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1.
Med Anthropol Q ; 37(3): 280-295, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37335932

RESUMO

Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about themselves and how clinicians responded to such narratives through an intervention known as the Cultural Formulation Interview that anthropologists have helped develop. We conducted over 500 hours of fieldwork from 2014 to 2019 at an outpatient clinic in New York, analyzing multiple data (participant observation, medical records, patient-clinician sessions, and individual debriefing interviews) in a trial joining clinical and ethnographic methods. Our study enrolled 45 patients and six clinicians, yielding 117 patient-clinician appointments and 98 debriefing interviews. Most patients differed in how they presented their identities through demographic forms and discussed them in sessions with their clinicians. Two-thirds of the patients drew connections between their personal identities and experiences of mental illness. These results reveal why cultural identities should not be taken for granted in clinical settings.


Assuntos
Antropologia Cultural , Competência Cultural , Humanos , Cidade de Nova Iorque , Antropologia Médica , Narração
2.
Community Ment Health J ; 53(6): 647-660, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27900495

RESUMO

Research collaboration in "real world" practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies. This study describes an initiative to integrate research into a hospital-based outpatient psychiatric clinic within an academic medical center, focusing on collaborative processes across three research projects. We report on the varied outcomes of the projects and utilize data from two focus groups to identify the key elements that contributed to the challenges and successes. We identify barriers to practice-research collaborations that emerged even when the initial circumstances of the partnership were favorable. These barriers include the presence of varied agendas across clinicians and investigators, resource constraints, limited staff buy-in, and staff turnover. In highlighting the lessons learned in this collaborative process, we hope to facilitate successful partnerships in other clinical settings.


Assuntos
Centros Médicos Acadêmicos , Pesquisa Biomédica/organização & administração , Relações Interinstitucionais , Ambulatório Hospitalar , Centros Médicos Acadêmicos/organização & administração , Atitude do Pessoal de Saúde , Pesquisa Biomédica/métodos , Pesquisa Participativa Baseada na Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade/organização & administração , Feminino , Grupos Focais , Humanos , Masculino , Cidade de Nova Iorque , Ambulatório Hospitalar/organização & administração , Unidade Hospitalar de Psiquiatria , Transtornos de Estresse Pós-Traumáticos/terapia
3.
J Cross Cult Gerontol ; 30(3): 305-18, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26208782

RESUMO

Older men are less likely than older women to receive depression treatment. Latino older men in particular have been found to have significantly lower rates of depression treatment than their white-non-Mexican (WNM) counterparts. Prior research has shown that men are less likely than women to express overt affect and/or report depression symptoms that may prompt primary care physicians' inquiry about depression. Previous studies have overlooked the idioms of distress common among older men. This study investigates: a) the range of idioms of distress that emerge in the narratives of depressed older men, and b) the use of these idioms among depressed WNM and Mexican-origin older men. The present report is based on qualitative data collected through the Men's Health and Aging Study (MeHAS), a mixed-method study of clinically depressed WNM and Mexican-origin older (65 and above) men recruited in primary care settings. Qualitative analysis of 77 interviews led to identification of idioms of distress and informed idiom categories. Study findings show that: a) both groups of men utilized a range of idioms of distress that met current DSM criteria for depression, b) both groups were also likely to utilize idioms that feel outside clinical depression criteria, and c) there were similarities as well as differences between WNM and Mexican-origin men. This study provides a larger vocabulary that clinicians might consider in recognizing depression and initiating depression care for older men from diverse ethnic backgrounds. This is important to improve depression care among older men in general and those of Mexican-origin in particular.


