Cultural Competency - Multicultural Health Generalizations: Patient-Provider Relationship
Latinos and the Patient-Provider Relationship
Normative cultural values are defined as the beliefs, ideas, and behaviors that a particular cultural group (or subculture) values and expects in interpersonal interactions. One Latino normative cultural value and its clinical impacts is as follows:
In Spanish, simpatía means kindness - a value placed on politeness and pleasantness. In clinical settings, simpatía includes the normative cultural idea that a health care provider will have an encouraging approach - noticeably polite and pleasant. The relatively neutral approach of some U.S. providers may be viewed as negative by some Latino patients. As a result, lack of simpatía in a clinical setting could potentially decrease patient satisfaction with care, impact disclosure for a complete patient history, discourage adherence to treatment, and decrease making follow-up visits. Health care providers can ensure simpatía by emphasizing social courtesies, extending an encouraging approach, and being sensitive to other cultural values.
Source: Flores, Glenn, "Culture and the Patient-Physician Pelationship: Achieving Cultural Competency in Health Care." The Journal of Pediatrics, 136:14-23, (2000).
The Korean-American Patient-Provider Relationship
The following are some of the cultural health beliefs and communication practices that might be present in the Korean-American culture:
- Korean-Americans show respect for those in senior positions by not looking at them directly in the eye.
- Korean-Americans are often times comfortable with silence, according to Confucius' belief that "silence is gold." Therefore, small talk could appear senseless and insincere.
- In the Korean culture, the physician's social role can be extremely powerful. Families trust the physician and do not question other options.
- The sharing of thoughts, feelings, and ideas is very much based on age, gender, and status in Korean society. The Korean-American community might value age over youth, men over women, and the group over the individual.
- In general, no restrictions exist that prevent healthcare providers from delivering care to the opposite gender. However, female physicians might be preferred for gynecologic and obstetric problems since some women feel more comfortable discussing these issues with a female physician.
Source: Purnell, L. D., and Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach . Philadelphia: F. A. Davis Company.
Chinese and the Patient-Provider Relationship
- Physicians and nurses are viewed as people who can be trusted with the health of a family member.
- Healthcare providers usually receive the same respect as elders in the family.
- Healthcare providers are recognized by Chinese children as
authority figures. - While the physician makes decisions about the type of treatment, the family is expected to oversee the direct care.
- Although Chinese patients may rely on the physician to make medical decisions, if they disagree with the physician, they may not follow instructions.
- Chinese patients might not outwardly contradict healthcare
providers because of fear that either they or the provider may suffer a loss of face. - Chinese patients may question Western practices because of the invasiveness and pain of some treatments.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach. Philadelphia, PA: F. A. Davis Company.
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