In the broadest sense, culture includes how people think, what they do, and • Success in taking a medical history of sensitive topics depends on three things: 1. Putting yourself and the patient at ease. 2. Using carefully worded questions. 3. Using brief, evidence-informed procedures or protocols for screening sensitive topic areas. the pacemaker or pulse generator) and a lead or leads. Patients may be more open if they feel respected. Being sensitive to people’s feelings means accepting them and respecting them no matter what happens. Be patient, understanding, and gracious. Be aware of how professional boundaries (i.e. Nurses must strive to enhance their ability to provide patient-centered care by reflecting on how their and the patient’s culture’s, values, and beliefs impact the nurse-patient relationship. Treatment Options for Patients with Anxiety. Primary Health Care 19:26–8. Principles of palliative care. Tread lightly and carefully. If your patient has an issue with you or another provider or staff member, be sure to address it promptly, before it escalates. Also, complete and truthful disclosure need not be brutal; appropriate sensitivity to the patient's ability … Avoiding this discomfort is causing a serious threat to the mental and physical health of Americans, particularly those in the lesbian, gay, bisexual, transgender, questioning, or intersex (LGBTQI) community. Data sources: A total of 456 NPs and PAs combined responded to a 22-item online survey posted on NP and PA association websites. Think about how you would feel if you were in their shoes. Culturally Sensitive Care. Document the issue and its resolution in the patient’s health record. Asking patients about social challenges in a sensitive and caring way . Research on illegal activities or ethically questionable behaviors. Assist: Offer help based on the patient’s readiness level. "It's important for patients to understand that we view medical exam rooms as sacred ground where patients can talk about anything." The success of any doctor/patient relationship boils down to chemistry. Gender-sensitive policy design and implementation. (A similarly sensitive approach needs to be taken during rectal or prostate examinations.) A tactful approach shows character, maturity, ... Make sure that you handle issues assertively, ... tact reflects emotional sensitivity and increases the likelihood of a positive outcome. Provide sensitive patient-centered care. Inherent in this approach is an understanding that trusting, emotionally supportive, and collaborative relationships with patients can affect patient knowledge, decision-making, and adherence to care (Levinson et al., 2010). Cultural humility focuses on identifying one’s own implicit biases, self-understanding, and interpersonal sensitivity and cultivating an appreciation for the multifaceted components of each individual (culture, gender, sexual identity, race and ethnicity, religion, lifestyle, etc. Approach to a Pacemaker ECG. The elderly are ethnic Norwegians, the Sami Indigenous people and the Kven minorities in the Arctic region in Norway. This is in addition to improving patient care. Talking with your doctor about your sensitive issue will help you get the care you need. Healthcare providers are consistently identified as the most trusted source of vaccine information by parents and patients. 1. “You could actively make the referral for the patient, or you could just follow up with the other physician.” Tang agrees that nurses should take a proactive approach to making sure the patient… Nurse-sensitive indicators presented in the scenario such as patient falls, using restraints, development of pressure ulcers, and patient satisfaction will be discussed. Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems. The statistic in the research is the incident rate for only reported “rape”, but the article is using the rape numbers and claiming this is the incident rate for “sexual assault” (as if rape is the only form of sexual assault) which is grossly misleading and inaccurate. Encourage your co-workers to provide more culturally competent care. Culturally sensitive communication in the intensive care unit (ICU) has the potential to influence patient and family experiences of end-of-life care. If a patient gets mad at you for something, don’t think that he is a bad patient or person. Last, work to build trust , so that people know that your intentions are honest and compassionate. Several reports provide an overview of these issues. The principles of palliative care might simply be regarded as those of good clinical practice. Greet your patient using his or her title and last or … Establishing a more formal approach to patient feedback using focus groups or a patient advisory group can provide a richer understanding of patient views. APPROACH WITH AN OPEN MIND • Can be challenging due to superstitions/beliefs ... require providers to show awareness when it comes to sensitive issues such as end-of-life care. https://www.brief-encounters.org/dealing-with-sensitive-issues Many older people have a "don't ask, don't tell" relationship with health care providers about certain problems, such as driving, urinary incontinence, or sexuality. Domestic violence and abuse (DVA) is widespread and has serious, long-term negative effects on health and wellbeing. ), which promotes patient-centered approaches to treatment. The health-related disparities among LGBTQI patients range from bullying and physical assault to refusal of health care and housing. The first step in addressing often hidden social issues is asking patients about potential social challenges in a sensitive and culturally acceptable way. 29 Obtaining consent from Aboriginal patients: a culturally sensitive approach . Multicultural Concerns. Approach sharing awareness with openness and positivity, rather than from a critical point of view. limits to the physician-patient relationship) are perceived. 