cross cultural Flashcards
what is the essence of pt centredness *
learning about and respecting the diverse perceptives of others
helps health care professionals develop supportive, co-operative and more effective relationships with patients
how do individual backgrounds affect consultations *
they alter communication characteristics, health beliefs, and customs based on their individual backgrounds - these influence healthcare needs, health behaviours, and info sharing
what does it mean to be part of a culture *
that yoi can communicate with members of a culture with a level of understanding
summarise the iceburg model of cultural influences on communication *
some cultural issues may be readily apparent while other major issues may be hidden and may not be easily recognised by the health care professional
those above are age, gender, ethnicity, nationality
below are - socioeconomic status, occupation, health, previous health experience, religion, education, social grouping, sexuality, political orientation, cultural beliefs, expectations and behaviours
even those above sea level - difficult to know which are predominant characteristics in a particular setting at a particular time
things you need to consider when talking to people of different cultures *
have I made assumptions - are these helpful
have I dealt with this person as an equal
have I made an effort to understand the person’s way of thinking about their problem, did I really hear what they are telling me
have I made an effort to explain what I intend to do and how I see their problem
have I sought permission/consent
in what ways have I ensured that the approach to dealing with the patient is compatible with their personal and professional life
what are the possible issues in cross-cultural presentation *
language NVC cultural beliefs and healthcare sensitivity issues health care practice issues/barriers
areas where language can be an issue *
foreign language
slang
accent/dialect
risk of causing offence through over-familiarity
areas of NVC that can cause issues *
physical touch body lang proximetry eye contact expression of emotion
areas where cultural beliefs can affect the consultation *
interpretation of symptoms - what is considered normak and abnormal
beliefs about cause
beliefs about treatmets and alternatives
attitude towards illness and disease
use of complementary/alternative sources of healthcare
gender and age expectations about roles and relationships
role of doctor related to power and respect
perceived responsibilities regarding adherence to medical recommendations
family life events/rituals
psychological issues - identifying common stressors, awareness of diversity in family/community supports
role of clinician in mental health
sensitive issues that may be approached differently in different cultures *
sexuality, sexual practices and birth control
ineasiness about some physical examinations
use and abuse of alcohol
domestic violence and abuse
sharing bad news
areas of health care practice issues/barriers *
extent of clinician-pt relationship
extent of family involvement - personal na dfamily responsibility for healthcare and treatment
ethical issues
drs assumptions/stereotypes or prejudices
concurrent consulting with a practitioner of complementary medicine or alternative medicine
ways to reduce stress when there is no shared language *
get the pts name right
pronounce it correctly
allow more time than you would for an English speaking pt
give verbal reassurance
communicate some information about what is going to happen next even if very simple
keep fuller notes - prevents pt having to be repeatedly questioned in future consultations
try to get pt to same staff if possible every time
se if pt has any fears or worries
write down any important points on paper for the patient to take away
clearly state intentions at start of interview
identify PC and ICE - prioritise these
summarise
invite pts to ask questions and clarify anything
how do you adapt your voice when you speak to people with poor English *
speak clearly but don't raise your voice slowly repeat when you hve not been understood use wors the pt is likely to know be careful f idions simplify toe form of each sentacnce don't use pidgin English give instructions in a clear logical sequence 1 topic at a tim e be careful when you use examples pictures or geestures judge how much people are likely to remember
how do you check a pts understanding *
don’t just ask - they will say yes
get them to repeat back to you
what factors vary between individuals and groups *
Health beliefs and attitudes to illness
Negative experience or fear of health services
Stigma attached to particular problems (e.g. mental health)
Fear of death
Particular problems encountered by refugees and recent immigrants
Socio-economic problems
Fear of attack, harassment and victimization and other stressful situations
