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Culture & Clinical Care

Ellison, Norig, MD

Section Editor(s): Ellison, Norig

doi: 10.1213/01.ANE.0000237542.18537.C8
Book and Multimedia Reviews: Media Review

Professor of Anesthesia, University of Pennsylvania, Philadelphia, PA,

Culture & Clinical Care

Lipson JG, Dibble SL, eds. San Francisco: UCSF Nursing Press, 2006. ISBN 0-943671-22-1. 487 pages, $39.95.

Culture & Clinical Care is the successor to Culture & Nursing Care: A Pocket Guide, a popular and widely used publication in 1990s. Culture & Clinical Care widens the focus to all who provide health care to patients from widely diverse origins, beliefs, and practices.. Ranging alphabetically from Afghans to (Former) Yugoslavians, 35 ethnic/ regional groups are discussed. The groups selected for inclusion are based on size (at least 100,000 according to the U.S. census) and/or the lack of information readily obtainable elsewhere. The editors point out that there is considerable variation in any group and each individual “views experiences through the lens of his/her own personality and resources.” Health care providers can improve the care provided by considering the culture of patients and their families—even, if necessary, by respectfully asking them with what they consider culturally appropriate.

Clearly due to faster transportation, planet Earth is getting smaller, and the chance of a patient from one of these groups requiring surgical anesthesia, pain relief, or critical care is greater today. The editors cite two additional reasons in their preface: the 1951 United Nations policy on refugees and the 1995 immigration law which loosened the U.S. quota system.

Most of the 55 authors who wrote the chapters either immigrated to America from the country or region discussed, lived there for some time, or were descendants of immigrants—e.g., one of the authors of the chapter on Japan is a third-generation Japanese-American. In some groups a region must be specified, rather than a country—e.g., the Hmongs are spread through China, Laos, Vietnam, Burma, and Thailand. Similarly, the Roma (gypsies) are divided into several “nations,” including Romanies (English origin), Travelers (English and Irish), Gitanos (Spanish), and other subgroups.

The chapters present their information in a uniform manner using a twelve point outline: (1) culture/ethnic identity, (2) spiritual/religious orientation, (3) communications (oral, written, and verbal), (4) activities of daily living, (5) food practices, (6) symptom management, (7) birth rituals/care of the new mother and baby, (8) developmental and sexual issues, (9) family relationships, (10) illness beliefs, (11) health issues, and (12) death rituals. The editors state in their introduction that, “diversity is part of the fabric of American public life.” To illustrate the diversity within these 35 groups, the second outline point, spiritual/religious orientation, was compared across the groups. Again, beliefs ranged alphabetically from animism in Cambodia to Zoroastrianism in Iran. The total number of religious beliefs/practices is difficult to determine because of overlaps between groups but clearly greatly exceeds the number of countries/regions discussed. Several interesting aspects of religions are discussed—e.g., in India 83% of the population are Hindu, but the 12% who are Muslims (120,000,000) means India has one of the world's largest Muslim population; in the Dominican Republic “witches” are listed as a legacy; and in Haiti, Voodoo (an African spirit religion closely related to Catholicism) is an important religious component.

This reviewer suggests that this is not a book that one will sit and read as one would a novel. Rather this is a book one will use as a reference when caring for patients from one of the 35 groups— although one can learn many fascinating facts by reading the book. These range from the fact half the 60,000–100,000 Afghans living in America reside in the San Francisco Bay area to the fact the (Former) Yugoslavians represent more than 25 nationalities and ethnic groups. Each department library would benefit by having a copy of this book available for consultation when one must care for a patient from one of these groups, especially recent immigrants who have not been assimilated into the melting pot that is America. Said consultation will “help clinicians assess group patterns and acknowledge individual variation within a cultural group.”

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Receipt of the books listed below is acknowledged. Selected books from this list will be reviewed in future issues of the Journal.

The Journal solicits reviews of new books from its readers. If you wish to submit a review, before proceeding please send a letter of intent, identifying the book in question, to Dr. Norig Ellison, Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104. The Journal reserves the right of final decision on publication.

Hammond E, McIndoe AK (eds): QBASE ANESTHESIA, MCOS FOR THE FINAL FRCA, Vol. 5, Cambridge University Press, New York, NY, 2006. ISBN 0-521-67705-X. 211 pages + CD-ROM, $50.00.

Holdcroft A, Jaggar S (eds): CORE TOPICS IN PAIN, Cambridge Univ. Press, New York, NY, 2006. ISBN 0-521-85778-3. 345 pages, $70.00.

McConacchie I (ed): ICU THERAPY, 2nd edition, Cambridge University Press, New York, NY, 2006. ISBN 0-521-68247-9. 439 pages, $600.00.

Meiler SE (ed): INFLUENCE OF PERIOPERATIVE CARE ON OUTCOME, Vol. 24, No. 2 of NESTH CLIN, Elsevier/Saunders, Phila., 2006. ISBN 1-4160-3572-9. 181 Pages, $184.00 annual subscription for four issues or $84.00 single issue.

Springman SR (ed): THE REQUISITES IN ANESTHESIOLOGY; AMBULATORY ANESTHESIA, Mosby/Elsevier, Phila., PA. 2006. ISBN 0-323-03225-7. 204 pages, $79.95.

© 2006 International Anesthesia Research Society