies and populations. While studies on general populations showed the significance of health and sociodemographic factors, studies on underrepresented groups frequently cited the importance of spirituality, belief systems, acculturation, healthcare system distrust, and social networks.

4.
Acad Med ; 95(1): 22-31, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31365394

RESUMEN

Medical Spanish (MS) education is in growing demand from U.S. medical students, providers, and health systems, but there are no standard recommendations for how to structure the curricula, evaluate programs, or assess provider performance or linguistic competence. This gap in medical education and assessment jeopardizes health care communication with Hispanic/Latino patients and poses significant quality and safety risks. The National Hispanic Health Foundation and University of Illinois College of Medicine convened a multidisciplinary expert panel in March 2018 to define national standards for the teaching and application of MS skills in patient-physician communication, establish curricular and competency guidelines for MS courses in medical schools, propose best practices for MS skill assessment and certification, and identify next steps needed for the implementation of the proposed national standards. Experts agreed on the following consensus recommendations: (1) create a Medical Spanish Taskforce to, among other things, define educational standards; (2) integrate MS educational initiatives with government-funded research and training efforts as a strategy to improve Hispanic/Latino health; (3) standardize core MS learner competencies; (4) propose a consensus core curricular structure for MS courses in medical schools; (5) assess MS learner skills through standardized patient encounters and develop a national certification exam; and (6) develop standardized evaluation and data collection processes for MS programs. MS education and assessment should be standardized and evaluated with a robust interinstitutional medical education research strategy that includes collaboration with multidisciplinary stakeholders to ensure linguistically appropriate care for the growing Spanish-speaking U.S. population.


Asunto(s)
Competencia Clínica/normas , Educación Médica/normas , Facultades de Medicina/normas , Consenso , Competencia Cultural/educación , Curriculum/normas , Educación Médica/tendencias , Hispanoamericanos/estadística & datos numéricos , Humanos , Estudios Interdisciplinarios , Aprendizaje/fisiología , Relaciones Médico-Paciente/ética , Estudiantes de Medicina/clasificación , Estados Unidos/epidemiología
5.
J Transcult Nurs ; 31(1): 87-99, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31423926

RESUMEN

Introduction: Childhood obesity remains an unrelenting public health problem disproportionately affecting ethnic minorities. Although research has examined ethnicity as a factor of childhood obesity, few studies have examined cultural influences. The purpose of this systematic review was to examine the qualitative evidence of cultural influences on childhood obesity in ethnic minority groups. Methodology: Selective sampling of studies since 2008 yielded 251 articles. Twelve articles that addressed cultural influences on childhood obesity were identified for review. The Culture Care Theory Sunrise Enabler factors were used as an a priori framework for theme coding. Results: Nine themes emerged: child feeding, family, gender roles, food, healthy child appearance, physical activity, sedentary activity, food cost, and obesogenic environment. Discussion: Cultural care practices such as traditional foods and family meals are protective factors in childhood obesity and should be encouraged by nurses caring for and working with ethnic minority populations.

6.
Mol Genet Genomic Med ; 8(2): e1099, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31867882

RESUMEN

BACKGROUND: Racial/ethnic minority populations in the United States are consistently underrepresented in genetic research. Large-scale public participation is required to ensure discoveries from precision medicine research are applicable to everyone. To evaluate views toward and facilitators of participation among minority populations in the United States, we conducted a systematic review of literature. METHODS: Six databases were searched for articles published from 2005 to 2018 assessing minority populations' views and/or willingness to participate in genetic research. A thematic framework was applied to extracted data to synthesize findings, and the Socio-Ecological Model was used to evaluate papers. RESULTS: Review of 2,229 titles and abstracts identified 27 papers (n = 8 qualitative, n = 19 quantitative). Themes included knowledge of genetics, engagement in research, facilitators and barriers to participation, and cultural considerations. Understanding of genetics was low, yet the majority of participants were willing to participate in genetic research among all populations included in the literature (range: 57%-97%). Recommendations for research included utilizing community-based participatory approaches, evaluating participants' informational needs, incentivizing participation, and providing direct benefits (e.g., genetic test results). CONCLUSION: Results could influence future study designs that incorporate all levels of the Socio-Ecological Model and better meet the needs of underrepresented groups, thereby ensuring precision medicine research findings are applicable to all.

