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Culture in Clinical Care: Strategies for Competence explores theory and practice to define and describe the multidimensional nature of culture and its interaction with an individual's experience in the development of beliefs, values, and behavior. The newly updated Second Edition examines cultural beliefs related to health and wellness and how these beliefs and their associated actions affect intervention strategies. Based on ethnographic methods, strategies for culturally sensitive assessment and intervention are defined and illustrated, with ample opportunities for reflection and practice. Going beyond traditional fact-centered and attitude-centered approaches, Culture in Clinical Care, Second Edition describes the ways in which culture emerges as individuals interact with each other in physical and social environments. This one-of-a-kind text by Dr. Bette Bonder and Dr. Laura Martin provides health care practitioners and students with chapter objectives, critical thinking questions, interdisciplinary case studies and examples, numerous activities to build observation and interaction skills, comprehensive references and online resources, and images. The book's organization emphasizes practice and reflection by interweaving theory, examples, and continuous hands-on application of concepts. Readers have the opportunity to practice what they are learning and evaluate their own effectiveness while being constantly reminded that all individuals in any interaction embody numerous cultural influences. Benefits of the updated Second Edition: Training and practice in ethnographic methods that build awareness and skill Numerous examples, exercises, and activities for reflection and observation Interdisciplinary approach suitable for cross-disciplinary teaching contexts Definition of health care professions themselves as cultures Web and bibliographic resources Case studies involving a wide range of practitioner disciplines and cultural groups Culture in Clinical Care: Strategies for Competence, Second Edition fills a niche in health professions programs because of its combined emphasis on a theoretical foundation that highlights the individual as a cultural actor and on practical strategies and methods for clinical interventions. Instructors in educational settings can visit www.efacultylounge.com for additional material to be used in the classroom, including a sample syllabus. Occupational therapists, physicians, physician assistants, mental health professionals, and a variety of related health professionals will benefit from this interactive, interdisciplinary text.

Individuals with spinal cord injury (SCI) need options for negotiating architectural barriers, completing essential transfers, and accessing items on high shelves or in cupboards that cannot be reached from the wheelchair or safely managed with reachers. Case Western Reserve University (CWRU) and the Department of Veterans Affairs (VA) have developed an assistive technology device to assist individuals with SCI to stand and transfer. The 8-channel implanted CWRU-VA system enables persons with SCI to exercise, stand, and maneuver in the vicinity of their wheelchairs. Interventions that decrease barriers to mobility and participation can have a significant effect on an individual's perceived quality of life (QOL). This study uses a qualitative research methodology comprised of a series of semi-structured interviews to determine the effects on perceived QOL of an implanted 8-channel functional electrical stimulation (FES) system for standing after SCI. The results reveal that individuals with SCI currently using an implanted FES standing system perceived significant improvements in QOL related to the neuroprosthesis. Implanted neuroprostheses for standing have the potential to improve QOL for veterans living with SCI.

Culture in Clinical Care: Strategies for Competence explores theory and practice to define and describe the multidimensional nature of culture and its interaction with an individual's experience in the development of beliefs, values, and behavior. The newly updated Second Edition examines cultural beliefs related to health and wellness and how these beliefs and their associated actions affect intervention strategies. Based on ethnographic methods, strategies for culturally sensitive assessment and intervention are defined and illustrated, with ample opportunities for reflection and practice. Going beyond traditional fact-centered and attitude-centered approaches, Culture in Clinical Care, Second Edition describes the ways in which culture emerges as individuals interact with each other in physical and social environments. This one-of-a-kind text by Dr. Bette Bonder and Dr. Laura Martin provides health care practitioners and students with chapter objectives, critical thinking questions, interdisciplinary case studies and examples, numerous activities to build observation and interaction skills, comprehensive references and online resources, and images. The book's organization emphasizes practice and reflection by interweaving theory, examples, and continuous hands-on application of concepts. Readers have the opportunity to practice what they are learning and evaluate their own effectiveness while being constantly reminded that all individuals in any interaction embody numerous cultural influences. Benefits of the updated Second Edition: Training and practice in ethnographic methods that build awareness and skill Numerous examples, exercises, and activities for reflection and observation Interdisciplinary approach suitable for cross-disciplinary teaching contexts Definition of health care professions themselves as cultures Web and bibliographic resources Case studies involving a wide range of practitioner disciplines and cultural groups Culture in Clinical Care: Strategies for Competence, Second Edition fills a niche in health professions programs because of its combined emphasis on a theoretical foundation that highlights the individual as a cultural actor and on practical strategies and methods for clinical interventions. Instructors in educational settings can visit www.efacultylounge.com for additional material to be used in the classroom. Occupational therapists, physicians, physician assistants, mental health professionals, and a variety of related health professionals will benefit from this interactive, interdisciplinary text.