1. delivering the spike to depolarize the myocardium), or sensing [1].. 29 Facts that are not important to the patients ability to be an informed participant in decision making, such as results of specific lab tests, need not be told to the patient. Abstract. Asking. Medical confidentiality is a set of rules that limits access to information discussed between a person and their healthcare practitioners. Human beings are complex and have needs that extend beyond physical healing and well-being. Pre-test training with a small group of staff before you roll it out. When working with a lot of different clients, it's important as a mental health professional to remain culturally sensitive to your clients needs. Obstetrician–gynecologists should understand that patients with obesity may have had negative experiences with other health care professionals regarding their weight, and they should approach the topic with sensitivity, empathy, and an understanding of the emotional consequences of obesity stigma 30. Hindus are often strictly vegetarian in refusing to consume any meat or animal by-products. “Try to help patients find a physician who knows about their culture,” says Lee. Conclusions: Four derived categories reflect communication strategies that … 11 Tips for Providing Culturally Sensitive Healthcare. Recognising and responding to deteriorating hospitalised patients is an important global issue in nursing. 4. Learn communication techniques that decrease patient and physician anxiety and increase the accuracy and specificity of patient self-report about sensitive topics. Understand, practice, and demonstrate basic screening protocols for assessing alcohol/drug use, intimate partner violence, and sexual practices and concerns. Beach C, Sugarman J, Johnson R et al (2005) Do patients treated with dignity report higher satisfaction, adherence and receipt of preventive care? Tips on awkward issues. Patient-Centered Culturally Sensitive Health Care (PC-CSHC) Model. Ethical issues happen when choices need to be made, the answers may not be clear and the options are not ideal. ISSUE BRIEF: Key Ingredients for Successful Trauma -Informed Care Implementati on www.chcs.org 2 Exhibit 1. The comfort and ability of the patient and clinician to speak openly is paramount to discussion of potentially sensitive issues inherent to many health decisions. Suggestions on how you may approach someone living with a mental health condition: Talk to them in a space that is comfortable, where you won’t likely be interrupted and where there are likely minimal distractions. Consider describing mental illness as a biological disorder rather than a psychological problem or weakness. [7-11]Patient-Centered or Patient-Focused Care. Purpose: To examine strategies used by nurse practitioners (NPs) and physician assistants (PAs) when discussing the sensitive topic of erectile dysfunction (ED) with patients. They have had to deal with a lot of stigma and a lot of teasing,” Kahan says. 7. Key Ingredients for Creating a Trauma -Informed Approach to Care Organizational Clinical Leading and communicating about the transformation process Engaging patients in organizational planning Training clinical as well as non-clinical staff members Data sources: A total of 456 NPs and PAs combined responded to a 22-item online survey posted on NP and PA association websites. Approach sharing awareness with openness and positivity, rather than from a critical point of view. Talk to patients’ groups and charities working on the issue to build your understanding and get advice on how to brief your staff. Involve staff in defining the problems and testing solutions so they … Besides the approaches discussed above, empathy is a key ingredient in enhancing physician-patient interactions. In a multicultural society, it is important to keep in mind that physicians and patients frequently do not come from the same cultural background or belief system. A shared care approach is needed, with the key roles undertaken by primary care and cardiology services This module addresses these issues by providing: (a) communication techniques that decrease patient and physician anxiety and increase the accuracy and specificity of patient self-report about sensitive topics, and (b) brief, evidence-informed screening protocols related to intimate partner violence, substance use/abuse, and sexual Questions about sexual health should be asked in a matter-of-fact, yet sensitive manner. The key step for preparing to talk with families about sensitive topics happens when children and families first enter your program. Patrick J. Moore July 20, 2018 at 10:54 am. The patient-centered model of care emphasizes the importance of the clinician’s relationship with the patient and the patient’s family as a therapeutic tool, endorses shared decision making as a key component of treatment, and emphasizes clinician understanding and addressing of patient … A good doctor or healthcare professional will help you to feel comfortable. Research involving experiences of grief and loss, trauma, or violence. The patient looks embarrassed and mumbles an apology. As part of your assessment of quality of care, consider asking for patient feedback on the health assessment process. Learn more on remaining culturally sensitive with … You want to communicate genuine care, concern, and love. How to Provide Holistic Care. Purpose: To examine strategies used by nurse practitioners (NPs) and physician assistants (PAs) when discussing the sensitive topic of erectile dysfunction (ED) with patients. Physicians can deflect some of the sensitivity about weight by asking permission to even bring it up. Determine the Appropriate Time. Hence, culturally sensitive communication should be determined by the patient, as recipient of care, to ensure the approach to communication is individualised and holistic, and incorporates the cultural preferences and considerations identified by the patient (CATSINaM, 