Intercultural encounters between United States health care providers and Hispanic immigrant health care seekers: A critical ethnography

Although health communication scholars are increasingly examining the influence of culture on health communication, intercultural health care encounters between non-Hispanic health care providers and Hispanic immigrant health care seekers remains largely understudied. In this study, ethnographic and focus group methods were employed in order to examine influences of Hispanic culture on the choices and behaviors of Hispanic immigrants in intercultural health care encounters. Cultural characteristics and ideologies of being an immigrant were considered in this examination. This study was guided by two theories: (1) Sharf's culturally sensitive model of patient-physician communication, and (2) Leininger's cultural care diversity and universality theory.;The research took place in a small community in Indiana where Hispanic immigrants reside. The Guadalupe Center, a religious community based center serving the needs of the local Hispanic population, was the primary location for this study. The study began in January 2005 and concluded in November 2006. Twenty-one structured and nine unstructured interviews with immigrants (documented and undocumented) who ranged in age from 21 to 60 were conducted.;In the process of making observations and interviewing Hispanic immigrant health care seekers, I developed a four-stage process model of "becoming an immigrant." The four stages are: preparatory, mobilization, ingression, and abiding. This model was developed directly from the voices of the immigrants in this study. Each stage of this process influences the identity of the immigrant and may affect the Hispanic immigrant's choices and behaviors in an intercultural health care encounter.;The participants in this study reported that being a patient means: waiting, treating oneself, not having a primary care physician, asking few questions of providers, and being prepared to die. Cultural issues with translation were also identified. To conclude this study, a needs assessment and a list of strategies for Hispanic immigrant health care seekers are provided.