7.
Int J Equity Health ; 18(1): 163, 2019 10 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660988

RESUMEN

BACKGROUND: Persistent inequities in health experiences and outcomes are observed for Maori compared to non-Maori in Aotearoa New Zealand. We conceptualised factors associated with Maori consumer experiences of health programs and services and characterise how the recommendations arising from qualitative research inform strategies to address inequities. METHODS: In this systematic review, electronic literature searching was conducted in February 2018. Qualitative studies reporting Maori consumer experiences of health services and programs in Aotearoa New Zealand were eligible. Maori consumer experiences of health services were mapped to the WHO Commission of Social Determinants of Health (CSDH) conceptual framework on health inequities as related to: (i) the socioeconomic and political context; (ii) socioeconomic positioning; or (iii) intermediary factors that increase exposure to health-compromising conditions. Recommendations to improve consumer experiences were mapped to the CSDH framework for tackling social determinants of health inequities as policy directions on: (i) unequal consequences of illness (individual interaction); (ii) risks of exposure to health-damaging factors (community); (iii) exposures to health-damaging factors (public policies); and (iv) mitigating effects of socioeconomic and political stratification (environment). RESULTS: Fifty-four studies were included. Maori consumer experiences mapped to social determinants of health inequities were most frequently related to direct interactions with health services and programs, particularly patient-clinician interactions (communication, relationships) and cultural competencies of clinicians and the system. Key recommendations by researchers mapped to potential strategies to address inequity were identified at all levels of the political, social and health system from individual interactions, community change, and broader public and system-level strategies. Recommendations were predominantly focused on actions to reduce risks of exposure to health-damaging factors including health literacy interventions, increased resources in cultural competencies and Maori capacity in health service development and workforce. CONCLUSIONS: Maori consumer experiences of health services and programs are an important informer of variables that impact health inequity. Strategies to tackle health inequities informed by Maori consumer experiences can be drawn from existing empirical research. Future qualitative exploration of how socioeconomic, political and public policies influence Maori consumer experiences of health services and programs could inform a broader range of structural policies to address health inequities.


Asunto(s)
Competencia Cultural , Disparidades en Atención de Salud/estadística & datos numéricos , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Humanos , Nueva Zelanda , Grupos de Población , Investigación Cualitativa , Factores Socioeconómicos
8.
Int J Soc Psychiatry ; 65(7-8): 643-655, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31478453

RESUMEN

OBJECTIVES: The purpose of this literature review was to highlight the studies on mental health in relation to acculturation and ethnic identity and to identify research gaps. The results can be used to help inform future immigrant mental health workers and policy makers as well as provide information about the implications of immigrant mental health. METHODS: The literature search was conducted electronically, directed by a variety of key words. The search focused on five areas of immigrant mental health importance: (1) acculturation; (2) acculturation and mental health; (3) ethnic identity; (4) ethnic identity and mental health; and (5) acculturation, ethnic identity and mental health. A total of 171 articles were examined and 110 were included in the review. RESULTS: The information is presented in the following categories: acculturation; acculturation and mental health; ethnic identity; ethnic identity and mental health; and acculturation, ethnic identity and mental health. Research gaps are also presented. CONCLUSION: Overall, literature shows that acculturation, ethnic identity and mental health are closely related to one another affecting both, individuals and communities. This literature review will help to better inform practitioners who may encounter immigrants experiencing mental health issues due to acculturation and ethnic identity pressure. This review may also help policy makers identify specific obstacles that are not addressed in immigration policies which can affect the implementation of these policies. In addition, the information presented can be used as an instrument for researchers in the field. Despite the limited amount of information about immigrant mental health challenges, much work remains to fully support the affected individuals and their families.