Assuntos
Comunicação , Depressão/etnologia , Depressão/psicologia , Americanos Mexicanos/psicologia , População Branca/psicologia , Idoso , Envelhecimento , California , Humanos , Entrevistas como Assunto , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Narração , Pesquisa Qualitativa , Inquéritos e Questionários , População Branca/estatística & dados numéricos
4.
Qual Health Res ; 24(8): 1126-1137, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24966198

RESUMO

People living with serious mental illness (SMI) have shorter life expectancies than the general population. We examined how contextual factors influence the physical health of this population. We conducted interviews, focus groups, and participant observations with stakeholders from six behavioral health organizations. We found that consumers' avoidance of overt disagreement during medical visits, their mistrust of medical institutions, and cultural variations in body image influenced the clinical encounter. Mental health providers' ambivalence about intervening in consumers' physical health, primary care providers' misattribution of physical symptoms to mental disorders, and providers' stigmatization of consumers shaped clinical encounters. Consumers' diets were shaped by food environments and social norms associated with traditional diets. Internal and external factors impacted consumers' physical activity. In this article, we illustrate the importance of considering contextual factors in the development and implementation of interventions aimed at improving the physical health of people with SMI.

5.
J Trauma Stress ; 24(6): 635-42, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22144133

RESUMO

Trauma has been understudied among Latina immigrants from Central and South America. This study examined the types and context of trauma exposure experienced by immigrant women from Central America, South America, and Mexico living in the United States. Twenty-eight women seeking care in primary care or social service settings completed life history interviews. The majority of the women reported some type of trauma exposure in their countries of origin, during immigration, and/or in the United States. In the interviews, we identified types of trauma important to the experience of these immigrants that are not queried by trauma assessments typically used in the United States. We also identified factors that are likely to amplify the impact of trauma exposure. The study highlights the importance of utilizing a contextualized approach when assessing trauma exposure among immigrant women.


Assuntos
Emigrantes e Imigrantes/psicologia , Ferimentos e Lesões/etnologia , Ferimentos e Lesões/psicologia , Adolescente , Adulto , Idoso , América Central/etnologia , District of Columbia , Feminino , Humanos , Entrevistas como Assunto , México/etnologia , Pessoa de Meia-Idade , América do Sul/etnologia , Adulto Jovem
6.
Cultur Divers Ethnic Minor Psychol ; 16(2): 215-25, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20438160

RESUMO

Poor antidepressant adherence is a significant issue in depression treatment that adversely affects treatment outcomes. Although being a common problem, it tends to be more common among Latinos. To address this problem, the current study adapted a Motivational Interviewing (MI) intervention to improve adherence among Latinos with depression. The adaptation process included six focus groups that elicited participants' perspectives (N = 30), applying the intervention with test cases (N = 7) to fine-tune the intervention, and eliciting feedback on the intervention (N = 5). The findings generated from these adaptation phases are described, along with a case example. Examples of adaptations to the MI included reframing antidepressant adherence as a way to luchar (struggle) against problems, focusing on motivation for improving depression and not just medication, refining methods for imparting antidepressant information, and inclusion of personalized visual feedback on dose-taking. The findings provide a description of the antidepressant issues experienced by a group of Latinos, as well as considerations for applying MI with this population. The intervention remained grounded in MI principles, but was contextualized for this Latino group.


Assuntos
Adaptação Psicológica , Antidepressivos/uso terapêutico , Atitude Frente a Saúde/etnologia , Comportamento Cooperativo , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/etnologia , Promoção da Saúde , Hispânico ou Latino/estatística & dados numéricos , Entrevistas como Assunto , Motivação , Cooperação do Paciente/etnologia , Adulto , Cultura , Feminino , Humanos , Masculino , Projetos Piloto
7.
Cult Med Psychiatry ; 34(2): 219-43, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20414799

RESUMO

Past research on idioms of distress among U.S. Latinos has revealed that ataque de nervios and altered perceptions, such as hearing and seeing things when alone, are independent markers of higher morbidity and mental health utilization despite having no one-to-one relationships with any single psychiatric diagnosis. It has been proposed that the idioms exert this effect because they are signs of distressing dissociative capacity associated with traumatic exposure. This study examines the relationships in an ethnically diverse Latino psychiatric outpatient sample (N = 230) among interpersonal trauma, posttraumatic stress disorder (PTSD), major depressive disorder, dissociative capacity and four cultural idioms of distress associated with the popular overall category of nervios. We particularly explore how these relationships change with varied measures of traumatic exposure, including trauma severity and timing or persistence of trauma. A series of adjusted bivariate regressions assessed the matrix of associations between the idioms and the clinical variables. In this highly traumatized population, we identified a strong 'nexus' of associations between dissociation and three of the idioms: currently being ill with nerves, ataque de nervios and altered perceptions. These idioms were largely independent from PTSD and depression and were associated with trauma persistence and severity. A fourth idiom, being nervous since childhood, was not associated with any other variable and may represent a personality trait rather than a diagnosable condition. Our results validate the clinical utility of the construct of nervios as a set of specific idioms associated with dissociation that are useful markers of mental health need among Latinos independently of their association with clinical diagnoses.