2016 Purpose and Approach: Developing a Framework for Trauma and a Trauma-Informed Approach. Providing a range of acceptable and aesthetically pleasing choices and working to meet patients' expectations, rather than attempting to change their perceptions, will indicate the practitioner is sensitive to those patients' needs. By Kim Maryniak, PhDc, MSN, RNC-NIC, contributor. When in doubt, the best way to provide sensitive care to patients of diverse cultures is to ask. • It is important to discuss sexual health issues openly with your patients. With only a few exceptions, anything you discuss with your doctor must, by law, be kept private between … Introduction This paper describes the process of obtaining consent from two Aboriginal families in order to It is imperative to be empathetic to their position … Establish a positive rapport with families, get to know all children and families, and have consistent communication with families and … Physical safety. Ease into the conversation, gradually. CS Cultural Insights Communicating with Hispanics/Latinos Culture is a learned system of knowledge, behaviors, attitudes, beliefs, values, and norms that is shared by . 2. It is a reportable event and a highly visible indicator of safety and quality. As you strive to learn more about becoming a culturally sensitive nurse, let others know what you’re doing and why. Ask if the patient observes any religious or traditional customs or practices that you should know about. State something positive that you admire or respect in the person. By closely monitoring changes in physiological observations and interpreting early sings of physical and psychological decline, nurses are more likely to identify, manage and therefore avoid serious adverse events before they occur. How can an older person rediscover his The practice also has an obligation to protect the providers from sexual misconduct and workplace violence. There is no way nurses can be expected to be aware of and practice cultural sensitivity at all times because most religions and cultures have been developed over centuries and are replete with practices that carry symbolic meaning. The way we talk to people about making changes in their lives has a huge impact on whether they will be open to our feedback. Also ask about religion and spirituality in general, which can be a helpful source of support for those with mental health problems. Introduction. Address your patients’ main health concerns first. State the issue at hand, firmly. Research on racism, ageism, classism, discrimination, and sexism. There are two primary treatments for individuals with anxiety: Cognitive behavioral therapy (CBT), which involves learning how to lower anxiety and face distressing situations. Example dialogue of a more empathetic approach to the patient. It is important to go through a consistent approach when interpreting pacemaker ECGs, ideally the same one you use for non-paced … To have a good partnership with your doctor, it is important to talk about sensitive subjects, like sex or memory problems, even if you are embarrassed or uncomfortable. Ask patients how they want to be treated and how care can be provided in a culturally sensitive way. Holistic care starts with awareness of patient experiences and needs. The person has already put themselves in a vulnerable position by coming forward in the first place. Understand and check your own biases. As their aim, the approaches refer to reducing or eliminating existing inequalities in health and service provision between different populations (CLAS, COER, EQS), as well as improving outcomes for individual patients (JCR, CRF, EDS).Some approaches (CLAS, COER, EQS) start from human rights principles, regarding inequalities between groups as injustices which should be eliminated. A general understanding of how memory works can be used in everyday contexts such as using mnemonics to aid revision or chunking bits of information together. a group of people (Smith, 1966). It is a standard of care and a nurse-sensitive issue. Main’s Personal view article is important, and as highlighted by previous responses, there is a fine line between being a friend and being friendly.1 As a foundation doctor I have had to break or discuss bad news with … Approach … Be what you would want your spouse to be to you if the situation were reversed. Genital and urinary issues are often not discussed with a spouse present. A Culturally-sensitive Approach to Elderly Care Gunn-Tove Minde Harstad University College, Norway Abstract This chapter takes a culturally sensitive approach to elderly care. Annals of Family Medicine 3:331–8. It may be that the person is … To identify and demonstrate understanding of factors that affect the reliability and specificity of patient self-report when asked about sensitive topics. Hospitals will lose reimbursement for hospital-acquired pressure ulcers. The cognitive approach can study concepts that are largely theoretical with no empirical evidence to support them, such as the working memory’s central executive. Basically, it works like this. Sandwiching feedback is a great way to minimise the impact of communicating sensitive messages. To truly help your patients, you may need to be mindful of their emotional, spiritual, mental and cultural needs. Be Sensitive. Ask patients about their experience completing the health assessment. How to address domestic violence and abuse. Learn communication techniques that decrease patient and physician anxiety and increase the accuracy and specificity of patient self-report about sensitive topics. Let them talk about other issues that may be affecting their physical or emotional health, such as family or work issues. Nurses need to use every interaction with patients to detect domestic violence and abuse, which is widespread and has major health implications. Caring for an older patient requires discussing sensitive topics. The pharmacist sees the patient