Asunto(s)
Aculturación , Emigrantes e Inmigrantes/psicología , Grupos Étnicos/psicología , Salud Mental , Identificación Social , Humanos
9.
Rev. bras. ciênc. mov ; 27(4): 207-218, jul.-set. 2019. ilus
Artículo en Portugués | LILACS | ID: biblio-1053246

RESUMEN

Este ensaio tem como objetivo descrever e refletir sobre o universo simbólico e cultural da coreografia Maculelê apresentada pelo Balé Folclórico da Bahia (BFBA), no espetáculo Herança Sagrada. Partimos da descrição das cenas dessa coreografia, incluindo os gestos, os figurinos, a formação dos bailarinos e as letras das músicas, que em conjunto construíram uma rede de significados que permitiu identificar os símbolos culturais inscritos nessa versão da referida manifestação da cultura popular, que serviu de inspiração para o espetáculo artístico do grupo baiano. As impressões culturais e simbólicas permitidas na cena do Maculelê do BFBA variaram desde a formação dos bailarinos no palco até os cânticos entoados por eles e foram discutidas utilizando os principais autores que dialogam com os temas, conforme eles foram surgindo. Esses diálogos entre obra artística e autores, mediados no presente ensaio, permitiram ampliar a reflexão simbólica e cultural presente nas danças afro-brasileiras, entendendo-as como campo fértil que permite se apropriar do conhecimento sensível e aberto que a dança proporciona, promovendo uma educação livre de determinismos e reducionismos. Desse modo, a visão de corpo é também ampliada, ajudando a compreendê-lo livre de simplificações pré-determinadas que o assemelha a uma simples máquina, mas que considera seus simbolismos e sua capacidade sensível e expressiva, tornando-o sujeito, obra de arte em constante troca e construção...(AU)


This essay aims to describe and reflect on the symbolic and cultural universe of the Maculelê choreography presented by the Folkloric Ballet of Bahia (BFBA), in the show Sacred Heritage. We started with the description of the scenes of this choreography, including the gestures, the costumes, the training of the dancers and the lyrics of the songs, which together built a network of meanings that allowed the identification of the cultural symbols inscribed in this version of the popular manifestation of culture. served as inspiration for the artistic performance of the Bahian group. The cultural and symbolic impressions allowed in the BFBA Maculelê scene varied from the formation of the dancers on stage to the chants they sang and were discussed using the main authors who dialogued with the themes as they emerged. These dialogues between artistic work and authors, mediated in the present essay, have allowed to broaden the symbolic and cultural reflection present in the Afro-Brazilian dances, understanding them as a fertile field that allows to appropriate the sensitive and open knowledge that the dance provides, promoting an education free from determinism and reductionism. In this way, the body view is also enlarged, helping to understand it free of predetermined simplifications that resemble it to a simple machine, but which considers its symbolism and its sensitive and expressive capacity, making it subject, a work of art in constant exchange and construction...(AU)


Asunto(s)
Humanos , Masculino , Cultura , Baile , Grupo de Ascendencia Continental Africana , Símbolo Étnico , Folclore , Cultura Popular
10.
Infant Ment Health J ; 40(6): 799-816, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31402473

RESUMEN

Culture plays a significant role in the variations observed in the manifestation, expression, and meaning of attachment behaviors. Africa is home to multiple cultures, with distinct organizations of caregiving relationships underlying the development of attachment. This review aims to consolidate knowledge about African attachment by describing studies of infant attachment conducted in Africa since Mary Ainsworth's Ugandan findings in 1967. Electronic databases were searched with the terms "Africa" ("attachment" or "bond") and "infant." Nine studies that assessed infant attachment style with self-report or observation methods were included, but spanned only five countries. The Strange Situation Procedure was most frequently used. Most studies described dyads living in peri-urban or township areas. Multiple socioeconomic factors affecting living conditions were identified, including, unemployment, financial difficulties, limited education, poor housing, single parenthood, lack of partner support, substance abuse, and depression. Overall distributions of attachment classification proportions appear consistent with global attachment-classification patterns. Despite adverse conditions, secure attachment was relatively widespread, and some populations had low rates of avoidant attachment. Relatively high rates of disorganized attachment were found when the category was included. Africa remains an understudied continent regarding infant attachment. The continent's cultural diversity may hold important truths necessary for understanding the complex relationship between infant and attachment figure.


