Cultural Competency - Cross-Cultural Communication
Effective cross-cultural communication is necessary in the provision of culturally competent care. The following communication models can assist you in your patient-provider interactions.
- LEARN: Guidelines for Overcoming Obstacles in Cross-Cultural Communication with Patients
- ETHNIC: A Framework for Culturally Competent Clinical Practice
- BATHE: A Useful Mnemonic for Eliciting the Psychosocial Context
LEARN: Guidelines for Overcoming Obstacles in Cross-Cultural Communication with Patients
Listen with empathy and understanding of the patient's perception of the problem.
Explain your perceptions of the problem.
Acknowledge and discuss the differences and similarities.
Recommend treatment.
Negotiate agreement.
Source:
Elois Ann Berlin and William C. Fowkes Jr., A Teaching Framework
for Cross-cultural Health Care. The Western Journal of
Medicine , 1983, 139(6), 934.
ETHNIC: A Framework for Culturally Competent Clinical Practice
Explanation:
- What do you think may be the reason you have these symptoms?
- What do friends, family, others say about these symptoms?
- Do you know anyone else who has had or who has this kind of problem?
- Have you heard about it on TV or radio or read about it in a newspaper? (If patients cannot offer explanations, ask what most concerns them about their problems).
Treatment:
- What kinds of medicines, home remedies, or other treatments have you tried for this illness?
- Is there anything you eat, drink, or do (or avoid) on a regular basis to stay healthy?
- Please tell me about it. What kind of treatment are you seeking from me?
Healers:
- Have you sought any advice from alternative/folk healers, friends, or other people (non-doctors) for help with your problems?
- Tell me about it.
Negotiate:
- Negotiate options that will be mutually acceptable to you and your patient and that do not contradict, but rather incorporate, your patient's beliefs.
- Ask what are the most important results your patient hopes to achieve from this intervention.
Intervention:
- Determine an intervention with your patient.
- May include incorporation of alternative treatments, spirituality, and healers as well as other cultural practices (e.g., foods eaten or avoided in general, and when sick).
Collaboration:
- Collaborate with the patient, family members, other health care team members, healers, and community resources.
Source:
© 1997 Developed by: Steven J. Levin, MD Robert C. Like,
MD, MS Jan E. Gottlieb, MPH Center for Healthy Families and
Cultural Diversity Department of Family Medicine UMDNJ-Robert
Wood Johnson Medical School.
BATHE: A Useful Mnemonic for
Eliciting the Psychosocial Context
Background: A simple question, "What is going on in your life?" elicits the context of the patient's visit.
Affect: (The feeling state) Asking "How do you feel about what is going on?" or "What is your mood?" allows the patient to report and label the current feeling state.
Trouble: "What about the situation troubles you the most?" helps the physician and patient focus, and may bring out the symbolic significance of the illness or event.
Handling: "How are you handling that?" gives an assessment of functioning and provides direction for an intervention.
Empathy: "That must be very difficult for you." legitimizes the patient's feelings and provides psychological support.
Source:
Stuart, M.R. and Lieberman, J.A. III. "The Fifteen Minute
Hour: Practical Therapeutic Interventions in Primary Care"
3rd Edition. Philadelphia: Saunders, 2002.