Assuntos
Assistência Ambulatorial , Comparação Transcultural , Transtorno Depressivo Maior/etnologia , Transtornos Dissociativos/etnologia , Hispânico ou Latino/psicologia , Transtornos Mentais/etnologia , Transtornos Psicóticos/etnologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Transtornos de Estresse Traumático/etnologia , Adulto , Delusões/etnologia , Delusões/psicologia , Transtorno Depressivo Maior/psicologia , Transtornos Dissociativos/psicologia , Feminino , Alucinações/etnologia , Alucinações/psicologia , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos da Percepção/etnologia , Transtornos da Percepção/psicologia , Transtornos Psicóticos/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Traumático/psicologia
8.
J Nerv Ment Dis ; 197(12): 923-9, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20010029

RESUMO

Among Latino adults and children, ataques de nervios has been associated with an array of psychiatric disorders. Using data from a probability sample of Puerto Rican children, aged 5 to 13 years (N = 2491), we assessed the lifetime prevalence and psychiatric correlates of ataques in youth residing in the South Bronx, New York and San Juan, Puerto Rico. Baseline site comparisons indicated that between 4% and 5% of children had a lifetime prevalence of ataques (either by child or parent report) and that ataques were associated with greater global impairment and a host of childhood disorders within the previous twelve months. Ataques were also correlated with greater exposure to violence, as well as more stressful life events for the South Bronx sample. After controlling for several covariates, ataques continued to be significantly associated with psychopathology. Ataques are, therefore, a significant correlate of global impairment and childhood psychopathology among Puerto Rican youth.


Assuntos
Hispânico ou Latino/psicologia , Transtornos Mentais/etnologia , Adolescente , Criança , Pré-Escolar , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Cidade de Nova Iorque/epidemiologia , Pais , Prevalência , Porto Rico/epidemiologia , Estresse Psicológico/etnologia , Violência/psicologia
9.
J Nerv Ment Dis ; 197(5): 337-47, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19440107

RESUMO

In US regional studies, Latinos frequently endorse psychotic symptoms associated with impairment and mental health service use, yet do not meet criteria for psychotic disorder. Using a nationally representative Latino sample (N = 2554), we examined the prevalence of psychotic symptoms, their relationship to psychotic disorder, their correlates, and their relationship to mental health outcomes. In this sample, 9.5% (SE = 0.7) endorsed 1 or more lifetime psychotic symptoms, yet 93% of endorsers did not meet Structured Clinical Interview for DSM-IV criteria for psychotic disorders. Endorsement was associated with physical and emotional distress, particularly lifetime anxiety and current substance use disorder. Acculturation to US society and reliance on spiritual/religious help were also associated with psychotic symptom endorsement. These symptoms have substantial clinical significance, being independently associated with suicidal ideation, mental health-related disability, and outpatient mental health service utilization. Endorsed psychotic symptoms in Latinos may constitute a clinically significant marker of general psychiatric vulnerability rather than a sign of psychotic disorder.


Assuntos
Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Psicóticos/psicologia , Índice de Gravidade de Doença , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
10.
Rev Lat Am Enfermagem ; 27: e3135, 2019 Apr 29.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31038629

