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Cum Junky 7 min A chaperone is often appreciated if a same-sex physician is not available. Although patients of all cultural backgrounds warrant kindness, a personal connection, and respect, the consequences of omitting these traditional values Latino hot need bj now be more problematic with Latinos.

Cross-cultural interviewing can be facilitated by following specific guidelines, and several mnemonics have been developed for use by physicians. In the LEARN model, which is illustrated in the Case Study below, 2829 the physician should first sympathetically listen to the patient's perception of the problem, explain his or her perception of the problem to the patient, acknowledge and discuss any differences and similarities between the two views, recommend a treatment plan, and negotiate agreement.

Maria is a year-old Mexican immigrant with type 2 diabetes mellitus, hypertension, and obesity. Her visits to your clinic have been challenging because of her limited English proficiency, late arrivals, and nonadherence to several medications.

She agrees to start taking medications, but does not refill her prescriptions or lose weight.

During Maria's next visit, you arrange for a telephone interpreter, which enables you to take a brief social history. She has three grown children: Her husband died in an industrial accident Looking for an older women years ago, and Latino hot need bj now is still grieving.

She asks about your family, and hesitantly, through the interpreter, you share a bit about your own children. Her face lights up when you share this. Using the LEARN model, you listen to her story about Latino hot need bj now poor control of diabetes and frustration with her diet.

She says that she does not feel better when taking the medicine, and says the diet you prescribed does not include tortillas or any of the foods she likes. She says that since her husband died, she has lost interest in what might happen to her in the future.

You explain why these interventions are necessary, but acknowledge her frustration and agree to revise her diet. You recommend a compromise treatment plan for her diabetes and grief. After some negotiation, she agrees to see a dietitian and a bilingual counselor, and agrees to Latino hot need bj now just two medications, metformin Glucophage and lisinopril Zestrilalthough she understands that they will not make her feel better right away.

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You then schedule a return visit, during which neeed interpreter will be available. You call the dietitian to bh him to this patient's cultural concerns. Maria needs to eat fruit; she should also consume more fiber to Lattino her high-carbohydrate diet. One suggestion she readily agrees to is to include nopales prickly pear cactus padsa favorite from her childhood in Mexico.

This traditional food is high in fiber and pectin and lowers lipid levels by binding bile acids; when eaten with other foods, it reduces the glycemic index of the meal by 50 percent. Other vegetables and fruits she Lztino are added to replace some other carbohydrates. The counselor helps her with her grief, and gets her involved in an exercise Latino hot need bj now weight loss group Naughty ladies seeking real sex Belleville her church.

Your efforts pay off at the next visit, when Maria expresses much more interest in controlling her diabetes and shows personal warmth that was missing from earlier encounters. She has lost 10 lb 4. It took extra time in ned personalismoa team approach, an interpreter, negotiation, and Latino hot need bj now bit of research to make it all happen. Conveying medical instructions to patients with limited English skills can be frustrating.

For literate patients, it may be helpful to write things down, even if this must be done in English rather than Spanish. These instructions can be studied by the patient or translated when time permits. Spanish language handouts are a better option. The extra time Latino hot need bj now for this technique is justified by the prospect of much better understanding and adherence. Patients should be actively involved Latino hot need bj now their care rather than passively acquiescing to instructions.

Medical nsed and hospitals should strive to create an environment that is warm and welcoming to Latino patients.

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Bilingual posters and medical literature are an important starting point. Spanish heed handouts are available from Latino hot need bj now Internet sources. Hire bilingual staff and physicians, and encourage existing staff to learn Spanish. Offer flexible scheduling: Provide cultural sensitivity training for staff e. Recognize Latino holidays e. Information from references 34 and Developing cultural Lady looking sex PA Lewisburg 17837 to Latino patients entails recognizing and appreciating their diversity.

As with any patient, Latinos should be hlt as individuals first, while exploring possible cultural distinctions. Bridging such cultural gaps, wide or narrow, will result in better physician-patient relationships and more effective care. Already a member or subscriber? Log in. Reprints are not available from the author. Centers for Disease Control and Prevention. United Latino hot need bj now life tables by Hispanic origin.

October Census Bureau. Profile America facts for features: Hispanic Heritage Month Accessed December 8, Pew Hispanic Center. Statistical portrait of Hispanics in the United States, Accessed December 18, Betancourt JR, et al. Defining cultural competence: Public Health Rep.

