Question

George Garcia, a 23-year-old construction worker, and his wife, Anita, age 20, bring their 4-month-old daughter to the emergency room of a small community hospital. They speak broken English. They have another small child with them, as well as two older women. They are very worried about the infant, who they say has been unable to retain feedings of diluted cow's milk. Now, because of poor sucking and increased sleeping, the infant has not had anything by mouth for the last 24 hours. When asked, the parents say the infant has been sick for 3 or 4 days. The infant is listless, and her eyes are sunken. Anita is newly pregnant with her third child.

The Garcia family lives together in a small house 2 miles from the Mexican border in a predominantly Mexican American neighborhood.. The padrinosor compadres (godparents) live next door to the Garcias. The family is Catholic, and a medal of Our Lady of Guadalupe is on a chain around the older child's neck. The baby has a bracelet with a seed in it around her wrist. The 2 older women with the Garcias are the mothers of George and Anita. George's mother is a curandero, and has been treating the baby with weak specially brewed teas.

1. How would the health care practitioner approach the family to demonstrate respect, compassion, and understanding?

2. Describe family roles and common living arrangements in a family of Mexican-American heritage.

   If the doctor's recommendation is that the infant should be hospitalized, who in the family would make the decision?

3. What is a curandero? Name 2 other kinds of folk practitioners, and describe what they do.

4. Discuss spirituality and the meaning of life for persons of Mexican-American heritage.

5. The infant could have mal de ojo. What is this, and how is it treated? Should the health care professional touch the infant?

Answer 1

1).

The medical assistant must be able to assess the patient’s ability to understand, language, skills in English language and cultural beliefs and interests while communicating with them. These techniques greatly reduce the patient’s education problems.

The following approaches are helpful to avoid the educational barriers and measures that help the healthcare practitioner approach the family to demonstrate respect, compassion, and understanding:

1. Addressing the patient in a formal and courteous manner
2. Speaking clearly without slang
3. Using non-verbal communication such as touch and empathy appropriately to enhance patient’s comfort and understanding
4. Using pictures and modes to illustrate the material and explaining in simple language
5. Identifying the signs of anxiety and confusion in the patient and responding appropriately
6. Providing demonstration as necessary
7. Implementing teaching in small, manageable steps
8. Offering written instructions and appropriate use of interpreter