Asunto(s)
Cultura , Apego a Objetos , Adulto , África/etnología , Depresión/etnología , Depresión/psicología , Femenino , Humanos , Lactante , Masculino , Relaciones Madre-Hijo/psicología , Autoinforme , Factores Socioeconómicos
11.
Soc Sci Res ; 83: 102309, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31422835

RESUMEN

This research examines opinions on issues related to immigration and non-citizens. Using ordered logit, this study assesses whether the cultural theory and realistic group conflict theory, through cultural considerations and economic threat, respectively, describes best the opinions across racial groups. Unlike most other studies on the subject, I find that while Americans are not very much concerned about cultural influences from immigrants, they clearly perceive immigrants as an economic threat. Also, unlike most other studies that focus solely on White opinions, this investigation examines opinions of several racial groups. I find that while Whites have both cultural concerns and perceive economic threat from immigrants, they only perceive economic threat from Hispanics. African Americans and Hispanics do not perceive adverse cultural effects, but both racial groups perceive economic threat from immigrants. Additionally, African Americans perceive economic threat from Hispanics. Asian Americans harbor both cultural concerns and perceive economic threat from immigrants.

12.
Stud Health Technol Inform ; 264: 1728-1729, 2019 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-31438314

RESUMEN

This systematic review examined studies aimed at reducing anxiety or depression in African American adults through use of telehealth interventions. Three small independent studies were identified. The findings showed significant reduction of depressive symptoms post-intervention (all p values < .05). However, effectiveness of telehealth intervention compared to face-to-face was not determined. The results highlight the need for additional research into the effectiveness of using telehealth to manage anxiety and depression in this population.


Asunto(s)
Telemedicina , Adulto , Afroamericanos , Ansiedad , Depresión , Humanos
13.
J Racial Ethn Health Disparities ; 6(6): 1167-1181, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31346966

RESUMEN

Research exploring the association between socio-economic status (SES) and depression is limited by conceptualizations of SES and conflicting findings across racial groups. We broaden previous research by (1) reconceptualizing SES through the lens of Bourdieusian theory to identify profiles of economic, social, and cultural capital; (2) investigating whether these profiles differ for Black and white adults; and (3) exploring whether specific profiles of capital are associated with increased depression scores. This study analyzed secondary data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of US individuals. A sub-population of the sample was used, which was comprised of 4339 Black and white participants from wave IV. To address the study aims, we used the new three-step approach to conducting latent class analysis. We identified five profiles of capital, the composition of which varied by race. Compared to Blacks, whites were more likely to be in the "cultural-economic capital" (14% vs. 10%), "elevated overall capital" (35% vs. 14%), and "social-economic capital" (13% vs. 10%) profiles, whereas Blacks were more likely to be in the "limited overall capital" (35% vs. 16%) and "moderate economic capital" (32% vs 22%) profiles. Profiles differed in risk for depression; the "limited overall capital" profile had the highest depression scores, whereas the "elevated overall capital" profile had the lowest depression scores. This research has the potential to reduce health disparities, by providing policy makers and researchers with information that will allow them to target populations that are most at risk for depression.