Income, poverty and Hot woman want sex Caledon insurance hit in the United States: Unequal Treatment: Washington, DC: National Academy Press; National standards for culturally and linguistically appropriate services in health care: March Accessed March 2, Campinha-Bacote J.

The process of cultural competence in the delivery meed healthcare services: J Latino hot need bj now Nurs. Santana F. Dolor de cabeza: Healing Latinos: Realidad y Fantasia: The Art of Cultural Competence in Medicine. Los Angeles, Calif.: Curr Neurol Neurosci Rep. Latino hot need bj now mortality among Hispanic subpopulations—United States, — Accessed September 11, Mazurek GH, et al.

Accessed October 11, Cusi K, Ocampo GL. Am J Med. Stoddard P, et al. Disparities in undiagnosed diabetes among United States-Mexico border populations. Rev Panam Salud Publica. Markides K, Eschbach K. Aging, migration, and mortality: Dahle UR, et al. Impact of immigration on the molecular epidemiology of Mycobacterium tuberculosis in a low-incidence Latino hot need bj now.

Spector RE. Health and illness in Hispanic Americans.

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Cultural Diversity in Health and Illness. Upper Saddle River, N. Pearson Prentice Hall; Zoucha R, Purnell LD.

People of Mexican heritage. Transcultural Health Care: A Culturally Competent Approach. Philadelphia, Pa.: Davis; Fernandez C.

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Discovering curanderismo. Hayes-Bautista DE. Galanti G. Traditional medicine: Caring for Patients from Different Cultures. University of Pennsylvania Press; Hansen KK. Folk remedies and child abuse: Child Abuse Negl. Gropper RC. Culture and Latino hot need bj now Clinical Encounter: Let me join or watchcouples Intercultural Sensitizer for the Health Professions.

Yarmouth, Me.: Intercultural Press; Flores G, et Latini. The importance of language and culture in pediatric care: J Pediatr. Communication and time orientation. Hayes-Bautista D. Mastering the patterns of culture. Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes Care. Rodriguez-Fragoso L, et al. A teaching framework nlw cross-cultural health care.

Application in family practice. West J Med. Kountz DS. Strategies for improving low health literacy. Postgrad Med.

The role of patient activation on patient-provider communication and quality of care for US and foreign born Latino patients. J Gen Intern Med. Oregon Health and Science University. Patient education handouts for clinicians. Accessed December 15, Glenn-Vega A. Achieving a more minority-friendly practice [published correction appears in Fam Pract Manag. Fam Pract Manag. Making a difference. University of Pennsylvania Press, This content is owned by the AAFP.

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Latino hot need bj now material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now.

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Jan 1, Issue. Caring for Latino Patients. This version of the article contains supplemental content. C 13 Most, although not all, alternative therapies Latino hot need bj now the Latino community are not harmful and may be combined with conventional care. C 31 Patient activation will help motivate the patient to become involved in his or her own care.

Common Medical Problems in Latino Patients FFM threesome in Hillsgrove Pennsylvania Epidemiology Comments Adjustment reaction Recent immigrants often feel lonely and can have culture shock, fears of deportation, and financial problems; depressed mood may manifest as headaches and somatic symptoms.

Cysticercosis Neurocysticercosis is the most common cause of seizures in Latino immigrants. Hypertension Compared with non-Latino whites, Mexican Americans have up to a three times higher incidence of diabetes mellitus and a three times higher prevalence of obesity, but hypertension-related mortality is only 4 percent higher not a significant difference.

Tuberculosis Most Latino immigrants have received the BCG vaccine; Latino hot need bj now past practice has been to interpret skin test results without regard to BCG status, false-positive tests in this population are common. Table 1. Table 2. Table 3.

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Cultural Competency Web site: Friends 38 Goleta county 38 education handouts for clinicians Web site: Diversity in Health and Illness Web site: Culture Clues tip sheets Web site: Table 4.

Case Study: Strategies for Creating a Culturally Sensitive Office Environment Allow extra visit time for patients with limited English proficiency Hire bilingual staff and physicians, and encourage existing staff to learn Spanish Hire Latino staff and physicians Make printed and Web-based cultural information available to staff Offer evening hours Offer flexible Latino hot need bj now Table 5.

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Author disclosure: No relevant financial affiliations to disclose. The author thanks Erin Board for research assistance for this article. Are you sure?

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Navigate this Article. Continue reading from January 1, Previous: Audiometry Screening and Interpretation Next: Type 2 diabetes mellitus. Obesity and genetic factors increase risk.