According to Dr. Hayes-Bautista, “a sound
understanding of our diverse cultures, and the importance of culture to
health, is still lacking” (2003). The term “cultural competence” is making
its way into many healthcare systems in the United States today and it is
important that, as a physician, you understand the culture of the patients
you treat. Latinos use botanicas because they offer them a
culturally appropriate way to get medical advice, and if physicians can
understand these beliefs, Latinos will feel more comfortable seeking
advice in a medical office.
Familismo is the belief that in many Latino
culturesla familia—the family—comes first. Many Latinos
are raised to believe that the needs of the family come before there
own. Thus, they usually emphasize cooperation, assistance, and
sharing resources in order for their family to function.
This holds especially true for older Latinos
because they rely on the support of their family for help and this can
sometimes include financial support, as well. It is important to
consider these factors when treating Latino patients because, oftentimes,
the extended family will be included in the healthcare decisions.
Traditionally, the Latino family is considered
patriarchal. The head of the house is usually the eldest male and
all decisions must go through him. It is also important to respect
the leader of the household. There is also an emphasis on respecting
the older persons versus the younger persons.
Because most decisions are taken to the head
of the house, sometimes privacy is not valued as much for Latinos, like it
is for Western society. Therefore, many Latinos may need to consult
with another person before making a healthcare decision.
This belief values building personal
relationships based on trust, respect, pride, and dignity. Latinos
value the person as a whole rather than an individualist in society.
This can present some misunderstandings in the healthcare field because
interactions that may seem ok between an Anglo physician and Latino
patient, may be perceived as disrespectful. It is often suggested
that, as a physician, you establish a more personal relationship with your
patient and not be concerned just with their medical situation.
It is important to understand this belief as a
physician because it can affect the way in which your Latino patients seek
healthcare. Value is not given to the past or future times in Latino
culture. Rather, value is given to the present time and
situation. This can lead to a delay in seeking healthcare and not
practicing prevention of disease because both of these things do not have
a direct impact on the present.
Cultural competence affects the: