Cultural Fault Lines in Healthcare

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Publisher : Lexington Books
ISBN 13 : 0739149679
Total Pages : 119 pages
Book Rating : 4.7/5 (391 download)

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Book Synopsis Cultural Fault Lines in Healthcare by : Michael C. Brannigan

Download or read book Cultural Fault Lines in Healthcare written by Michael C. Brannigan and published by Lexington Books. This book was released on 2012 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare in the U.S. faces two interpenetrating certainties. First, with over 66 racial and ethnic groupings, our "American Mosaic" of worldviews and values unavoidably generates clashes in hospitals and clinics. Second, our public increasingly mistrusts our healthcare system and delivery. One certainty fuels the other. Conflicts in the clinical encounter, particularly with patients from other cultures, often challenge dominant assumptions of morally appropriate principles and behavior. In turn, lack of understanding, misinterpretation, stereotyping, and outright discrimination result in poor health outcomes, compounding further mistrust. To address these cultural fault lines, healthcare institutions have initiated efforts to ensure "cultural competence." Yet, these efforts become institutional window-dressing without tackling deeper issues, issues having to do with attitudes, understanding, and, most importantly, ways we communicate with patients. These deeper issues reflect a fundamental, original fault line: the ever-widening gap between serving our own interests while disregarding the concerns of more vulnerable patients, those on the margins, those Others who remain disenfranchised because they are Other. This book examines this and how we must become the voice for these Others whose vulnerability and suffering are palpable. The author argues that, as a vital and necessary condition for cultural competency, we must learn to cultivate the virtue of Presence - of genuinely being there with our patients. Cultural competency is less a matter of acquiring knowledge of other cultures. Cultural competency demands as a prerequisite for all patients, not just for those who seem different, genuine embodied Presence. Genuine, interpersonal, embodied presence is especially crucial in our screen-centric and Facebook world where interaction is mediated through technologies rather than through authentic face-to-face engagement. This is sadly apparent in healthcare, where we have replaced interpersonal care with technological intervention. Indeed, we are all potential patients. When we become ill, we too will most likely assume roles of vulnerability. We too may feel as invisible as those on the margins. These are not armchair reflections. Brannigan's incisive analysis comes from his scholarship in healthcare and intercultural ethics, along with his longstanding clinical experience in numerous healthcare settings with patients, their families, and healthcare professionals.

Intercultural Horizons Volume III

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Publisher : Cambridge Scholars Publishing
ISBN 13 : 1443884235
Total Pages : 370 pages
Book Rating : 4.4/5 (438 download)

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Book Synopsis Intercultural Horizons Volume III by : Lavinia Bracci

Download or read book Intercultural Horizons Volume III written by Lavinia Bracci and published by Cambridge Scholars Publishing. This book was released on 2015-10-05 with total page 370 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume brings together a representative set of the papers given at the third annual Intercultural Horizons conference held in Siena, Italy, in October 2013. The conference attracted presenters and attendees from a variety of nations throughout five continents. The papers included in this volume are drawn from a series of conference sessions in which academicians and practitioners in the field offered theoretical analyses, case studies and other perspectives on intercultural studies, civic engagement and related topics. The volume is divided into four sections: Theoretical Considerations of Intercultural Competence and Interculturalism; Intercultural Development and Assessment: Practical Examples and Research; Civic Engagement in International and Culturally Diverse Contexts; and Intercultural Education and Training. The reader will find that most of the papers address a variety of intercultural topics beyond their specific chapter designations. In particular, the theme of second language acquisition, education and use was an overarching theme that emerged from a large number of papers and presentations, specifically with regards to the complexities now faced by intercultural educators and researchers as a result of the increasing dominance of English as a “lingua franca” both in academe and many nations.

The Essential Guide to Religious Traditions and Spirituality for Health Care Providers

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Publisher : CRC Press
ISBN 13 : 1910227730
Total Pages : 959 pages
Book Rating : 4.9/5 (12 download)

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Book Synopsis The Essential Guide to Religious Traditions and Spirituality for Health Care Providers by : Steven Jeffers

Download or read book The Essential Guide to Religious Traditions and Spirituality for Health Care Providers written by Steven Jeffers and published by CRC Press. This book was released on 2012-12-17 with total page 959 pages. Available in PDF, EPUB and Kindle. Book excerpt: This extraordinary compendium of religious traditions is invaluable to all healthcare providers. The user-friendly resource contains specific and detailed information on faith traditions vital for providing optimal spiritual care in a clinical setting. A series of inspirational introductory chapters promote the importance of spiritual well-being as

The Healthcare Professional's Guide to Clinical Cultural Competence

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Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0779699602
Total Pages : 366 pages
Book Rating : 4.7/5 (796 download)

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Book Synopsis The Healthcare Professional's Guide to Clinical Cultural Competence by : Rani Hajela Srivastava

Download or read book The Healthcare Professional's Guide to Clinical Cultural Competence written by Rani Hajela Srivastava and published by Elsevier Health Sciences. This book was released on 2006-10-17 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: With a focus on client-centred care, this book provides an introduction to developing cultural competence in the health care setting. A unique presentation covering both theory and practice, the book begins with a strong foundational model for understanding culture. It then introduces general knowledge on culture which can be provided to a variety of settings, and ends with clinical applications illustrating how to apply knowledge and awareness to a variety of populations. With contributions from twelve leading experts, material is drawn from a wide range of health care settings and has strong practical coverage throughout. Unique approach: looks at populations the way health care workers encounter them, not by ethno-cultural/religious labels Multidisciplinary approach to writing reflects a variety of perspectives and direct front-line experience Discussion is broad and inclusive, integrating different perspectives, but also makes visible the different paradigms used to approach the topic Case studies and questions encourage critical thinking and dialogue

Japan's March 2011 Disaster and Moral Grit

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Publisher : Lexington Books
ISBN 13 : 0739196693
Total Pages : 240 pages
Book Rating : 4.7/5 (391 download)

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Book Synopsis Japan's March 2011 Disaster and Moral Grit by : Michael C. Brannigan

Download or read book Japan's March 2011 Disaster and Moral Grit written by Michael C. Brannigan and published by Lexington Books. This book was released on 2015-08-27 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Japan’s March 11, 2011 triple horror of earthquake, tsunami, and nuclear meltdown is its worst catastrophe since Hiroshima and Nagasaki. Recovery remains an ongoing ordeal. Japan's Responses to the March 2011 Disaster: Our Inescapable In-between uncovers the pivotal role of longstanding cultural worldviews and their impact on responses to this gut-wrenching disaster. Through unpacking the pivotal notion in Japanese ethics of aidagara, or “in-betweenness,” it offers testament to a deep-rooted sense of community. Accounts from survivors, victims’ families, key city officials, and volunteers reveal a remarkable fiber of moral grit and resilience that sustains Japan’s common struggle to rally and carve a future with promise and hope. Calamities snatch us out of the mundane and throw us into the intensity of the moment. They challenge our moral fiber. Trauma, individual and collective, is the uninvited litmus test of character, personal and social. Ultimately, whether a society rightfully recovers from disaster has to do with its degree of connectedness, the embodied physical, interpersonal, face-to-face engagement we have with each other. As these stories bring to light, along with Michael Brannigan’s extensive research, personal encounters with survivors, and experience as a volunteer in Japan’s stricken areas, our degree of connectedness determines how we in the long run weather the storm, whether the storm is natural, technological, or human. Ultimately, it illustrates that how we respond to and recover after the storm hinges upon how we are with each other before the storm.

Applying Business Intelligence Initiatives in Healthcare and Organizational Settings

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Author :
Publisher : IGI Global
ISBN 13 : 1522557199
Total Pages : 402 pages
Book Rating : 4.5/5 (225 download)

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Book Synopsis Applying Business Intelligence Initiatives in Healthcare and Organizational Settings by : Miah, Shah J.

Download or read book Applying Business Intelligence Initiatives in Healthcare and Organizational Settings written by Miah, Shah J. and published by IGI Global. This book was released on 2018-07-13 with total page 402 pages. Available in PDF, EPUB and Kindle. Book excerpt: Data analysis is an important part of modern business administration, as efficient compilation of information allows managers and business leaders to make the best decisions for the financial solvency of their organizations. Understanding the use of analytics, reporting, and data mining in everyday business environments is imperative to the success of modern businesses. Applying Business Intelligence Initiatives in Healthcare and Organizational Settings incorporates emerging concepts, methods, models, and relevant applications of business intelligence systems within problem contexts of healthcare and other organizational boundaries. Featuring coverage on a broad range of topics such as rise of embedded analytics, competitive advantage, and strategic capability, this book is ideally designed for business analysts, investors, corporate managers, and entrepreneurs seeking to advance their understanding and practice of business intelligence.

Cultural Sensibility in Healthcare: A Personal & Professional Guidebook

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Author :
Publisher : Sigma Theta Tau
ISBN 13 : 1937554953
Total Pages : 173 pages
Book Rating : 4.9/5 (375 download)

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Book Synopsis Cultural Sensibility in Healthcare: A Personal & Professional Guidebook by : Sally N. Ellis Fletcher

Download or read book Cultural Sensibility in Healthcare: A Personal & Professional Guidebook written by Sally N. Ellis Fletcher and published by Sigma Theta Tau. This book was released on 2015-06-10 with total page 173 pages. Available in PDF, EPUB and Kindle. Book excerpt: The healthcare workforce and landscape continues to evolve with the ongoing education systems forming in foreign countries and immigration and foreign employment continuing to grow in the United States. Every heath care provider and patient is challenged with cultural competency and acceptance on a daily basis. Often times our own prejudices and beliefs have great potential to interfere with effective health care interactions when what is truly important is providing the best patient care possible. There is much discussion around cultural sensitivity and cultural expertise, but now the discussion has shifted to cultural sensibility, which is a deliberate behavior that proactively provides an enriched provider consumer/patient interaction, where the health care provider acknowledges cultural issues and situations through thoughtful reasoning, responsiveness, and discreet (attentive, considerate, and observant) interactions. In this highly practical and informative handbook, author Sally Ellis Fletcher offers healthcare providers a process that encourages them to first consider their own attitudes, biases, beliefs, and prejudices through self-reflection. Cultural Sensibility in Healthcare challenges readers to examine cultural issues beyond just theory and to instead explore culture as it affects your professional role thus creating culturally sensibility health care encounters.

The Active Female

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Publisher : Springer Nature
ISBN 13 : 3031154851
Total Pages : 621 pages
Book Rating : 4.0/5 (311 download)

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Book Synopsis The Active Female by : Jacalyn J. Robert-McComb

Download or read book The Active Female written by Jacalyn J. Robert-McComb and published by Springer Nature. This book was released on 2023-02-27 with total page 621 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now in a revised and expanded third edition, the aims of The Active Female are threefold: first, to increase the awareness of wellness and fitness issues for active females and their family members; second, to provide an avenue for medical practitioners, allied health professionals, health educators/providers, and certified individuals in sports medicine/athletics to gain critical, updated knowledge of a field specific to active females; and third, to introduce the concept of obesity as a growing health concern even for normal weight individuals. Part I of the book offers a foundation for understanding the interrelationships between female physiology, body image and other psychological issues, the female reproductive cycle, and the musculoskeletal anatomy and physiology of females that makes their health risks and concerns unique. In Part II, the concepts of eating disorders from a global perspective and the health disparities and inequities in women’s health are discussed in detail. Part III describes the prevention and management of common musculoskeletal injuries in active females across the lifespan, including the management of osteoporosis. Appropriate exercise and nutritional guidelines and recommendations for active females are discussed in detail in Parts IV and V. Part VI is a new addition to the book and highlights the obesity epidemic and co-morbid diseases associated with obesity even for normal weight obese individuals. Each chapter is bookended by clear learning objectives and review questions for additional pedagogical appeal. An invaluable addition to the literature, The Active Female: Health Issues throughout the Lifespan, 3e will be of great interest to all clinicians and allied health care professionals concerned with women’s health and related issues, from sports medicine and family practitioners to endocrinologists, gynecologists and orthopedic surgeons.

Spirituality and Deep Connectedness

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Publisher : Rowman & Littlefield
ISBN 13 : 149856593X
Total Pages : 157 pages
Book Rating : 4.4/5 (985 download)

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Book Synopsis Spirituality and Deep Connectedness by : Michael C. Brannigan

Download or read book Spirituality and Deep Connectedness written by Michael C. Brannigan and published by Rowman & Littlefield. This book was released on 2018-09-15 with total page 157 pages. Available in PDF, EPUB and Kindle. Book excerpt: What is spirituality? Does it enable us to be better persons? Is spirituality related to religion? These days, is it even relevant? On college campuses, does it promote student well-being? Does it further moral growth? Can spirituality make a difference in healthcare? What about social justice and service to the marginalized? This rich collection of essays by respected scholars and practitioners in diverse fields in academic, healthcare, social justice, and interfaith contexts addresses these questions in strikingly profound and meaningful ways. Their voices offer alternatives to the prevailing notion of spirituality as a purely private matter, and make a case for living spiritually through deep and genuine engagement with others, bridging our inherent and original fault-line of Self and Other. Their keen observations resuscitate the spiritual fabric of defiance against and liberation from forces of oppression which show their face not only through chronic inequities and social injustice but in consumer capitalism’s grip on our souls. This volume’s dispatch to our minds and hearts is timely in an age of looming cynicism, pessimism, fear, and distrust. In carving out a renewed sense of what lies at the heart of living a life of the spirit, or spirituality, it offers an antidote to our widespread hermeneutic of suspicion. None of the authors claims to encapsulate one, pure meaning of the spiritual. Yet they share one collective voice: spirituality is indeed genuine when it calls forth compassion and wears the worn and tangled face of humaneness, freeing ourselves from the prison of ego. Here we find messages of hope, much needed in a time when our society seems increasingly shadowed by dark clouds. These essays remind us of what’s right in the world.

Caregiving, Carebots, and Contagion

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Publisher : Rowman & Littlefield
ISBN 13 : 1793649197
Total Pages : 175 pages
Book Rating : 4.7/5 (936 download)

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Book Synopsis Caregiving, Carebots, and Contagion by : Michael C. Brannigan

Download or read book Caregiving, Carebots, and Contagion written by Michael C. Brannigan and published by Rowman & Littlefield. This book was released on 2022-02-21 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: Would you want to be cared for by a robot? Michael C. Brannigan’s Caregiving, Carebots, and Contagion explores caring robots’ lifesaving benefits, particularly during contagion, while probing the threat they pose to interpersonal engagement and genuine human caregiving. As our COVID-19 purgatory lingers on, caring robots will join our nursing and healthcare frontlines. Carebots can perform lifesaving tasks to minimize infection, safeguard vulnerable persons, and relieve caregivers of certain burdens. They also spark profound moral and existential questions: What is caring? How will we relate with each other? What does it mean to be human? Underscoring carebots' hands-on benefits, Brannigan also warns us of perils. They can be a dangerous lure in a culture that settles for substitutes and venerates the screen. Alerting us to the threatening prospect of carebots becoming our surrogate for interpersonal connection, he maintains they are not the culprits. The challenge lies in how we relate to them. While they beneficially complement our caregiving, carebots cannot replace human caring. Caring is a fundamentally human act and lies at the heart of ethics. As humans, we have a binding moral responsibility to care for the Other, and genuine caring demands our embodied, human-to-human presence.

Handbook for Culturally Competent Care

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Author :
Publisher : Springer
ISBN 13 : 3030219461
Total Pages : 353 pages
Book Rating : 4.0/5 (32 download)

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Book Synopsis Handbook for Culturally Competent Care by : Larry D. Purnell