RESUMO

OBJECTIVES: this case-control study compared levels of stress and allostatic load (AL) among Mexican women in the US ( n =19) and Mexico ( n = 40). METHOD: measures of stress included the Perceived Stress Scale (PSS) and the Hispanic Women's Social Stressor Scale (HWSSS). A composite measure of 8 indicators of AL (systolic and diastolic blood pressure, body mass index (BMI), waist-to-hip ratio, total cholesterol, glycated hemoglobin (hemoglobin A1C), triglycerides and C-reactive protein) was calculated. RESULTS: there were no significant group differences in AL between Mexican and Mexican immigrant women ( t = 1.55, p = .126). A principal component factor analysis was conducted on the 8 AL indicators; a 2-factor solution explained 57% of the variance. Group differences in the two AL factors were analyzed using MANOVA. BMI and waist-to-hip ratios were lower, but blood pressure and triglycerides were higher in the US group and were mediated by time in the US. Greater acculturation stress was significantly related to increased waist-to-hip ratio ( r = .57, p = .02). FINAL REMARKS: findings suggest some measures of AL increased with time in the US, and acculturation stress may be a significant factor.


Assuntos
Aculturação , Alostase , Estresse Psicológico/psicologia , Análise de Variância , Biomarcadores/análise , Pressão Sanguínea , Índice de Massa Corporal , Proteína C-Reativa/análise , Estudos de Casos e Controles , Emigrantes e Imigrantes , Feminino , Hispânico ou Latino , Humanos , México , Escalas de Graduação Psiquiátrica , Estresse Psicológico/etnologia , Triglicerídeos/sangue , Estados Unidos
11.
Am J Epidemiol ; 168(3): 345-52, 2008 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-18550562

RESUMO

To evaluate the prevalence of mental disorders for persons of non-English-language origin, it is essential to use translated diagnostic interviews. The equivalence of translated surveys is rarely tested formally. In the National Latino and Asian American Study (NLAAS), the authors tested whether a carefully translated mental health survey administered in Spanish produced results equivalent to those obtained by the original English version, using a randomized survey experiment. The NLAAS is a nationally representative survey carried out in the United States in 2002-2003. Bilingual respondents from the Latino section of the NLAAS (n = 332) were randomly assigned to receive either a Spanish- or English-language version of the World Mental Health Survey Composite International Diagnostic Interview. In tests of differences in lifetime and 12-month prevalences of 11 diagnoses and four higher-order aggregate disorder categories, in only one case was there an apparent difference between randomized language groups: Lifetime reports of generalized anxiety disorder were more prevalent in the bilingual group assigned to English than in the group interviewed in Spanish. Detailed follow-up analyses did not implicate any specific question in the generalized anxiety disorder protocol. Translation and back-translation of surveys does not guarantee that response probabilities are exactly equivalent. Randomized survey experiments should be incorporated into cross-cultural psychiatric surveys when possible.


Assuntos
Asiático/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Idioma , Transtornos Mentais/etnologia , Escalas de Graduação Psiquiátrica , Comparação Transcultural , Inquéritos Epidemiológicos , Humanos , Testes de Linguagem , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Prevalência , Psicometria
12.
Risk Anal ; 28(6): 1531-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18795998

RESUMO

Conflict frequently occurs between community members and environmental/public health officials when an unusual number of cancer cases is reported. This conflict may result from different ways in which laypeople and experts interpret facts to judge whether there is an environmental cause of the cancer cases, but little is known about this issue. Volunteer laypeople (N= 551) and epidemiologists (N= 105) read a hypothetical scenario about cases of cancer on one neighborhood block. Participants judged whether each of the 23 facts about the situation made it "much more likely" to "much less likely" that something in town was causing the cancer cases (7-point scale). The facts were designed to be "alarming,""reassuring," or "neutral" (i.e., according to epidemiological principles, should increase, decrease, or have no impact on the likelihood of an environmental cause). The laypeople were alarmed by most of the facts (mean response significantly greater than the scale midpoint), including all of the neutral facts and over half of the reassuring facts. The experts were more balanced: they were alarmed by none of the neutral or reassuring facts. Their responses showed significantly less alarm than the laypeople's responses (p < 0.0001 for all comparisons). This study reveals that laypeople are not reassured by information that substantially lowers the chance of an environmental cause for cancer cases. Lay responses differ significantly and systematically from experts who are far less alarmed by relevant facts. These findings may help explain the conflicts between the two groups in situations where concern about cases of cancer arises in a community.


