Diversity in practiceWorking with diverse groups of patients

This afternoon

Presentation - 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

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

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 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 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?

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)