Download or read book Handbook for Culturally Competent Care written by Larry D. Purnell and published by Springer. This book was released on 2019-06-29 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: This concise, easy-to-read book tackles the potentially awkward subject of culture in a direct, non-intimidating style. It prepares all health professionals in any clinical setting to conduct thorough assessments of individual from culturally specific population groups, making it especially valuable in today's team-oriented healthcare environment. The book is suitable for healthcare workers in all fields, particularly nurses who interact with the patients 24 hours a day, every day of the week. Based on the Purnell Model for Cultural Competence, it explores 26 different cultures and the issues that healthcare professionals need to be sensitive to. For each group, the book includes an overview of heritage, communication styles, family roles and organization, workforce issues, biocultural ecology, high-risk health behaviors, nutrition, pregnancy and child bearing, death rituals, spirituality, healthcare practices, and the views of healthcare providers. It also discusses the variant characteristics of culture that determine the diversity of values, beliefs, and practices in an individual's cultural heritage in order to help prevent stereotyping. These characteristics include age, generation, nationality, race, color, gender, religion, educational status, socioeconomic status, occupation, military status, political beliefs, urban versus rural residence, enclave identity, marital status, parental status, physical characteristics, sexual orientation, gender issues, health literacy, and reasons for migration. Each chapter offers specific instructions, guidelines, tips, intervention strategies, and approaches specific to a particular cultural population.

Medical Humanities and Medical Education

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Author :
Publisher : Routledge
ISBN 13 : 1317676246
Total Pages : 295 pages
Book Rating : 4.3/5 (176 download)

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Book Synopsis Medical Humanities and Medical Education by : Alan Bleakley

Download or read book Medical Humanities and Medical Education written by Alan Bleakley and published by Routledge. This book was released on 2015-03-02 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of the medical humanities is developing rapidly, however, there has also been parallel concern from sceptics that the value of medical humanities educational interventions should be open to scrutiny and evidence. Just what is the impact of medical humanities provision upon the education of medical students? In an era of limited resources, is such provision worth the investment? This innovative text addresses these pressing questions, describes the contemporary territory comprising the medical humanities in medical education, and explains how this field may be developed as a key medical education component for the future. Bleakley, a driving force of the international movement to establish the medical humanities as a core and integrated provision in the medical curriculum, proposes a model that requires collaboration between patients, artists, humanities scholars, doctors and other health professionals, in developing medical students’ sensibility (clinical acumen based on close noticing) and sensitivity (ethical, professional and humane practice). In particular, this text focuses upon how medical humanities input into the curriculum can help to shape the identities of medical students as future doctors who are humane, caring, expressive and creative – whose work will be technically sound but considerably enhanced by their abilities to communicate well with patients and colleagues, to empathise, to be adaptive and innovative, and to act as ‘medical citizens’ in shaping a future medical culture as a model democracy where social justice is a key aspect of medicine. Making sense of the new wave of medical humanities in medical education scholarship that calls for a ‘critical medical humanities’, Medical Humanities and Medical Education incorporates a range of case studies and illustrative and practical examples to aid integrating medical humanities into the medical curriculum. It will be important reading for medical educators and others working with the medical education community, and all those interested in the medical humanities.

Fault Lines of Care

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Author :
Publisher : Rutgers University Press
ISBN 13 : 0813586933
Total Pages : 205 pages
Book Rating : 4.8/5 (135 download)

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Book Synopsis Fault Lines of Care by : Carina Heckert

Download or read book Fault Lines of Care written by Carina Heckert and published by Rutgers University Press. This book was released on 2018-06 with total page 205 pages. Available in PDF, EPUB and Kindle. Book excerpt: The HIV epidemic in Bolivia has received little attention on a global scale in light of the country’s low HIV prevalence rate. However, by profiling the largest city in this land-locked Latin American country, Carina Heckert shows how global health-funded HIV care programs at times clash with local realities, which can have catastrophic effects for people living with HIV who must rely on global health resources to survive. These ethnographic insights, as a result, can be applied to AIDS programs across the globe. In Fault Lines of Care, Heckert provides a detailed examination of the effects of global health and governmental policy decisions on the everyday lives of people living with HIV in Santa Cruz. She focuses on the gendered dynamics that play a role in the development and implementation of HIV care programs and shows how decisions made from above impact what happens on the ground.