Assuntos
Neoplasias/epidemiologia , Neoplasias/etiologia , Adulto , Análise por Conglomerados , Comunicação , Epidemiologia , Feminino , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Projetos de Pesquisa , Risco , Inquéritos e Questionários
13.
Hisp J Behav Sci ; 30(3): 357-378, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19444326

RESUMO

This paper presents analyses of a representative sample of US Latinos (N=2540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggests a significant association between family cohesion and lower psychological distress and the combination of strong family cohesion with presence of family cultural conflict was associated with higher psychological distress. However, this association differed by Latino groups. We found no association for Puerto Ricans, Cuban results were similar to the aggregate group, family cultural conflict in Mexicans was associated with higher psychological distress, while family cohesion in Other Latinos was associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups.

14.
Soc Sci Med ; 65(2): 214-30, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17499899

RESUMO

This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the US account for differences in 12-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were US-born or arrived before age 6: In-US-as-Child [IUSC]; or whether they arrived after age 6: later-arrival immigrants [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the US after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the US is a multidimensional process that includes maintenance of family harmony, integration in advantageous US neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought.


Assuntos
Hispânico ou Latino/psicologia , Transtornos Mentais/etiologia , Meio Social , Aculturação , Cuba/etnologia , Emigração e Imigração , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , México/etnologia , Modelos Psicológicos , Porto Rico/etnologia , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
15.
Psychiatr Serv ; 58(12): 1591-4, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18048562

RESUMO

OBJECTIVE: This study sought to describe the role of stigma in antidepressant adherence among Latinos. METHODS: The study utilized data generated from six focus groups of Latino outpatients receiving antidepressants (N=30). By using a grounded theory approach, qualitative analysis focused specifically on the role of stigma in antidepressant treatment, as well as salient Latino values. RESULTS: Perceptions of stigma were related to both the diagnosis of depression and use of antidepressant medication. Qualitative analyses showed that antidepressant use was seen as implying more severe illness, weakness or failure to cope with problems, and being under the effects of a drug. Reports of stigma were also related to social consequences. Also, the perceived negative attributes of antidepressant use were at odds with self-perceived cultural values. CONCLUSIONS: Stigma was a prominent concern among Latinos receiving antidepressants, and stigma often affected adherence. Furthermore, culture is likely to play an important role in the communication of stigma and its associated complications.


Assuntos
Antidepressivos/uso terapêutico , Depressão/tratamento farmacológico , Hispânico ou Latino/psicologia , Estereotipagem , Adulto , Assistência Ambulatorial , Depressão/etnologia , Estudos de Avaliação como Assunto , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , New Jersey
16.
Psychiatr Serv ; 58(3): 385-94, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17325113

RESUMO

This article reports on the outcome of an expert consensus meeting in August 2005 sponsored by the National Institute of Mental Health, which assembled 15 senior researchers with a background in treatment and services research with the Hispanic population. The purpose of the workshop was to identify research issues most pertinent for improving quality and effectiveness of treatment for Hispanics experiencing persistent mental disorders, defined as psychiatric syndromes that are of sufficient severity and duration to cause long-term impairment in social and occupational functioning and significant disability. The spectrum of ideas and recommendations advanced at the one-day meeting was wide and overlapping; therefore, the rich body of material was subsequently organized into five topics: diagnosis, quality of care and culturally appropriate services, psychosocial intervention development, psychopharmacologic interventions, and access to care. Although the authors recognize that the review was broad and the agenda presented is ambitious and in many instances generalizes to priority areas in overall mental health services and treatment research, the recommendations are intended to stimulate research for addressing the unique problems and research deficits that affect Hispanics with persistent mental disorders.


