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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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Stereotyping of middle eastern culture

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ask the family, who is the decision-maker?

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ask the family, who is the decision-maker?

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consider cultural background, do not make assumptions and treat patients as individuals 

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consider cultural background, do not make assumptions and treat patients as individuals 

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concept of face: do not want to lose face and other people's face

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concept of face: do not want to lose face and other people's face

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do not want to ask even if he did not understand 

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do not want to ask even if he did not understand 

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doctor needs to show that they understand patient's feelings (doctor is supposed to address issue, should build good patient-doctor relationship)

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doctor needs to show that they understand patient's feelings (doctor is supposed to address issue, should build good patient-doctor relationship)

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makes patient feel comfortable
emphasize that patient understands the situation to avoid miscommunication

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ask patient to repeat what I (the doctor) said

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ask patient to repeat what I (the doctor) said

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patient is more open to doctor --> comfortable

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patient is more open to doctor --> comfortable

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patient understood how and when and why to take the medication

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patient understood how and when and why to take the medication

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learned about the concept of face and how to deal with it

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learned about the concept of face and how to deal with it

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individual: one should not make assumptions

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individual: one should not make assumptions

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institutional level: need to educate healthcare professionals on how to deal with different cultures 

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institutional level: need to educate healthcare professionals on how to deal with different cultures 

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so they can take the medication suggested by doctors

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Patient would think that the doctor does not understand where the patient is coming from

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Patient would think that the doctor does not understand where the patient is coming from

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yes because of great communication skills. He integrated both folk medication and modern/western medication

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yes because of great communication skills. He integrated both folk medication and modern/western medication

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respect culture
make sure patient is involved in the management
read more about the effect of the 'herbal medication'

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do surveys on patients and doctors