Questions five and six address a patient’s views about treatment. Latinos/as may hold a broad range of expectations. The best plan will result from mutual communication in order to satisfy both the patient and practitioner. With this in mind, the information that follows introduces possible issues regarding treatment.
Addressing Views of Balanced Health
If a patient believes in the hot and cold theory of illness, a treatment method must follow these beliefs. If the condition is caused by too much heat, the treatment must be cold and vice versa. Color, sex, origin, nutritive value, physiological effect, and medical cause are all factors that affect hot or cold categorization. For example dark and female are hot while light and male are cold.16 If a hot medication is prescribed for a hot disease, the patient may not take it because that would unbalance his or her health even more. Practitioners should choose a treatment that fits both the condition and hot/cold categorization necessary.
The reasons why a Latino/a seeks medical attention may vary. At times, he or she may be seeking just a diagnosis. In other situations, the patient may want multiple forms of treatment including both biomedical and traditional healing methods. Practitioners need to communicate with the patient to discover if other treatments are being used. Some practices, such as consuming lead or mercury-containing substances, can be harmful.20 If these are being used, a compromise should be reached without disregarding the patient’s beliefs to prevent further danger. Certain herbs could also interact negatively with prescription drugs.5 Arthur Rubel gives examples of cases when physicians and traditional healers worked together. As long as it is safe, massages, herbs, rituals, and prayers may be some of the additional treatments used.22 Practitioners do not need to believe in these options themselves, but they should respect the beliefs of the patient. In the end, the common goal is to improve the person’s health.
Health Education and Disease Prevention
Knowledge about health and illness may be lower among Latino/a populations; part of their care should address this issue. Diaz, Roberts, Goldman, Weitzen, and Eaton found that Latinos/as may not seek medical care because they do not feel any symptoms.6 Health education could address asymptomatic disease. A greater problem that needs addressing is lack of knowledge about HIV/AIDS. Hillman showed that many believed myths regarding transmission including that a person could contract the virus from mosquitoes, coffee, donating blood, and public toilets.12 Some people did not know that condoms have a specific way in which they must be used.12 Even among those who know that condoms would help prevent HIV infection, a majority still did not use them.12 This is often due to cultural factors such as machismo, or the belief that males have a dominant role in relationships. In the traditional gender roles, men are supposed to be experienced before marriage. Using condoms is less masculine.12,23 Women on the other hand are supposed to be submissive and naïve. Requesting that a partner use a condom could be taken as too dominant or too knowledgeable.12,23 Additional reasons cited for not using condoms include believing that they are not reliable and that a woman is too old to get pregnant. Culturally sensitive education programs should be developed to address these concerns . In one such successful program called Cuidate!, youth participated in peer group discussions and sessions about using condoms.14 (Addressing what specifically should be in the education programs is beyond the scope of this guide; however many resources exist to aid such efforts.) A final problem involves general health and preventative care knowledge. Diaz, Roberts, Goldman, Weitzen, and Eaton surveyed Latinos/as over the age of fifty on their knowledge of colon screenings.6They found that many could not identify the colon on an illustration of the body. Some did not realize that the large intestine and the colon were the same organ. Participants often did not know the risk factors for colon cancer, and many had not received regular screenings. Cultural issues would need to be addressed with regards to colonoscopies and other preventative tests, but the study illustrates the lack of knowledge some patients may have regarding health. Increased education could help patients better reach their health potential.
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