e-TBL1-THP_9_Bahrain by Eric Clarke https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67 THP_2_Cross cultural communication and health disparities en-us 2021-11-08 09:45:49 UTC 2021-11-16 09:54:23 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/h9kefpwxoy3hfr67/wish/1874621856 2021-11-08 09:45:49 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1874621856 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/h9kefpwxoy3hfr67/wish/1874621859 2021-11-08 09:45:49 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1874621859 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/h9kefpwxoy3hfr67/wish/1874621860 2021-11-08 09:45:49 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1874621860 Stereotyping, collectivism, masculinity https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893600077 2021-11-16 08:55:23 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893600077 involve the mother, or ask both parents who would be able to manage the daughter's condition. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893605336 2021-11-16 08:58:19 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893605336 The mother would also be involved since the parents would know the Amira best. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893605355 2021-11-16 08:58:20 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893605355 engagement of both parents. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893606412 2021-11-16 08:58:54 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893606412 Come to an understanding with the parents and have a shared responsibility amongst them. The parents need to engage with Amira's care https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893608432 2021-11-16 08:59:58 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893608432 Micro --> no stereotyping, Meso --> involve the parents with decision making, Macro --> bring more awareness towards T1DM management https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893609278 2021-11-16 09:00:28 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893609278 Collectively consult all available family members with priority placed on the mother, 🤬 their judgement capacity and communicate accordingly 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893610769 2021-11-16 09:01:19 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893610769 Avoid stereotyping, involve parents in minor health care https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893610946 2021-11-16 09:01:25 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893610946 The doctor didn't ask the patient to paraphrase and repeat what has been mentioned. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893614136 2021-11-16 09:03:18 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893614136 The doctor didn't make sure that the patient understood what he was talking about. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893614892 2021-11-16 09:03:45 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893614892 Masculinity and Stereotyping 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893615907 2021-11-16 09:04:18 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893615907 The patient may not have been comfortable showing that they didn't understand what was being mentioned. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893616149 2021-11-16 09:04:28 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893616149 It's the doctor's job to make sure that the patient understands everything. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893616814 2021-11-16 09:04:52 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893616814 The patient was afraid of losing face in front of the doctor https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893619667 2021-11-16 09:06:37 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893619667 Assure that parents have clearly understood the matter, whilst maintaining their comfort. 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893620759 2021-11-16 09:07:20 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893620759 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 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893620953 2021-11-16 09:07:26 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893620953 Ask the patient to demonstrate how he injects the insulin into his body https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893622044 2021-11-16 09:08:05 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893622044 Begin by apologizing to the patient if they didn't understand from the first consultation and make sure to rectify the issue at hand. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893623062 2021-11-16 09:08:43 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893623062 Reassure the patient that there is no shame in not understanding; make him/her feel comfortable enough to ask for help https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893623491 2021-11-16 09:09:00 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893623491 The desired outcome would be that the patient is capable of understanding what the doctor was explaining. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893626395 2021-11-16 09:10:41 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893626395 Tell the patient that it is fine if he didn't understand. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893627153 2021-11-16 09:11:08 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893627153 He has another understanding of how medication should work on the body. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893634544 2021-11-16 09:15:25 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893634544 Be patient with patients and understand your duty of ensuring the patient is fully understanding of the condition https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893639611 2021-11-16 09:18:32 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893639611 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893640738 It either low educational background, false beliefs or experienced incidents that lead to reduced patient trust. ]]> 2021-11-16 09:19:09 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893640738 Clarify and address all issues regarding patient's concern to ensure better healthcare provision. https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893650575 2021-11-16 09:25:02 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893650575 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893657111 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.]]> 2021-11-16 09:28:44 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893657111 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893687668 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.]]> 2021-11-16 09:45:30 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893687668 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893692136 Asking questions might be perceived as in-dignifying, the physician is responsible for ensuring that patients clearly understand information for their own safety. ]]> 2021-11-16 09:48:06 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893692136 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893699791 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. ]]> 2021-11-16 09:52:24 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893699791 The patient achieves adequate understanding that enables safe management of illness + maintaining patient comfort. 18229425 https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893703403 2021-11-16 09:54:23 UTC https://padlet.com/RCSI_MedProf/h9kefpwxoy3hfr67/wish/1893703403