Transcript Diversity in practice

Diversity in practice
Working with diverse groups of
patients
This afternoon
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Asian patients
Refugees and asylum seekers
Gay and lesbian patients
When language is an issue
DVD on consultations with patients with
different language backgrounds
Tea
Case discussions
From last week - don’t forget
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Cultural competence = cultural knowledge plus
open-mindedness
Everyone’s culture is a bit mixed-up
Culture is dynamic and changes over time
Consultation involves interaction between your
culture and the patient’s
A few generalisations about
Asian culture
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Respect for elders
Families more important than individuals
Importance of marriage
Distinct roles for men and women
Importance of mother in law within the home
Big families, desire for sons
Mental illness carries more stigma than general population
Taboo subjects e g termination of pregnancy, STDs,
domestic abuse
British-born generation are very different
Cultural conflict for second generation
Refugees and asylum seekers
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Very diverse group
Small welcoming gestures are worth a lot
Don’t make assumptions
May have complex health needs
Often have different health beliefs/expectations of health care
system
May be separated from family
Post traumatic stress very common
And stress from the way they are treated in the UK
May tell distressing stories - doctor needs personal
housekeeping
Hard to get old information
Consultations usually take a v long time
Confidentiality v important
Gay and lesbian patients
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Huge change in public attitudes in last 20 years
Diverse in terms of age, class etc
Need to feel their sexuality will be accepted by doctor
Vary a lot in how much they define themselves by their
sexuality
Doctors need phrases which indicate they’re not
assuming everyone is heterosexual
Doctors need knowledge about sexual health for gay and
lesbian patients
Next-of-kin issues important
What can we do when language
is an issue?
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Excellent non verbal communication appropriate
to culture
Learn a few friendly expressions
Express yourself as simply as possible
Don’t rush things
Family member interpreters - with care and with
reservations
Practice staff with language skills - preferably
trained in interpreting
Telephone interpretation (plus non verbal)