This paper describes an approach to instruction for allied health students in screening and brief intervention to assist children and adolescents living with adults who are abusing substances. Substance abuse is a major public health problem in the United States; among its outcomes is damage to children living in the home. Health professionals should screen child and adolescent clients to determine whether adults in the home are substance abusers, and provide help for children living with such adults. An interactive electronic instructional unit, suitable for either independent study or classroom use, was developed to provide this content to allied health students. The unit includes an introductory page, followed by pages focused on the scope of the problem, screening, and brief intervention. Evaluation by means of a pre and post-test suggested that the unit has the potential to increase occupational and physical therapy students' knowledge and modify attitudes regarding their role in providing screening, referral, and brief intervention for this population.

The ways in which cultural beliefs are reflected in the enactment of specific occupations are not well described. A comparison of weaving in the Guatemala Highlands and in Northeast Ohio was completed using interview and observation to provide detailed information about the enactment of weaving, and its meaning to women in the two cultures. Findings demonstrate that there are significant differences in content, context, pattern, affect, and meaning of the occupation. However, weavers also express similar experiences of connection with others, maintenance of tradition, and creative and spiritual expression. Findings also suggest that interventions to maintain the important meanings of the occupation must be tailored to the specific cultural beliefs of the two different groups.

Allied health includes occupational therapists and physical therapists, speech-language pathologists and audiologists. All of these professions emphasize functional ability as the core of their intervention. There is growing demand, but reduced funding, for their services. This article discusses education and training of allied health professionals, credentialing, retention of professionals, and cultural competency.

Individuals with spinal cord injury (SCI) need options for negotiating architectural barriers, completing essential transfers, and accessing items on high shelves or in cupboards that cannot be reached from the wheelchair or safely managed with reachers. Case Western Reserve University (CWRU) and the Department of Veterans Affairs (VA) have developed an assistive technology device to assist individuals with SCI to stand and transfer. The 8-channel implanted CWRU-VA system enables persons with SCI to exercise, stand, and maneuver in the vicinity of their wheelchairs. Interventions that decrease barriers to mobility and participation can have a significant effect on an individual's perceived quality of life (QOL). This study uses a qualitative research methodology comprised of a series of semi-structured interviews to determine the effects on perceived QOL of an implanted 8-channel functional electrical stimulation (FES) system for standing after SCI. The results reveal that individuals with SCI currently using an implanted FES standing system perceived significant improvements in QOL related to the neuroprosthesis. Implanted neuroprostheses for standing have the potential to improve QOL for veterans living with SCI. [PUBLICATION ABSTRACT]

This article presents an integrative perspective on the role that doctor-patient communication and cultural competency training play in health care disparities. Communication between minority patients and physicians is characterized by doctors' biased expectations, patients' perceptions of discrimination, linguistic asymmetry, and self-fulfilling prophecy spirals. Cultural competency training, which has been put forth as a remedy, is itself a complex construct, and methodological variations in cultural competency research make it difficult to reach simple conclusions about its effects. The authors review and synthesize the cross-disciplinary literature in these areas. They propose several directions for research, emphasizing that new studies can lay the groundwork for more trusting verbal communication between doctors and minority patients.

The ways in which cultural beliefs are reflected in the enactment of specific occupations are not well described. A comparison of weaving in the Guatemala Highlands and in Northeast Ohio was completed using interview and observation to provide detailed information about the enactment of weaving, and its meaning to women in the two cultures. Findings demonstrate that there are significant differences in content, context, pattern, affect, and meaning of the occupation. However, weavers also express similar experiences of connection with others, maintenance of tradition, and creative and spiritual expression. Findings also suggest that interventions to maintain the important meanings of the occupation must be tailored to the specific cultural beliefs of the two different groups.

As the U.S. population becomes more racially and culturally diverse, healthcare providers face situations in which their clients' cultural backgrounds are clearly different from their own. Furthermore, a more diverse group of individuals is joining the ranks of healthcare professions. This article describes skills that can enhance care providers' ability to recognize different cultural values, beliefs, and practices and their capability in addressing these factors in interventions, leading to more successful treatment outcomes.