The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 14: Culture and CareTable 14-1 presents a framework of issues to be considered with regard to Hispanic patients and15, 27palliative care.26 picasTable 14-1: Hispanic Cultural Themes That Can Influence Palliative CareTheme for Provider Meaning ImplicationFamilismoPersonalismoJerarquismoPresentismoEspiritismoFatalismoEmphasis on the well-being ofthe family over the individualPatient isolation due tofamily homophobiaTrust-building over time,based on the displayof mutual respectRespect for authorityPatient and families mayhave unrealistic treatmentexpectationsEmphasis on the present, noton the past or the futureBelief in good and evil spiritsthat can affect health andwell-beingFate determines lifeoutcomes, including health,and is unbeatableInclude family members inhealth care and end-of-lifediscussionsLearn about patientsand their culturePersonal and opencommunicationCheck whether patient iswithholding informationout of deference to providerPatient and families may avoidend-of-life discussions andadvance directivesPatients may seek spiritualhealers such as curanderos,instead of standard treatmentPatients may be reluctantto seek careSource: Adapted from references 15 and 27.306U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau