Relating to Patient's Families
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The Importance of Family in Healthcare Decisions
In many of the world’s cultures, an individual’s health problems are also considered the family’s problems, and it is considered threatening to exclude family members from any medical interaction. For these patients, providers must address the individual’s health problem in the context of his or her family. Family members can provide valuable information regarding the patient’s diet, health behavior, daily activities, and types of alternative medications used. Their involvement in a treatment plan may be vital to a patient’s ability to adhere to the recommended treatment.
At the same time, it is not always culturally appropriate to involve family members, and the provider must be sensitive about when it may NOT be appropriate to involve certain family members. For example, it is NOT appropriate to ask family members to serve as medical interpreters during clinical encounters.
(See Topic on Working with an Interpreter.)
Pregnancy and Childbirth: The Concern of Women
In many cultures, men are not involved in the activities surrounding pregnancy or childbirth. Despite this apparent exclusion, husbands are responsible for making decisions and giving permission for treatment, medication, and hospital stay. A provider needs to be ready to involve the mother, mother-in-law, sister, and aunt (rather than the husband) in the development of the patient care plan during the pregnancy and after childbirth in families that follow this tradition. Female relatives may also be the most appropriate persons to take care of such tasks as having the husband sign the necessary consent forms or explaining suggested treatment options.
Gender and Taboos
The roles of men and women, and the issues that they are able to discuss openly together, may be strictly prescribed by different cultures. If a patient does not speak English and an interpreter is not available, the provider should be careful about using a family member to interpret for the patient. For example, a son should not act as an interpreter with his mother’s obstetrician, nor should a wife act as an interpreter when speaking with her husband’s urologist or even cardiologist.
Food: An Important Factor in Culture
The food normally served in US hospitals tends to cater to what is seen as a “typical” bland American diet. This poses a significant problem for patients whose standard diet may be significantly different. The provider and attending nurses should engage the patient’s family in this issue. Can they bring food to the hospital? Do they know that certain foods will be beneficial and that others may be less beneficial? By involving the family in designing an appropriate diet for the patient, the provider will ensure that the family will bring food that is beneficial rather than harmful and will increase the likelihood that the patient will have a healthy diet after discharge. (Read more...)
Alternative Medicine: How Will It Interact with Recommended Treatment?
Many patients may be taking other medications, some prescribed by another provider and some by a traditional health care provider. Often the patient’s family is a valuable source of information about all medications the patient is taking, particularly alternative medications with which the provider may be unfamiliar. With this knowledge, the provider can explore the possible consequences of taking certain alternative medicines along with the prescribed medications and avoid dangerous interactions (if any) between Western medicines and traditional herbs. These concerns can be discussed openly and respectfully with the patient and his family.
In summary, relating to the patient’s family and maintaining open lines of communication with family members may be vital to a patient’s health. The culturally competent provider will discuss with the patient the patterns of decision-making in the family. Understanding the complex and often delicate interactions that may exist between family members will go a long way towards working with family members as a valuable resource, rather than an intrusion into the provider-patient relationship.
Continue reading:
http://www.familycenteredcare.org/
http://cecp.air.org/cultural/
http://cecp.air.org/cultural/Q_benefitchild.htm