TLE 1 Group_1_Dublin by Eric Clarke https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx THP_2_Cross cultural communication and health disparities en-us 2021-11-09 11:39:12 UTC 2021-11-16 12:38:50 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/n8hbyqjqn04sbtqx/wish/1877967956 2021-11-09 11:39:12 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1877967956 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/n8hbyqjqn04sbtqx/wish/1877967962 2021-11-09 11:39:12 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1877967962 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/n8hbyqjqn04sbtqx/wish/1877967964 2021-11-09 11:39:12 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1877967964 ask the guardian/parents who they would like to assign to make decisions for their child https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893919971 2021-11-16 12:05:15 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893919971 reaching a desirable conclusion while maintaining a good relationship with patient's family to ensure medication compliance and good care of the patient https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893921006

]]> 2021-11-16 12:05:56 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893921006 There is a child that need assistance however the child is too young to understand their situation on their own. Therefore the involvement of a family member/family members is required to facilitate the proper care of the child. The Doctor assumes that the father would be the main authoritative figure for the family and tries to convey his child's situation to him but he does not respond. https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893921517 2021-11-16 12:06:13 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893921517 Remove all bias and assumptions from decision making and have the patient and their family explain what their medical situation is in terms of the 3 year old patient https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893923450 2021-11-16 12:07:33 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893923450 asian culture of 'face' , face means honouring pride , Mr Chang was thinking that he will lose his face if he ask something that the Dr already explains https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893927503 2021-11-16 12:09:46 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893927503 The language barrier between the patient and the doctor influenced the patient's ability to be able to properly inject his insulin https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893927812 2021-11-16 12:09:57 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893927812 Sit down again with the patient, this time with a translator, and go through the process again of injecting insulin and even watch him inject the insulin to make sure he understands https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893930177 2021-11-16 12:11:23 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893930177 Have the patient speak first and have them explain to you what they understand (as a baseline) https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893931229 2021-11-16 12:11:46 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893931229 Explain to the patient that nothing is coming from a place of judgement https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893931861 2021-11-16 12:12:08 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893931861 Reassure Mr Chang that misunderstanding is not something to be embarrassed about. As doctors, we will gladly explain to patients again clearly to ensure that patient's health is prioritised. https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893934384 2021-11-16 12:13:26 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893934384 Would like to leave off with the patient understanding how to inject their insulin and being more understanding of their diagnosis and how to manage it https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893935034 2021-11-16 12:13:51 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893935034 Mr Chang afraid of losing face and it is the job of the doctor to make the patient engaged with their discussion https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893937465 2021-11-16 12:15:14 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893937465 try to be more understanding of differences in culture and what can we do to bridge the gap https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893938676 2021-11-16 12:15:59 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893938676 be more sensitive of patients' body language and face expressions, clearly Mr Chang leaves in a hurry, the doctor should get back to him/contact to ensure understanding https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893942440 2021-11-16 12:18:04 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893942440 https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893944856 Ensure that the patient understands his condition and how to manage it appropriately in order to prevent such occurrence from. happening again. The patient should come on his next visit stable due to appropriate communication between both parties. ]]> 2021-11-16 12:19:28 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893944856 Individual: approach the situation without bias and without assumption and be straightforward with the father of the patient asking who is the usual primary care giver for the patient and work with what that norm usually is for the patient and their family. Move forward by making decisions for the patient based off the family's preferences of the care for the patient. https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893946107 2021-11-16 12:20:10 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893946107 not making assumptions, put patients at the center of treatment and ask them their preference of who they think should make the decision on behalf of their child https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893947665 2021-11-16 12:21:02 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893947665 C - https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893952316 2021-11-16 12:23:35 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893952316 B https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893953486 2021-11-16 12:24:13 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893953486 patients will be offended and reluctant to follow the doctor's advice later https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893957238 2021-11-16 12:26:18 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893957238 Considering the patient's beliefs, views and practices helps to make them feel more included in the choices that are being made for their care https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893957377 2021-11-16 12:26:22 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893957377 By recognising the patient's practices for medicine and healing this can make the patient feel more compliant to listen to the doctor and feel more respected. The patient will have a more positive experience and will feel more included https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893959883 2021-11-16 12:27:46 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893959883 try to be more understanding of patient's cultures & beliefs https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893960863 2021-11-16 12:28:18 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893960863 if they do take the medications, the level of compliance to them is not certain https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893961135 2021-11-16 12:28:28 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893961135 There's benefits to compromising with patient's beliefs as long as the approach that patient personally take does not have any negative counter-effect with prescribed medications https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893961880 2021-11-16 12:28:48 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893961880 Patient will feel disrespected if their methods and practices of medicine and healing are not recognised https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893962011 2021-11-16 12:28:52 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893962011 acknowledge patient's cultural belief and embrace the differences https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893968295 2021-11-16 12:32:25 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893968295 https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893976934 Establishing a method of communication, and breaking down stereotypes. ]]> 2021-11-16 12:37:18 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893976934 cultural sensitivity and communication with patient's guardian https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893978365 2021-11-16 12:38:07 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893978365 https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893978419 Additionally, it would be useful to change the fathers fixed mindset and get him to be involved in the management plan ]]> 2021-11-16 12:38:09 UTC https://padlet.com/RCSI_MedProf/n8hbyqjqn04sbtqx/wish/1893978419