Title

Navigating burdens: Understanding the intersection between cultural values, health decision-making, and everyday occupations in the Latino population

1

Location

Studio 3

Start Time

21-10-2017 11:30 AM

End Time

21-10-2017 12:30 PM

Session Type

Research Paper

Abstract

Background:

Despite facing a disproportionate distribution of disease and health disparities, Latinos often report high levels of ethnic identity and social support provided by family cohesion, known as familismo.1 These ties serve as protective factors to their mental health,2 and help to maintain a cultural identity. However, these networks can also contribute to stress related health issues for Latinos.3 Because family well-being is related to the status of the group as well as the individual health of its members, Latino individuals can feel burdened for both themselves and a collective responsibility for their family.

Statement of Purpose:

This purpose of this paper is to discuss how Latino patients make health related decisions given their complicated family contexts, and the impact of these decisions on their everyday occupations.

Methods:

Two research projects provide the case studies for this paper. From the first, treatment notes for patients living with a spinal cord injury who were enrolled in a lifestyle intervention and developed a serious pressure ulcer (n=25) were separated by ethnicity. Of 11 Latino patients, a research assistant coded the treatment notes and selected 3 individual cases based on completion of the intervention, description of family-orchestrated occupations and conflicts, and ability to produce a narrative from clinical information. The second project was interviews conducted with 10 Latina women who sought acupuncture as an alternative to western medicine as a means to treat and cope with daily stress. Interviews lasted 2-2.5 hours, were transcribed verbatim, and two coders conducted a thematic analysis of the data. Though burdens were described in all interviews, 2 cases were selected for presentation.

Results:

The cases demonstrate how the interplay between person and context shapes occupational performance by exploring factors that are enmeshed in a Latino family’s habits, culture, environment, and routines. This tension between health as a personal responsibility and the social connectivity of the Latino family units creates situations where Latino patients are unduly burdened, and must make difficult medical decisions that lay between their individual health and the health of their family.

Relationship to Occupational Science

Latinos’ performances of health-related occupations are influenced by a multitude of factors related to their cultural identities and family structures. In presenting examples from these studies, we aim to take an occupational perspective of health,4 and facilitate a discussion regarding the relationship of burden, culture, and stress, to health decision-making and occupational engagement in the Latino population.

Key Words: Latinos, Health Disparities, Health decision-making, Familism

Discussion Questions:

How do we better understand family-orchestrated occupations and conflicts in this under served population?

How can our current approach to occupational participation help minimize burden and stress?

References

References:

1. Sabogal, F., Marín, G., Otero-Sabogal, R., Marín, B. V., & Perez-Stable, E. J. (1987). Hispanic familism and acculturation: What changes and what doesn't? Hispanic Journal of Behavioral Sciences, 9(4), 397-412.

2. Ribas, A. C., & Lam, C. S. (2010). Social support and quality of life among Latinos with mental illness. The Journal of Nervous and Mental Disease, 198(2), 137-143.

3. Arbona, C., Olvera, N., Rodriguez, N., Hagan, J., Linares, A., & Wiesner, M. (2010). Acculturative stress among documented and undocumented Latino immigrants in the United States. Hispanic Journal of Behavioral Sciences, 32(3), 362-384.

4. Wilcock, A. A. (2007). Occupation and health: Are they one and the same?. Journal of Occupational Science, 14(1), 3-8.

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Oct 21st, 11:30 AM Oct 21st, 12:30 PM

Navigating burdens: Understanding the intersection between cultural values, health decision-making, and everyday occupations in the Latino population

Studio 3

Background:

Despite facing a disproportionate distribution of disease and health disparities, Latinos often report high levels of ethnic identity and social support provided by family cohesion, known as familismo.1 These ties serve as protective factors to their mental health,2 and help to maintain a cultural identity. However, these networks can also contribute to stress related health issues for Latinos.3 Because family well-being is related to the status of the group as well as the individual health of its members, Latino individuals can feel burdened for both themselves and a collective responsibility for their family.

Statement of Purpose:

This purpose of this paper is to discuss how Latino patients make health related decisions given their complicated family contexts, and the impact of these decisions on their everyday occupations.

Methods:

Two research projects provide the case studies for this paper. From the first, treatment notes for patients living with a spinal cord injury who were enrolled in a lifestyle intervention and developed a serious pressure ulcer (n=25) were separated by ethnicity. Of 11 Latino patients, a research assistant coded the treatment notes and selected 3 individual cases based on completion of the intervention, description of family-orchestrated occupations and conflicts, and ability to produce a narrative from clinical information. The second project was interviews conducted with 10 Latina women who sought acupuncture as an alternative to western medicine as a means to treat and cope with daily stress. Interviews lasted 2-2.5 hours, were transcribed verbatim, and two coders conducted a thematic analysis of the data. Though burdens were described in all interviews, 2 cases were selected for presentation.

Results:

The cases demonstrate how the interplay between person and context shapes occupational performance by exploring factors that are enmeshed in a Latino family’s habits, culture, environment, and routines. This tension between health as a personal responsibility and the social connectivity of the Latino family units creates situations where Latino patients are unduly burdened, and must make difficult medical decisions that lay between their individual health and the health of their family.

Relationship to Occupational Science

Latinos’ performances of health-related occupations are influenced by a multitude of factors related to their cultural identities and family structures. In presenting examples from these studies, we aim to take an occupational perspective of health,4 and facilitate a discussion regarding the relationship of burden, culture, and stress, to health decision-making and occupational engagement in the Latino population.

Key Words: Latinos, Health Disparities, Health decision-making, Familism

Discussion Questions:

How do we better understand family-orchestrated occupations and conflicts in this under served population?

How can our current approach to occupational participation help minimize burden and stress?