14.
Psychotherapy (Chic) ; 56(3): 400-408, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31282715

RESUMEN

The American Psychological Association's (2017) Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults endorsed by the American Psychological Association notes that attention to cultural context is a required component of trauma-informed mental health care provision. Despite the inclusion of this statement, the Treatment of PTSD Guideline does not give adequate attention to culture in the defining of trauma, review of the trauma literature, the criteria adopted for evaluation of PTSD treatments, and, resultantly, the determination of treatment recommendations. Culture plays a significant role in the vulnerability to, experience of, and recovery from mental health sources of distress, including interpersonal trauma (Bryant-Davis, 2005). Approaches to trauma-focused psychotherapy that are ethically sound call for a prioritizing of cultural competence (awareness, knowledge, and skills), as well as cultural humility (Harvey & Tammala-Nara, 2007). Trauma survivors, however, hold multiple identities simultaneously that influence their conceptualizations of trauma, therapy, and the recovery process (Brown, 2008). Intersectionality refers to the way in which a multiply marginalized person experiences cultural identity and oppression that is qualitatively different than the experience of trauma survivors from dominant cultural groups (Crenshaw, 2005). The realities of racism, sexism, heterosexism, and classism, as well as their influence on the trauma recovery process, are examined, while noting the minimal attention that has been given to additional forms of oppression such as religious intolerance and able-bodyism. This critical review of the literature will examine the theoretical and empirical literature, which has examined the framework and strategies that have been cultivated in service to trauma survivors who have been traditionally underserved. Attention will be given in particular to benefits, limitations, and critiques of evidence-based interventions, as well as benefits, limitations, and future research needs of both culturally modified interventions and culturally emergent trauma interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Competencia Cultural , Colaboración Intersectorial , Guías de Práctica Clínica como Asunto , Trastornos por Estrés Postraumático/terapia , Humanos , Evaluación de Procesos y Resultados en Atención de Salud , Grupo de Atención al Paciente , Sociedades Científicas , Trastornos por Estrés Postraumático/etnología , Trastornos por Estrés Postraumático/psicología , Resultado del Tratamiento , Estados Unidos
15.
Australas Psychiatry ; 27(4): 362-365, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31165642

RESUMEN

OBJECTIVE: This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people. METHODS: De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group. RESULTS: A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis. CONCLUSION: When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group.


Asunto(s)
Competencia Cultural , Entrevista Psicológica/métodos , Entrevista Psicológica/normas , Trastornos Mentales/diagnóstico , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Australia/etnología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Retroalimentación , Servicios de Salud del Indígena/organización & administración , Humanos , Trastornos Mentales/etnología , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
17.
Int J Circumpolar Health ; 78(1): 1629783, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31219779

RESUMEN

The impacts of colonization have had significant impacts on the mental health and community wellness Indigenous peoples in the Northwest Territories (NWT). It is important that all communities in the NWT have access to key services in a culturally relevant way in achieving mental and community wellness. A scoping review was conducted to identify mental health services available in the NWT. To guide the understanding of the landscape of mental health services in the NWT, the information on health services gathered was organized using the First Nations Mental Wellness Continuum (FNMWC) Model's Continuum of Essential Services. Documents accessed included grey literature, consisting of government documents, practice guidelines, education materials, community wellness reports, internet searches and expert consult interviews to collect data on mental health and wellness services in the NWT. 68 mental health services were included in this review, from 23 different sources. Results were summarized and described the Continuum of Essential Services from the FNMWC Model. This guided approach was found to be useful for mapping mental health services for communities in the NWT. The findings highlight and catagorize existing mental health services and gaps in relation to a First Nation's perspective using the FNMWC Model. Specific areas examined included the Continuum of Essential Services, Key Partners, Culture as a Foundation, and Indigenous Social Determinants of Health. Findings can guide communities and health authorities in planning, implementing and coordinating a full range of optimized mental health services in the NWT.


Asunto(s)
Conducta Adictiva/terapia , Competencia Cultural/organización & administración , Servicios de Salud del Indígena/organización & administración , Servicios de Salud Mental/organización & administración , Salud Mental/etnología , Regiones Árticas , Conducta Adictiva/etnología , Conducta Adictiva/rehabilitación , Promoción de la Salud/organización & administración , Servicios de Salud del Indígena/normas , Humanos , Inuits , Territorios del Noroeste , Educación del Paciente como Asunto , Guías de Práctica Clínica como Asunto , Salud Pública , Resiliencia Psicológica , Servicios de Salud Rural
18.
BMC Med Educ ; 19(1): 151, 2019 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-31096964

