Cultural Differences

 

Medications

In many Hispanic countries, people will describe their symptoms to a licensed pharmacist and will receive medications based solely on the advice of the pharmacist, without consulting a physician. In most Spanish-speaking countries, the majority of medications can be purchased without a prescription from a doctor. This often leads to misdiagnoses and wrongfully administered medications. Because of this, many Hispanic patients will be wary about what is prescribed to them, and will need an explanation of how the particular medication is going to help them. Patients should be reassured that because of their medical examination and visit with a physician, they have been prescribed the right medication.

 

Proper names are not used often for medications, so when prescribing medications to the patient, besides translating the name or type of the medication, it is important to translate what the medication does. For example, besides telling a patient that they have been prescribed an antihistamine (“antihistamina”), the healthcare worker should tell the patient that they have been prescribed a medicine that will relieve symptoms and reactions caused by allergies. (La medicina alivia los síntomas y las reacciones alérgicas.)

 

Gender roles

Although times are changing, traditions are still valued by many Spanish speaking patients. That being said, gender roles still play an important role in the lives of Spanish-speaking patients. Traditionally, females have been the ones to help other females with reproduction and womanhood. Events such as puberty, childbirth, and menopause are important events which are unique to the lives of women. Male physicians in these areas of practice should recognize and understand that their female patients, particularly Spanish-speaking patients, may feel uncomfortable when being treated by a member of the opposite sex. Male doctors should be sensitive to the traditional gender roles and take extra measures to be sure their patients develop a level of comfort with them.

 

Contraception

Many Hispanic women believe it is their role in society to bear children. If birth control is necessary or recommended for a patient, it may be best to discuss it in terms of a health issue rather than a means to prevent having more children.

 

Traditional Healers

Hispanic patients may first try at-home remedies such as herbal supplements or teas for their conditions. As a second resort, the patient may have consulted a traditional healer such as a “curandero” or “yerbero” who may suggest herbal remedies or perform particular practices to try to cure the patient. "Curanderos" are unlicensed and rely on traditional approaches to medicine and healing. Examples of such practices may include massaging of joints, various breathing techniques, or standing facing away from the sun three times a day, at regular intervals. These particular folk healers are generally prevalent in the cultures of Spanish-speaking individuals from Mexico and Central and South America. An “espiritista” may also have been previously consulted with before seeking medical treatment. This traditional healer often uses herbs combined with a summoning of dead spirits to help with the healing process.

 

Another type of folk healer, found commonly in Caribbean cultures, is a “santero.” Santería is a commonly practiced method of healing and is considered its own religion in many parts of the world. Santería combines the summoning of ancient African gods and calling upon Catholic saints who all are supposed to have special healing powers to help patients with their suffering. Often times, admittance into a hospital is a last resort for Spanish-speaking patients when the traditional forms of medicine do not alleviate their illness. It is important to know if a patient has seen a “curandero” or some other traditional healer and if they are currently taking any herbal medicines in order to prevent harmful interactions with other medications. However, it is also important to respect the patient’s customs and beliefs and their decision in seeking help from a traditional healer.

 

Routine check-ups

Most Hispanic families will not schedule regular check-ups for their babies and young children. In their culture, it doesn’t make sense to bring in their child if nothing is wrong with him/her. Likewise, adults often will not schedule routine check-ups for themselves either. Doctor visits are scheduled if something is wrong with the patient. Routine visits to the doctor are important for a variety of reasons. It may provide evidence or discovery of a health problem early on that normally wouldn’t show any detectable symptoms. Also, routine visits are a way to monitor conditions of the patient such as blood pressure, cholesterol levels, organ functioning, and more.

 

Food and Body Image

In most Latino cultures, food is not only a necessity for survival, it is also a symbol of love, family, nurturing and more. Meals are a very important family time and the sharing of food with loved ones is a caring gesture. It is common for food to be brought as gifts for loved ones in the hospital. Doctors who prohibit their patients from eating certain foods may be seen as disrespectful and rude. If dietary changes need to be made, the importance of these changes need to be discussed not only with the patient, but also with the family, emphasizing why it is crucial for the wellbeing of the patient.

 

Latino Americans have a very different view when it comes to body image. Their culture is not as focused on achieving the thin frames of models and celebrities. In fact often times a little excess weight may even be celebrated and regarded as a sign of well-being. The prevalence of overweight and obesity is somewhere around 70% for Latino Americans. The terms "gorda" or "gordita" which translate to English as "fat" can actually be used as terms of endearment for loved ones such as a spouse or a child. In addition, traditional foods for Spanish-speakers are often less available than the more convenient packaged substitutes. For example, flour tortillas are more affordable and available than the traditional corn tortillas. The prevalence of overweight and obesity can have a direct effect on the health and lifestyle of Latino patients. This can lead to such problems as diabetes or heart disease.

 

Susto

Susto is believed to be sickness or disease caused by a great fright. The essential spirit, or "animo," is thought to have left the body due to a frightening experience and to be held captive by supernatural beings. This sickness can have many symptoms such as diarrhea, nausea, depression or anxiety. It can cause such problems as miscarriages, diabetes or even death. Patients experiencing susto will often go to a "yerbero" or a "curandero" for treatment. The traditional cure is generally to bring the essential spirit back. This can be done through a variety of methods. Another treatment method is to cure the susto, or fright, by having another frightening experience.

 

Caída de mollera

This problem is thought to occur when babies are weaned from the bottle or breast feeding too quickly. Also, shaking or dropping a baby can cause caída de mollera. The belief is that the palate, or roof of the mouth, drops down from its normal position. This condition is often paired with dehydration. Traditional treatments include holding the baby upside down, patting salt on its head, or pushing the roof of the mouth back up into place.

 

Empacho

Empacho is thought to be problems that arise from food being stuck in the digestive tract. The bolus formed in the intestine is thought to differ from normal digestion/indigestion because of outside events impacting the patient when the food was ingested. For example, a child forced to eat something they did not want to may develop empacho. Symptoms can include vomiting, diarrhea, constipation or others. Empacho may also be caused by eating something bad or too much of something such as sweets or gum.

 

Mal de ojo

Mal de ojo is a belief in the powerful effects of negative forces. These negative forces are thought to be the underlying cause for sickness and diseases. Translated to English, mal de ojo means "evil eye." It is thought to be brought upon babies when someone looks at them admiringly. Jealousy is also thought to bring on the symptoms. These symptoms include crying, lack of sleep, fever and more. Traditional treatments and preventions for mal de ojo vary from touching the baby, to wearing an amulet or string tied around the waist, to using an egg in practice and treatment for the sickness. The goal to cure mal de ojo is to drive out the negative forces that are thriving in the child and to bring back positive forces that will help make the child well.

 

Mal aire

Many Latino Americans believe that the bad night air can enter one's body and cause sicknesses and problems. These problems can be pain in the chest, difficulty breathing or pneumonia. Mal aire can also be caused by extreme changes in temperature. Traditional prevention methods include covering the ears, staying inside at night, or placing a raisin on a newborn's umbilical cord. One traditional treatment method is called "cupping." This method involves the use of a match and a cup to create suctions all over the body. Physicians may recognize this by large, red circles all over a patient's body.