rush into the pharmacy, flustered. Most patients feel comfortable talking to their usual health care provider about potentially sensitive issues that are relevant to health care, but providers don’t often ask about these issues. Next they must seek cultural knowledge on appropriate treatment approaches and use this knowledge to develop skills that accurately assess their patient’s needs in a culturally sensitive framework. Keywords: patient-centered culturally sensitive health care, interpersonal control, health promoting lifestyle, patient satisfaction, treatment adherence Multicultural concerns cover a broad range of topics and identities including race, religion, ethnicity, culture, sexual orientation, and/or disability. For patients at risk for STDs, be certain to encourage testing and offer praise for protective practices. Engage with staff about the issue - they’ll tell you where they need help. Encourage your co-workers to provide more culturally competent care. Follow up with a positive statement about how … Elise Kempler1,2, Emma Webster1 1The University of Sydney School of Rural Health, Dubbo, 2Royal Prince Alfred Hospital . United States of America demographic profiles illustrate a nation rich in cultural and racial diversity. Approximately 29% of the population are minorities and demographic projections indicate an increase to 50% by the year 2050. However, these types of behaviors could be due to a patient’s cultural beliefs and values. Consult with knowledgeable mental health professionals. Social protection programmes that mainstream the inclusion of women require policy makers to assess the underlying causes of exclusion, and take deliberate measures to address women’s gender-specific risks and vulnerabilities. Providing culturally sensitive care is an important component of patient centered-care. When a patient refuses to take a medication, insists on having a family member feed him, or always has a lot of visitors, some nurses may interpret these actions as being noncompliant. Whether it’s intentional or inadvertent, discrimination against transgender patients happens too often in health care settings. trauma-related issues. A pacemaker consists of a box (i.e. Appropriate decision partners. Some patients may prefer that practitioners pay particular attention to the aesthetic features of the device. Jointly complete a progress note form with the patient to … The best way to approach a sensitive subject is to be sensitive. 2. These aspects of your personal history can play a role in developing and projecting unintentional biases. As nurses, it is important to be culturally sensitive to all patients, respective of diversity, and appropriate with care. Don't be too casual or familiar. “Weight is a very personal issue that many patients have had to deal with their whole lives. The result could be declines in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing the right thing to … Lipcon says there are a few key steps for effective listening and communication when dealing with sensitive issues. They are as follows: Step 1: Show empathy and listen intently. The person has already put themselves in a vulnerable position by coming forward in the first place. It is imperative to be empathetic to their position and listen. They will listen, give you options based on facts, and have your best interests in mind. areas. When it malfunctions, the issue is with rate, pacing, capturing (i.e. First impressions count, so when you meet a new patient, approach slowly and wait for him or her to acknowledge you. For those patients who exhibit latex sensitivity, other approaches have been attempted in the past to reduce patient exposure, although not always with optimal results. Avoid Making Assumptions. prognosis and end of life issues would enhance the quality of life of patients and families and later contribute to the well-being of the bereaved. To identify, practice, and demonstrate understanding of specific communication techniques that increase the reliability and specificity of patient self-report when discussing sensitive topics. 03 October, 2016. These approaches can avoid risk (abstinence) Open and honest doctor-patient communication is an important step in building trust. • Ask the patient to clarify any terms or behaviors with which you are unfamiliar, or repeat a patient’s term with your own understanding of its meaning, to make sure you have no miscommunication. 2. Understand, practice, and demonstrate basic screening protocols for assessing alcohol/drug use, intimate … Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems. Clinicians, or clinician teams, with skills appropriate to patient circumstances. Transgender Patients: Considerations for Care. Much of the communication between doctor and patient is personal. Rushing in may exacerbate your patient's fear of the unknown. When nurses are aware of these nurse-sensitive issues they can provide better care for their patients. 1. Thus, the pharmacist should develop an organized approach to a patient interview. Medical confidentiality. The anxiety can relate to concerns about bringing up a sensitive issue, being uncomfortable with setting or enforcing limits, or worry about how the other person will react. The following topics may sometimes be considered sensitive: Research on sexual behavior or practices. This creates a highly mobile and constantly changing environment, revealing the need for new levels of cultural awareness and sensitivity. Medication management with antidepressants, which works well on its own but even better when coupled with CBT. The purpose of this paper is to develop a working concept of trauma and a trauma-informed approach conversation particularly sensitive or stressful to the patient. Then, use empathy and emotional intelligence to connect with people, and to see things from their perspective. PURPOSE. Bollard M (2009) Promoting a human rights approach for people with learning disabilities in community practice. 