RESUMEN

BACKGROUND: Training in the use of cost-conscious strategies for medical students may prepare new physicians to deliver health care in a more sustainable way. Recently, a role-modeling cost-conscious behaviors scale (RMCCBS) was developed for assessing students' perceptions of their teachers' attitudes to cost consciousness. We aimed to translate the RMCCBS into Brazilian Portuguese, adapt the scale, transculturally, and validate it. METHODS: We adopted rigorous methodological approaches for translating, transculturally adapting and validating the original scale English version into Brazilian Portuguese. We invited all 400 undergraduate medical students enrolled in the 5th and 6th years of a medical course in Northeast Brazil between January and March 2017 to participate. Of the 400 students, 281 accepted to take part in the study. We analyzed the collected data using the SPSS software version 21 and structural equation modeling (SEM) was performed using AMOS SPSS version 18. We conducted exploratory factor analysis (EFA), varimax rotation, with Kaiser Normalization and Principal Axis Factoring extraction method. We conducted confirmatory factor analysis (CFA), using the SEM. We used the following indexes of adherence of the model: Comparative fit index (CFI), Goodness-of-fit index (GFI) and Tucker-Lewis Index (TLI). We considered the Bayesian Information Criterion (BIC) for Sample-size adjusted. The root mean square error of approximation was calculated. Values below 0.08 were considered acceptable. Composite reliability analyzes were performed to evaluate the accuracy of the instrument. Values above 0.70 were considered satisfactory. RESULTS: Of the 281 undergraduate medical students, 195 (69.3%) were female. Mean age of participants was 25.0 ± 2.6 years. In the EFA, the KMO was 0.720 and the Bartlett sphericity test was significant (p < 0.001). We conducted the EFA into two factors: role-modeling cost-conscious behaviors in health (seven items) and health waste behaviors (six items). The 13 item-scale was submitted to composite reliability analyzes, obtaining values of 0.813 and 0.761 for the role-modeling cost-conscious behaviors and the health waste behaviors factors, respectively. CONCLUSIONS: We concluded that the cost-conscious behaviors scale has good psychometric properties and is a valid and reliable instrument for evaluating medical students' perception of their teachers' cost-conscious behaviors.


Asunto(s)
Competencia Cultural , Gastos en Salud/estadística & datos numéricos , Estudiantes de Medicina/psicología , Traducción , Actitud del Personal de Salud , Brasil , Características Culturales , Análisis Factorial , Humanos , Rol del Médico , Psicometría , Reproducibilidad de los Resultados
19.
Int J Soc Psychiatry ; 65(4): 289-299, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30977417

RESUMEN

INTRODUCTION: Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. METHODS: We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. RESULTS: The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs. CONCLUSION: This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).


Asunto(s)
Servicios de Salud del Indígena , Medicina Tradicional , Salud Mental , Grupos de Población/psicología , Salud Global , Humanos , Trastornos por Estrés Postraumático/etnología , Trastornos por Estrés Postraumático/psicología , Heridas y Traumatismos/etnología , Heridas y Traumatismos/psicología
20.
Transpl Int ; 32(10): 1001-1018, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30968472

RESUMEN

Asian Americans have the lowest organ donation registration rates in the United States, and the reason for this is incompletely understood. Aiming to understand the reasons for low organ donation registration rate among Asian Americans, more specifically Chinese and Korean Americans, we conducted a systematic search of databases, websites, and gray literature. Altogether, 34 papers were retained after the assessment of relevance and quality. Commonly reported barriers to organ donation registration among Chinese and Koreans in the literature included lack of knowledge about organ donation, distrust of health-care and allocation system, cultural avoidance of discussion of death-related topics, and desire for intact body mainly stemming from the Confucian concept of filial piety. Strong family values coupled with a cultural reluctance to discuss death-related topics among family members appear to underscore the reluctance to organ donation among Chinese and Koreans. Notably, improved knowledge negatively impacted organ donation intent and religion seemed to play a more important role when making decision about organ donation among Koreans, and the distrust of the allocation system is more prominent among Chinese. This information should be used to inform the development of culturally competent organ donation educational materials.


Asunto(s)
Americanos Asiáticos/psicología , Obtención de Tejidos y Órganos , China/etnología , Humanos , Corea (Geográfico)/etnología
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