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Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers / Edition 1 - Paperback | Diverse Reads

Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers / Edition 1

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Healing by Heart is a book of stories--stories of people's search for culturally responsive health care from U.S. providers. It offers resources to providers and institutions committed to delivering culturally responsive health care, paying special attention to building successful relationships with traditional Hmong patients and families. It makes available extensive information about the health-related beliefs, practices, and values of the Hmong people, including photographs of traditional healing methods.

Ranging in age from young infants to older adults, the patients in the stories present a wide range of health problems. The clinicians are from family practice, internal medicine, pediatrics, emergency medicine, surgery, obstetrics-gynecology, psychiatry/psychology, and hospice.

Each of the fourteen case stories is accompanied by discussion questions as well as two or three commentaries. The commentaries--written by patients, family members, shaman, Western clinicians (including Hmong physicians, nurses, and social workers), medical anthropologists, health care ethicists, social workers, psychologists, and clergy--are rich in personal reflections on cross-cultural health care experiences. Readers are rewarded with a combination of perspectives, including those of Hmong authors who have not previously published in English and scholars with years of professional experience working with the Hmong in Laos, Thailand, and the United States.

The editors offer a model for delivering culturally responsive health care with special attention to matters of cross-cultural health care ethics. The model identifies questions health care providers can focus on as they seek to understand the health-related moral commitments and practices prevalent in the cultural groups they serve, ethical questions that arise frequently and with great poignancy in cross-cultural health care relationships, and points to consider when a patient's treatment wish challenges the provider's professional integrity.

By sharing stories of suffering, confusion, and success, Healing by Heart couples an accessible method of learning about others with concrete recommendations about how to enhance cross-cultural health care relationships.

ISBN-13: 9780826514318

Media Type: Paperback

Publisher: Vanderbilt University Press

Publication Date: 10-01-2003

Pages: 368

Product Dimensions: 7.00(w) x 10.00(h) x (d)

Barbara Babbitt, BSN, RN, MA, has spent many years working to improve the way health care is delivered to culturally diverse families in the Twin Cities. Dorothy E. Vawter, PhD, associate director, Minnesota Center for Health Care Ethics, directs the Center's work on cross-cultural health care ethics. Kathleen A. Culhane-Pera, MD, MA, is a family physician at Ramsey Family and Community Medicine Residency and West Side Community Health Center. Mary M. Solberg, PhD, MSW, is a member of the religion faculty at Gustavus Adolphus College. Phua Xiong, MD, is a family-practice physician at the St. Paul Family Medical Center in St. Paul.

Table of Contents

List of Illustrations ix
Preface and Acknowledgments xi
Introduction 1
Part I Health-Related Cultural Beliefs, Practices, and Values
1 Hmong Culture: Tradition and Change 11
Part II Women's Health: Case Stories and Commentaries
2 Controlling Fertility: A Case Story 71
Hmong Preferences for Natural Family Planning 73
Social, Cultural, and Ethical Aspects of Controlling Fertility in the Hmong Community 80
3 Woman with Pregnancy Complications: A Case Story 88
The Cultural Complexity of Obstetrical Care 92
Conflicting Cultural Practices in Deciding about a Cesarean-Section 98
4 Woman with Vaginal Bleeding: A Case Story 104
Culturally Responsive Care for a Hmong Woman with Vaginal Bleeding 106
Influence of Conversion to Christianity on a Hmong Woman's Decision about Hysterectomy: A Pastor's Perspective 111
Part III Children's Health: Case Stories and Commentaries
5 Children with High Fevers: Case Stories 117
Hmong Health Beliefs and Practices Concerning Childhood Fevers 120
State-Ordered Medical Care for Our Son: Parents' Perspective 129
Family-Centered Cultural Collaboration in Pediatric Care 133
6 Bottle-Fed Toddler with Anemia: A Case Story 141
Iron-Deficiency Anemia in Bottle-fed Toddlers 144
A Culturally Informed Public Health Response to Pediatric Anemia in the Hmong Community 149
7 Infant with Down Syndrome and a Heart Defect: A Case Story 156
Defining Best Interest for a Hmong Infant: A Physician's Challenge 159
"Why Do They Want to Hurt My Child?": The Mother's Perspective 165
Part IV Chronic Disease: Case Stories and Commentaries
8 Man with Diabetes and Hypertension: A Case Story 173
Type 2 Diabetes Mellitus in the Hmong Community 176
"I Tell You This Story of Healing": A Shaman's Perspective 183
9 Young Woman with Kidney Failure and Transplant: A Case Story 186
Endstage 190
Painful Cultural Differences in a Hmong Family: The Mother's Perspective 198
Part V Mental Illness: Case Stories and Commentaries
10 War Veteran with Depression and Posttraumatic Stress Disorder: A Case Story 207
Social and Spiritual Explanations of Depression and Nightmares 209
Depression and Posttraumatic Stress Disorder: Prevailing Causes and Therapeutic Strategies with Hmong Clients 216
11 Domestic Violence: A Case Story 222
Traditional Hmong Concepts of Wife Beating 224
Changing Gender Roles and Domestic Violence in the Hmong Community: A Feminist Perspective 234
12 Woman with Psychosis: A Case Story 239
Cultural Interpretations of Psychosis 241
Integrating Hmong and Western Approaches to Spiritual Illnesses 251
Part VI End-of-Life Care: Case Stories and Commentaries
13 Hospice Patient with Gallbladder Cancer: A Case Story 255
Cultural Complications in End-of-Life Care for a Hmong Woman with Gallbladder Cancer 258
The Husband's Plea for Provider Honesty 265
14 Pregnant Woman with a Brain Hemorrhage: A Case Story 269
Strategies for Health Care Providers and Institutions to Deliver Culturally Competent Care 273
Accommodation of Cultural Differences in End-of-Life Care 280
15 A Widowed Mother's Search for a Good Place to Die: A Case Story 284
Providing a Spiritually Appropriate Place for My Mother's Care and Death 287
"Please Help Me": A Physician Responds to a Hmong Woman's End-of-Life Struggles 289
Part VII Culturally Responsive Health Care
16 A Model for Culturally Responsive Health Care 297
Recommendations for Health Care Practitioners 305
Recommendations for Health Care Administrators and Educators 343
Recommendations for Public Policy Makers 347
Editors and Contributors 357
Index 363