Successful Aging In the Division of General Medical Disciplines

Theories Used in Ethnogeriatrics: Dearth of Theoretical Bases

Kleinman's Questions*

  1. What do you call the problem?
  2. What do you think has caused the problem?
  3. Why do you think it started when it did?
  4. What do you think the sickness does? How does it work?
  5. How severe is the sickness?
  6. What kind of treatment do you think the patient should receive?
  7. What are the chief problems the sickness has caused?
  8. What do you fear most about the sickness?

*Adapted from Kleinman A, Eisenberg L, Good B. Culture, Illness and Care. Ann Intern Med. 1978;88:251-8.

Explanatory Models of Health and Ilness

Introduced by Arthur Kleinman and colleagues in the 1970s to recognize and validate patients’ conceptions, explanations, and expectations of their own illness experiences, many of which are based on cultural beliefs.

History of Double and Triple Jeopardy Hypotheses of Minorities, Aging, and Health

Discussed extensively in the geriatric literature in the 1970s and 1980s suggesting that as minorities grow older they are even more disadvantaged in health than at younger ages. Studies and discussions in the 1990s generally suggested there is little documented additional disadvantage with age among minority older adults (Markides, Liang, & Jackson, 1990).

Bronfenbrenner’s Ecological Approach

  1. Microsystem: Including any person or environment with which the person has direct day to day contacts (e.g., family, friends).
  2. Mesosystem: Involving the interactions of multiple Microsystems, (e.g., family members’ lack of agreement with diet prescriptions).
  3. Exosystem: Involving the larger community, especially decision-making bodies.
  4. Macrosystem: The overarching cultural belief systems which influence how individuals in each context interact with one another (e.g., health care providers’ attitudes about aging, ethnic older adults’ view of themselves).
  5. Chronosystem: The dimension of time, (e.g., the historical embeddedness of aging, health care, and ethnicity).

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