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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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involve the mother, or ask both parents who would be able to manage the daughter's condition. 

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involve the mother, or ask both parents who would be able to manage the daughter's condition. 

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The mother would also be involved since the parents would know the Amira best.

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The mother would also be involved since the parents would know the Amira best.

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 Come to an understanding with the parents and have a shared responsibility amongst them. The parents need to engage with Amira's care

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 Come to an understanding with the parents and have a shared responsibility amongst them. The parents need to engage with Amira's care

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Micro --> no stereotyping, Meso --> involve the parents with decision making, Macro --> bring more awareness towards T1DM management

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Micro --> no stereotyping, Meso --> involve the parents with decision making, Macro --> bring more awareness towards T1DM management

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Collectively consult all available family members with priority placed on the mother, 🤬 their judgement capacity and communicate accordingly 

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Collectively consult all available family members with priority placed on the mother, 🤬 their judgement capacity and communicate accordingly 

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Avoid stereotyping, involve parents in minor health care

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Avoid stereotyping, involve parents in minor health care

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The doctor didn't ask the patient to paraphrase and repeat what has been mentioned.

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The doctor didn't ask the patient to paraphrase and repeat what has been mentioned.

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The doctor didn't make sure that the patient understood what he was talking about.

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The doctor didn't make sure that the patient understood what he was talking about.

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The patient may not have been comfortable showing that they didn't understand what was being mentioned.

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The patient may not have been comfortable showing that they didn't understand what was being mentioned.

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It's the doctor's job to make sure that the patient understands everything.

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It's the doctor's job to make sure that the patient understands everything.

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The patient was afraid of losing face in front of the doctor

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The patient was afraid of losing face in front of the doctor

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Assure that parents have clearly understood the matter, whilst maintaining their comfort. 

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Assure that parents have clearly understood the matter, whilst maintaining their comfort. 

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I'd ask the patient to repeat what I've just talked about to make sure that the message has been received and well understood 

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I'd ask the patient to repeat what I've just talked about to make sure that the message has been received and well understood 

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Ask the patient to demonstrate how he injects the insulin into his body

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Ask the patient to demonstrate how he injects the insulin into his body

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Begin by apologizing to the patient if they didn't understand from the first consultation and make sure to rectify the issue at hand.

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Begin by apologizing to the patient if they didn't understand from the first consultation and make sure to rectify the issue at hand.

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Reassure the patient that there is no shame in not understanding; make him/her feel comfortable enough to ask for help

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Reassure the patient that there is no shame in not understanding; make him/her feel comfortable enough to ask for help

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The desired outcome would be that the patient is capable of understanding what the doctor was explaining.

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The desired outcome would be that the patient is capable of understanding what the doctor was explaining.

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Tell the patient that it is fine if he didn't understand.

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Tell the patient that it is fine if he didn't understand.

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He has another understanding of how medication should work on the body.

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He has another understanding of how medication should work on the body.

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Be patient with patients and understand your duty of ensuring the patient is fully understanding of the condition 

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Be patient with patients and understand your duty of ensuring the patient is fully understanding of the condition 

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It either low educational background, false beliefs or experienced incidents that lead to reduced patient trust.

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Clarify and address all issues regarding patient's concern to ensure better healthcare provision.

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Clarify and address all issues regarding patient's concern to ensure better healthcare provision.

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Individual Level :Educate Healthcare providers enabling them to identify stereotyping in their practice, work around it, whilst maintaining professional identity and persona.

Institutional Level: Promote individuality and tolerence

Regulatory: Introduce policies that ensure that decisions are taken by individuals with adequate judgement capacity wether it was the patient itself or family, depending on whoever is assigned to take decision.

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Patient fears that asking questions and appearing to not understand information perceived as simple is in-dignifying and an embarrassment that is to be avoided.

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Asking questions might be perceived as in-dignifying, the physician is responsible for ensuring that patients clearly understand information for their own safety.

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After identifying the cultural barrier, i would attempt to calm the patient and dismiss any dangers that he might've perceived, then i would the patient to demonstrate his understanding through repeating the lists of tasks and ways to do them and reasoning behind using a particular way/technique.

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The patient achieves adequate understanding that enables safe management of illness + maintaining patient comfort.

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The patient achieves adequate understanding that enables safe management of illness + maintaining patient comfort.