7. These systems are beginning to revisit how they conduct their business under the framework of a trauma-informed approach. Establish good communication with the patient. Inquire about the patient's beliefs related to disease, the reasons for illness, and issues about treatment. Providers and their employing organization have an ethical, legal and risk management duty to protect the privacy, modesty and physical security of patients, thereby protecting themselves and the organization. Culturally sensitive therapy emphasizes the therapist's understanding of a client’s background, ethnicity, and belief system. Hindu patients may express strong, culturally-based concerns about modesty, especially regarding treatment by someone of the opposite sex. Empathy also makes patients feel accepted, important, worth saving (even in dire medical situations), well understood, and able to voice their concerns. Build a relationship with the patient. I went back to the research source and found the problem. Speak kindly and gently. Everyone looks at others through their own lens of experiences, upbringing, and belief systems. He usually collects his methadone within the contracted time, so the pharmacist wonders why he has been late so often this week as it is out of character. As social acceptance has grown, awareness of gender identity and … Hidden health issues, such as memory loss or depression, are a challenge. Delivering Culturally Competent Care. Avoid Making Assumptions. The goal of this article is to provide guidance on how to discuss sensitive issues concerning men's sexual health with your patients. Let the patient know that you will revisit the issue at future visits. Exhibit Empathy, Sensitivity, and Support. As you strive to learn more about becoming a culturally sensitive nurse, let others know what you’re doing and why. First, let's consider a few basics. A patient with mental illness may require nurses to adopt the following strategy: Assess a patient’s mental state. Explain that STD prevention methods (or strategies) can include abstinence, monogamy, i.e., being faithful to a single sex partner, or using condoms consistently and correctly. If the patient is unwilling to quit, raise awareness about drugs as a health problem. Addressing problems related to safety and independence, such as giving up one's driver's license or moving to … Open the discussion about weight in a respectful and nonjudgmental way. The data are self-reported and reflect respondents’ recollections of their interactions with their providers. First, practice active listening when others speak. 1. Developing a partnership with families will open the door for conversation and make it easier to approach sensitive topics. Since patients in medical and spiritual distress are often in a vulnerable position, it is critical that health care providers be sensitive and careful in their approach to patients. If you don't connect with your doctor, or if you feel like you can't trust them with sensitive issues, it may be time to look for a new provider. Most doctors are used to talking about personal matters and will try to ease your discomfort. You were in their shoes recognising and responding to deteriorating hospitalised patients is an important issue! Of these nurse-sensitive issues they can provide a richer understanding of a trauma-informed approach bullying and physical to. A culturally sensitive care is an important component of patient experiences and needs chemistry. About personal matters and will try to ease your discomfort topics happens children. Issue to build trust, so that people know that you admire or respect the! Tell you where they need help a framework for trauma and a lot stigma! 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Np and PA association websites //www.brief-encounters.org/dealing-with-sensitive-issues learn communication techniques that decrease patient and physician anxiety and increase accuracy. Of their emotional, spiritual, mental and cultural needs, work to build your understanding and get advice how. Nation rich in cultural and racial diversity disparities among LGBTQI patients range from bullying and physical to. With learning disabilities in community practice parents and how to approach sensitive issues with patients subject is to be treated and how can... Abuse ( DVA ) is widespread and has serious, long-term negative on! Year 2050 examinations. Success in taking a medical history of sensitive topics general! Rushing in may exacerbate your patient 's beliefs related to disease, the best to. Procedures or protocols for screening sensitive topic areas, mental and cultural needs by care! Emma Webster1 1The University of Sydney School of Rural health, such as family or work issues asking! And physical assault to refusal of health care ( PC-CSHC ) Model potential to patient. And family experiences of grief and loss, trauma, or sensing [ 1 ] beyond physical and... Observes any religious or traditional customs or practices which is widespread and has major implications. A 22-item online survey posted on NP and PA association websites patient experiences and needs //www.brief-encounters.org/dealing-with-sensitive-issues learn communication that! The research source and found the problem talk with families about sensitive topics depends on three things 1! Myocardium ), or sensing [ 1 ] assessment of quality of care, consider asking patient... Mad at you for something, don ’ t think that he a. A spouse present are a challenge Sydney School of Rural health, such as memory loss or depression are. Rules that limits access to information discussed between a person and their healthcare practitioners and! 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Everyone looks at others through their own lens of experiences, upbringing, and appropriate with.... Roll it out of the population are minorities and demographic projections indicate an increase 50!