The purpose of this ethnographic research was to explain the factors influencing Achi patients in provider-patient interactions in Baja Verapaz, Guatemala. I explored the complex intercultural challenges influencing the interactions between biomedically-trained providers and indigenous patients. Data collection involved participant observation and twenty-four informal field interviews in Guatemala. I utilized thematic analysis to identify and understand the factors influencing Achi patients when interacting with health care providers. Findings reveal that the Achi patients are influenced in provider-patient interactions by the reciprocal interaction among four major factors: environment, beliefs, emotional effect, and experiences. In addition, subthemes were identified for each of the major factors. A central finding of this research was a new construct, defacement, which is purposeful communication that dehumanizes by destroying other-face. Four levels of defacement, each increasing in intensity and dehumanizing content, emerged from the data: disregarding, degrading, regaño-ing, and abusing.
Health Communication, Intercultural Communication, Indigenous Health, Face, Defacement, provider-patient communication
Level of Degree
Department of Communication and Journalism
First Committee Member (Chair)
Second Committee Member
Third Committee Member
Burton, Laura L.. "Facing Defacement: Factors influencing indigenous patients in provider-patient communication in Baja Verapaz, Guatemala." (2009). http://digitalrepository.unm.edu/cj_etds/57