that information you have about cultural traditions is a starting
point for understanding another individual. There are many influences
(age, socioeconomic status, education, etc.) on an individual's
cultural beliefs. Find out first if the individual fits the generalization
- there is always individual variation within a group.
the patient what they think caused their illness
every patient thinks that a "germ" or "virus" caused
their disease. Individuals may attribute a variety of etiologies
to their illness, including stress, spiritual forces, bodily
the patient's beliefs, however "strange" they may
appear to you
patients are afraid to tell a health care provider what home
treatments they may be using or other practitioners they may
be seeing because of ridicule they have experienced in the past.
Learning about what steps other than consulting you the patient
is engaged in will help you provide better care for the patient.
Most diseases are self-limiting and folk treatments appear "to
work" for this reason. If in the patient's family/culture
a particular action has generally resulted in the illness symptoms
abating, then it is logical and rational to the patient to engage
in that particular action. Remember peptic ulcers were treated
by antacids and surgery in allopathic medicine until recently.
possible, incorporate into your treatment plan the patient's
beliefs about treatment and prevention that are not contraindicated
will likely go ahead and use their own treatments anyway, but
if you incorporate their beliefs into the treatment plan, they
are more likely to follow your treatment plan as well. When a
belief is contraindicated, explain in a respectful manner why
this is for the patient's particular illness.
neglect the patient's family
many cultures, important decisions are made by the family, not
simply the individual. Involving the family in decision-making
processes and treatment plan will help to gain the patient's
compliance with treatment. Additionally, allow as many visitors
as the patient would like to have. And remember, in some cultures,
the husband or another male relative may make the final decision
regarding the healthcare of the wife, other females and children.
and do not discount a patient's concern about supernatural
influences on his/her health and well being
a patient believes that a supernatural influence is causing his
or her condition, do not minimize the patient's concerns. Your
minimization will not change the patient's beliefs. The patient
may not take any responsibility to follow through with your treatment
because he/she may believe that your treatment will not address
the supernatural cause. Listen respectfully to the patients concern
and when possible, involve an appropriate spiritual healer/advisor
in the patient's care.
about the beliefs and practices of the patient populations
in your community
about general beliefs and practices will help you better understand
your patients' attitudes and behaviors. You may also use this
knowledge to discreetly question a patient to learn more about
their own individual practices by saying something like, "Many
of my patients here in the community from [name of country] believe
[or do or visit]