Assuntos
Pesquisa Biomédica , Pesquisa sobre Serviços de Saúde , Hispânico ou Latino/psicologia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/normas , Avaliação de Resultados em Cuidados de Saúde , Garantia da Qualidade dos Cuidados de Saúde , Uso de Medicamentos/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Serviços de Saúde Mental/organização & administração , Educação de Pacientes como Assunto , Atenção Primária à Saúde/métodos , Psicoterapia/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores de Tempo , Estados Unidos/epidemiologia
17.
Hisp J Behav Sci ; 29(4): 510-534, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-19672330

RESUMO

This paper provides a profile of a range of important variables for assessing diversity among different Latino groups from the National Latino and Asian American Study (NLAAS). The NLAAS is a nationally representative study of the mental health needs and mental health services use of the Latino population of the United States. The NLAAS employs a stratified area probability sampling design. There are 2,554 respondents in the Latino portion of the NLAAS. The paper demonstrates through a detailed presentation of a wide range of variables the diverse experiences of Latino groups in their encounters with U.S. culture. Language use and migration experiences show considerable variability both within and across Latino groups and are promising areas for analysis of their mental health consequences.

18.
Sociol Anthropol (Alhambra) ; 4(2): 114-124, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27595125

RESUMO

Anthropologists' contribution to the study of cultural change is urgent in light of the increasing number of people of different backgrounds who are migrating around the globe and settling in new communities, and the opportunities and challenges that come along with that process. By examining the anthropological literature on acculturation going back to the 1936 Memorandum by Redfield, Linton and Herskovits, this paper reviews and assesses the discipline's perspective on acculturation, and lays out the case for why it is critical for anthropologists to re-engage the concept. Although other disciplines, particularly psychology and sociology, have dominated the field of acculturation research more recently, they mostly have done so with a narrow focus. While it is important to acknowledge the pitfalls of anthropology's past study of acculturation, there are important features of the acculturation construct that continue to be relevant. Among these are the study of acculturation as a process that is multidimensional; the investigation of how different kinds of power affect the acculturation process; the impacts of attitudes, actions and policies of the receiving group on how acculturation proceeds; the role of "real history" in understanding processes of acculturation; and the global perspective on these processes. We suggest ways in which anthropologists can reignite the field of acculturation research by engaging with Redfield, Linton and Herskovits' framework and subsequent anthropological literature.

19.
Springerplus ; 5: 384, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27065092

RESUMO

Cultural competence training is mandatory in the United States of America to alleviate minority health disparities though few studies have examined perceptions across stakeholders. We conducted separate focus groups with patients, clinicians, and administrators from the psychiatry department at one community hospital and compared responses to hospital policies. Stakeholders defined cultural competence through group-based or person-centered traits despite policies recommended person-centered approaches. Administrators and clinicians named clinician techniques for psycho-education whereas patients named these techniques for enlistment in treatment planning as equals. All groups named patient cultural views and institutional challenges as barriers to care, but only patients and administrators additionally named clinician biases as possible barriers. We discuss these discrepant perceptions and possible solutions to improve research, practice, and policy on cultural competence in mental health.

20.
Patient Educ Couns ; 99(2): 198-209, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26365436

RESUMO

OBJECTIVE: To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment. METHODS: Authors conducted electronic searches of published and grey literature databases from inception to November 2014, forward citation analyses, and backward bibliographic sampling of included articles. Included studies reported original data on clinician communication strategies to improve minority treatment engagement, defined as initiating, participating, and continuing services. RESULTS: Twenty-three studies met inclusion criteria. Low treatment initiation and high treatment discontinuation were related to patient views that the mental health system did not address their understandings of illness, care or stigma. Treatment participation was based more on clinician language use, communication style, and discussions of patient-clinician differences. CONCLUSION: Clinicians may improve treatment initiation and continuation by incorporating patient views of illness into treatment and targeting stigma. Clinicians may improve treatment participation by using simple language, tailoring communication to patient preferences, discussing differences, and demonstrating positive affect. PRACTICE IMPLICATIONS: Lack of knowledge about the mental health system and somatic symptoms may delay treatment initiation. Discussions of clinician backgrounds, power, and communication style may improve treatment participation. Treatment continuation may improve if clinicians tailor communication and treatment plans congruent with patient expectations.


Assuntos
Comunicação , Continuidade da Assistência ao Paciente , Etnicidade , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Grupos Raciais , Adolescente , Adulto , Idoso , Competência Cultural , Diversidade Cultural , Etnicidade/psicologia , Feminino , Humanos , Masculino , Relações Profissional-Paciente , Grupos Raciais/psicologia
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