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Geriatrics

Geriatrics

Ethnogeriatrics

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    • Ethnogeriatrics Overview
      • Introduction
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Maltreatment and Segregated Training

2. Physician-Based Factors: Maltreatment and Segregated Training

History of Maltreatment and its Effects

The long history of maltreatment of African Americans by the medical system has created a collective memory of exploitation and inferior care that remains an obstacle to effective patient-physician relationships. Qualitative interviews suggest that many African Americans older adults prefer to be kept alive on life supports because of their mistrust of the medical system and fear of suboptimal care (Blackhall, 1999).

Effects of Segregated Training

In addition the history of segregated training for health care providers has left a legacy of under-representation of minority health professionals and contributes to the social distance between African American patients and their healthcare providers. These socioeconomic and class differences partially account for African Americans’ lower satisfaction with health care providers compared to white patients (Malar, 2001).

The legacy of mistrust, exclusion and persistent racial bias (overt or covert) are likely to affect patterns of and responses to communication between healthcare providers, patients and family members” (Welch et al. 2005).

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African American

  • Description
  • Learning Objectives
  • Introduction & Overview
    • Population Growth and Distribution
    • Characteristics
  • Patterns of Health Risk
    • Life Expectancy
    • Mortality
    • Morbidity
    • Self-Rated Health and Functional Status

CULTURALLY APPROPRIATE CARE

  • Fund of Knowledge
    • Health History
      • Up from slavery
      • Health and Longevity Since the Mid-19th Century
      • Significant Dates and Periods
      • Cohort Experiences
    • Health Beliefs
    • Illness Causes & Interventions
  • Assesment
    • Cultural Biases and Misdiagnoses
    • Showing Respect
    • Use of Assesment Instruments
  • Delivery of Care
    • Cardiovascular Disease
    • Stroke
    • Breast Cancer
    • Mental Health
    • End-of-life Care
  • Cancer Care

Access and Utilization

  • Disparities
    • 1. Patient-Based Factors
    • 2. Physician-Based Factors
      • Maltreatment and Segregated Training
      • Discriminatory Patterns
      • Social and Kinship Networks
      • Informal Caregiving
      • Caregiver Burden
      • Long-Term Care
    • 3. End-of-Life Care Issues
      • Palliative and Hospice Care
      • Advance Directives
      • Role of Church and Religion
  • Health Promotion
    • Improving Health Care

Learning Resources

  • Instructional Strategies
    • Projects and Assignments
    • Case Study 1: Mr. S
      • Overview and History
      • Course and Outcome
      • Cultural Issues
    • Case Study 2: Mrs. P
  • Student Evaluation
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    • Fictive Kin
    • Breast Cancer
    • Tuskegee Study
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