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Amira Faroud was a three-year-old Middle Eastern patient, newly diagnosed with type 1 diabetes. Understanding the importance of involving the entire family in the patient’s care, Lisa tried to get the patient’s father, Mr. Faroud, to participate. She had seen other fathers being the “heads” of families and believed involving him was the best thing to do because Lisa the doctor in this case believes that all Middle-Eastern Culture people defer to male authority for ALL desicions. But in this case Mr. Faroud would not even consider her suggestions. 

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Amira Faroud was a three-year-old Middle Eastern patient, newly diagnosed with type 1 diabetes. Understanding the importance of involving the entire family in the patient’s care, Lisa tried to get the patient’s father, Mr. Faroud, to participate. She had seen other fathers being the “heads” of families and believed involving him was the best thing to do because Lisa the doctor in this case believes that all Middle-Eastern Culture people defer to male authority for ALL desicions. But in this case Mr. Faroud would not even consider her suggestions. 

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Dr Jones is part of a healthcare team helping a newly diagnosed Chinese diabetic patient to understand & manage his diet and insulin levels. He has just explained to the patient how to take his medication. Dr: “Have you understood how & when to take your insulin Mr Chang? Do you have any questions ?”Patient: “I understand Doctor, thank you for your time” (Patient leaves in a hurry)Some weeks later Mr Chang returns & is very unwell, his insulin levels are elevated & when interviewed by the Medical team it is clear that he had not clearly understood how & when to take his Insulin 

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Dr Jones is part of a healthcare team helping a newly diagnosed Chinese diabetic patient to understand & manage his diet and insulin levels. He has just explained to the patient how to take his medication. Dr: “Have you understood how & when to take your insulin Mr Chang? Do you have any questions ?”Patient: “I understand Doctor, thank you for your time” (Patient leaves in a hurry)Some weeks later Mr Chang returns & is very unwell, his insulin levels are elevated & when interviewed by the Medical team it is clear that he had not clearly understood how & when to take his Insulin 

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An American doctor enquires about the type of medication a Latin American patient (P) took against his hypertension symptoms: D: In order to help you with your current complaint as well as possible, we would like to know what kind of medication you take on a regular basis or that you have taken recently.P:  I do not take any medication on a regular basis but  The doctor I went to a week ago suggested I take something. But I didn’t do it. I do not think it is good for me.D: Can you tell me more about this, what do you feel you should do or take ? P: Yes, look, the doctor I went to wanted to give me something. But I do not think this medicine is good for me. I am not sure this is the right one. We say that when one feels like I do one should take something which contrasts the symptoms.D: “one should take something which contrasts the symptoms’? What do you mean exactly? Do you mean that in your country patients are given other remedies against the symptoms?you should do? P: Yes, exactly, , they give some teas and I believe they are very good.D: We will see what we can do. If you would you like to continue to drink these teas adding to another form of medication which we would suggest & I will explain to you now, I think you will benefit from both.P : Oh that would be great doctor! Thank you very much. 

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An American doctor enquires about the type of medication a Latin American patient (P) took against his hypertension symptoms: D: In order to help you with your current complaint as well as possible, we would like to know what kind of medication you take on a regular basis or that you have taken recently.P:  I do not take any medication on a regular basis but  The doctor I went to a week ago suggested I take something. But I didn’t do it. I do not think it is good for me.D: Can you tell me more about this, what do you feel you should do or take ? P: Yes, look, the doctor I went to wanted to give me something. But I do not think this medicine is good for me. I am not sure this is the right one. We say that when one feels like I do one should take something which contrasts the symptoms.D: “one should take something which contrasts the symptoms’? What do you mean exactly? Do you mean that in your country patients are given other remedies against the symptoms?you should do? P: Yes, exactly, , they give some teas and I believe they are very good.D: We will see what we can do. If you would you like to continue to drink these teas adding to another form of medication which we would suggest & I will explain to you now, I think you will benefit from both.P : Oh that would be great doctor! Thank you very much. 

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Dr lisa could have established a better picture of how the family actually worked if she had communicated with them instead of assuming how it worked

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Question the father about what he feels is appropriate when approaching the problem 

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Question the father about what he feels is appropriate when approaching the problem 

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Explain better what is happening to Amira for a better understanding of the situation 

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Explain better what is happening to Amira for a better understanding of the situation 

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Educate the family about type 1 diabetes

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Educate the family about type 1 diabetes

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For someone to take responsibility for Amira's care 

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For someone to take responsibility for Amira's care 

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Working in partnership with the family to provide adequate care

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Working in partnership with the family to provide adequate care

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Didn't want the doctor to have a certain impression of him (by asking more & showing he did not understand)

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The patient was embarrassed to ask for clarification from the doctor, as he may have felt like it would hurt his pride and prestige 

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The patient was embarrassed to ask for clarification from the doctor, as he may have felt like it would hurt his pride and prestige 

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Patient gets good care, understands his condition & how to manage it

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Patient gets good care, understands his condition & how to manage it

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While talking to the patient stop frequently and summarize the main points. Make sure the patient is aware of the points you are making by signposting  what you will be talking about next

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Understand the cultural differences, how it can contribute to miscommunication & how to overcome that 

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Understand the cultural differences, how it can contribute to miscommunication & how to overcome that 

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It's the doctor's job to make sure the patient understands the course of the treatment

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It's the doctor's job to make sure the patient understands the course of the treatment

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The patient may have felt embarrassed to show that he did not fully understand what the doctor was saying, hence why he refused to ask more questions 

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The patient may have felt embarrassed to show that he did not fully understand what the doctor was saying, hence why he refused to ask more questions 

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By doing this the doctor is able to establish a foundation  to build a strong doctor patient relationship

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the patient wants medications that contradict the actual effect so while the medication is meant tor eat the actual symptoms, his culture wants him to take meds that contrast the symptoms of his disease

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B) He does not like taking modern medication, and is more comfortable taking traditional medicine (i.e. tea) 

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B) He does not like taking modern medication, and is more comfortable taking traditional medicine (i.e. tea) 

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Can get patient to cooperate, gives patient a sense of control over their own health 

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Can get patient to cooperate, gives patient a sense of control over their own health 

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The patient is taking medications that they believe will make them feel better, rather than something they are told will make them feel better

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Patient mistrust, they leave & refuse treatment 

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Patient mistrust, they leave & refuse treatment 

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they may not comply with the administration of the medication

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they may not comply with the administration of the medication