e-TBL1-THP_5_Bahrain by Eric Clarke https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d THP_2_Cross cultural communication and health disparities en-us 2021-11-08 09:43:35 UTC 2021-11-16 09:31:06 UTC hello@padlet.com https://padlet.net/icons/png/1f349.png 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. RCSI_MedProf https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617886 2021-11-08 09:43:35 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617886 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 RCSI_MedProf https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617890 2021-11-08 09:43:35 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617890 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. RCSI_MedProf https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617891 2021-11-08 09:43:35 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1874617891 Cultural differences and a collectivism oriented system led Lisa to believe that she must get the dad involved. https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893598395 2021-11-16 08:54:28 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893598395 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893599713 Doctor made assumptions and generalizations about the patient and the family]]> 2021-11-16 08:55:11 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893599713 "all Middle-Eastern Culture people defer to male authority for ALL decisions" this assumption is not accurate. What if the patient's guardian was a single mom? https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893600379 2021-11-16 08:55:34 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893600379 Answer 2 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893602806 I would explain to the father that patient's thought should still be considered even if this is not how it is done in their culture.

I would put my attention towards the patient's mother, as my attempt with the father has failed.]]> 2021-11-16 08:56:51 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893602806 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893602815 I would explain to the father that patient's thought should still be considered even if this is not how it is done in their culture.]]> 2021-11-16 08:56:51 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893602815 I would explain to the dad the severity of his daughter's situation and get the mom involved too https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893603929 2021-11-16 08:57:30 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893603929 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604119 Resolve the issue in a way to optimize patient care as a type 1 diabetic.]]> 2021-11-16 08:57:37 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604119 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604626 Understand the father's perspective and identify ways to incorporate treatment with the father's culture]]> 2021-11-16 08:57:55 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604626 Ensure that the patient gets proper care for her diabetes https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604740 2021-11-16 08:57:58 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893604740 I would apologize to the patients parents and try to figure out the best way to solve this situation. https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893605490 2021-11-16 08:58:25 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893605490 I would ask the mom or whoever brought the patient to the clinic if they would like to get the father involved, but not take an action before I ask https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893606340 2021-11-16 08:58:52 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893606340 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893608092 Make sure the patient’s safety is a priority ]]> 2021-11-16 08:59:47 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893608092 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893608653 Ensure the patient is happy with the situation, that they understand their case and is welling to move forward in the treatment plan. For a 3 year old with chronic disease, it will be difficult for them to stick to life-long plan of restrictions. They need to be emotionally and psychologically supported. ]]> 2021-11-16 09:00:07 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893608653 Treating the patient with professionalism and not ask if I am uncertain about some cultural aspects before making any decision in involving other family members https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893609351 2021-11-16 09:00:31 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893609351 I will inform the father about the importance of his involvement, if he refused I will involve another family member https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893610211 2021-11-16 09:01:00 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893610211 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893610891 Get the father to understand that this is all for the benefit of his patient. And that taking patient's suggestions will ensure that the treatment plan is well adhered to.]]> 2021-11-16 09:01:23 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893610891 Some patients do not want to admit that they haven't understood what the healthcare staff said so that they do not lose face. This is especially prevalent with those from Asian countries. https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893611493 2021-11-16 09:01:43 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893611493 prioritizing the patient https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893611613 2021-11-16 09:01:47 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893611613 It is the doctor's job to make sure that the patient clearly understands what they're being told https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893615754 2021-11-16 09:04:13 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893615754 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893615810 at individual level: the doctor should not make assumptions/ stereotype every patient based on what the culture norms are.]]> 2021-11-16 09:04:15 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893615810 Micro: ask the guardian if they would like to get the other guardian involved. https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893617251 Meso: make sure there are protocols to follow for such situations

Macro: make sure that there are laws in place to protect pediatric patients in such situations]]> 2021-11-16 09:05:07 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893617251 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893617355 Lisa made a generalized assumption based on stereotyping, since the patient comes from a Middle-Eastern family.]]> 2021-11-16 09:05:10 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893617355 I'd explain how to use insulin to Mr Chang in simple terms, I'd get a translator if there is any language barrier. After explaining to him, I'd ask him to repeat what I said to ensure that he understood me. https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893619148 2021-11-16 09:06:16 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893619148 For the patient to administer insulin regularly and to avoid getting infections from improper needle use https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893620073 2021-11-16 09:06:52 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893620073 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621145 I will try to explain to the father once again the importance of his participation. In case he failed to listen, I will try to involve the mother instead.]]> 2021-11-16 09:07:33 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621145 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621201 Patient should remain the centre of the doctor's care. And taking their perspectives will ensure adherence to treatment plans.]]> 2021-11-16 09:07:35 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621201 This is because the patient comes from a high context culture. The doctor should have dealt with him differently to ensure the patient understood everything properly https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621405 2021-11-16 09:07:42 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893621405 High context cultures communicate with indirect messages. There is much reading between the lines and non-verbal communication is important in decoding meanings correctly https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623227 2021-11-16 09:08:49 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623227 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623633 Cultural misconceptions on medication and that natural remedies are better]]> 2021-11-16 09:09:05 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623633 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623752 Ensure the whole family understands and knows how to deal with Amira's diabetes diagnosis, keeping in mind the new lifestyle that must be implemented.]]> 2021-11-16 09:09:09 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893623752 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893624286 Generalisation about cultures norms should only aid understanding a conflict.the doctor should not deal with the patient based on their culture background only.]]> 2021-11-16 09:09:28 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893624286 The patient comes from a different culture https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893624872
such a direct style of communication may appear unfriendly and unclear to patients from this culture. It is the doctors job to ensure the patients understand everything]]> 2021-11-16 09:09:48 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893624872 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893625393 he hasn't as he has refused to intake it]]> 2021-11-16 09:10:05 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893625393 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893625738 Patient may have been embarrassed to ask more questions. It is the role of the doctor to ensure patient understands the treatment]]> 2021-11-16 09:10:17 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893625738 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627006 correct, as his culture implies that alternative remedies should be given to counteract the symptoms]]> 2021-11-16 09:11:03 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627006 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627600 Demonstrate to the patient how insulin is taken which can be done via visual aids, videos, etc. Then make sure the patient understands by repeating back to me the steps/showing]]> 2021-11-16 09:11:25 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627600 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627886 Correct, medicine should counteract the symptoms]]> 2021-11-16 09:11:36 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627886 I would make sure the patient is comfortable and that my language is clear, I would spend more time explaining and try not to seem emotionally distant https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627897 2021-11-16 09:11:37 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893627897 Micro: Get the mom involved https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893628503 Meso: Establish certain protocols in the hospital to better deal with situations like these in the future]]> 2021-11-16 09:12:00 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893628503 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893630396 Patient receives adequate treatment ]]> 2021-11-16 09:13:09 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893630396 The concept of face https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893632425 This is a known concept in some cultures. they would be trying to save their honour and the doctors honour and show that they understood the topic even if they did not.]]> 2021-11-16 09:14:12 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893632425 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893652226 from their culture point of view, they take herbals for their treatment. the patient had another understanding of how their meds should work.]]> 2021-11-16 09:25:59 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893652226 https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893657700 The doctor understood that integrating a herbal tea with their meds will be suitable for this patient.

Since from a biopsychosocial  point, knowing that aspects of the patient like their understanding of their disease and treatment influence their disease progression.

So in these cases we should incorporate the patients thoughts since it won’t do harm to them.]]> 2021-11-16 09:29:02 UTC https://padlet.com/RCSI_MedProf/49zn7cunjb8nix3d/wish/1893657700