Cultural Awareness in Nursing and Health Care, Second Edition

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Author :
Publisher : CRC Press
ISBN 13 : 0340972904
Total Pages : 258 pages
Book Rating : 4.3/5 (49 download)

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Book Synopsis Cultural Awareness in Nursing and Health Care, Second Edition by : Christine Hogg

Download or read book Cultural Awareness in Nursing and Health Care, Second Edition written by Christine Hogg and published by CRC Press. This book was released on 2010-04-30 with total page 258 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of this popular introductory text explores the many sensitive issues of culture, race and ethnicity as they affect patient care, including: -health and illness beliefs, and their relationship to religious beliefs -mental health and culture -women's health in a multicultural society -caring for older people death and bereavement All chapters have been updated to present the latest theory and practice and new chapters on men's health and cultural care, and migration and asylum seekers have been added, along with updated case studies and reflective exercises to help the reader link theory to practice. This book is essential reading for all nursing students, as well as midwifery, allied health and health and social care students. It is also a useful reference for qualified nurses, midwives, health care assistants, assistant healthcare practitioners and allied health professionals.

Cultural Competencies for Nurses

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Author :
Publisher : Jones & Bartlett Publishers
ISBN 13 : 1449687652
Total Pages : 441 pages
Book Rating : 4.4/5 (496 download)

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Book Synopsis Cultural Competencies for Nurses by : Linda Dayer-Berenson

Download or read book Cultural Competencies for Nurses written by Linda Dayer-Berenson and published by Jones & Bartlett Publishers. This book was released on 2014 with total page 441 pages. Available in PDF, EPUB and Kindle. Book excerpt: By compiling the history and theory behind cultural competency in nursing and health care, this text offers key information regarding health beliefs and the impact of culture on health and illness. This new edition contains an overview of the predominant cultural competency nursing theories, impact of diversity on health disparities, information on the health beliefs of several minority groups, and case studies to enhance student learning. This text is an excellent resource for courses that emphasize health promotion and disease prevention.

Discourses of Helping Professions

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Publisher : John Benjamins Publishing Company
ISBN 13 : 9027269432
Total Pages : 328 pages
Book Rating : 4.0/5 (272 download)

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Book Synopsis Discourses of Helping Professions by : Eva-Maria Graf

Download or read book Discourses of Helping Professions written by Eva-Maria Graf and published by John Benjamins Publishing Company. This book was released on 2014-12-15 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Discourses of Helping Professions brings together cutting-edge research on professional discourses from both traditional helping contexts such as doctor-patient interaction or psychotherapy and more recent helping contexts such as executive coaching. Unlike workplace, professional and institutional discourse – by now well established fields in linguistic research – discourses of helping professions represent an innovative concept in its orientation to a common communicative goal: solving patients’ and clients’ physical, psychological, emotional, professional or managerial problems via a particular helping discourse. The book sets out to uncover differences, similarities and interferences in how professionals and those seeking help interactively tackle this communicative goal. In its focus on professional helping contexts and its inter-professional perspective, the current book is a primer, intended to spark off more interdisciplinary and (applied) research on helping discourses, a socio-cultural phenomenon that is of growing importance in our post-modern society. As such, it is of great relevance for discourse researchers and discourse practitioners, caretakers and social scientists of all shades as well as for everybody interested in helping professions.

Reflections from Common Ground

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Author :
Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781530596232
Total Pages : 306 pages
Book Rating : 4.5/5 (962 download)

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Book Synopsis Reflections from Common Ground by : Beth Lincoln

Download or read book Reflections from Common Ground written by Beth Lincoln and published by Createspace Independent Publishing Platform. This book was released on 2016-04-08 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: Reflection from Common Ground . . . Cultural Awareness in Healthcare showcases many of the opportunities and tools available for healthcare professionals to develop cultural awareness and competency. This unique book offers a way forward and easily lends itself to personal, group or institutional use. It is a tool to promote change, while also an interesting look into the origin of what we encounter in ourselves and others. Discovery begins with our understanding of how cultural influences affect the decisions about our health and wellness. Self-reflective exercises are placed strategically throughout the book, and offer opportunities for readers to gain insight into many cultural beliefs, values and health care practices. Real-life scenarios are included and illustrate the challenge of finding common ground with patients, families and colleagues. The concluding chapters focus on cultural awareness and competency in various healthcare institutions and academic settings. Reflections from Common Ground enables the reader, whether a healthcare professional, administrator, or educator, to gain fuller awareness and to open the doors to culturally sensitive healthcare.