- General Guidelines for Transcultural Therapeutic Communication
- Communicating with Patients with Limited English Proficiency (LEP)
- Concepts that Vary by Culture and Ethnicity
When nurses communicate with patients from cultures different from their own, the likelihood of miscommunication increases dramatically. There are major problems in verbal communication; however, there are as many pitfalls, if not more, in nonverbal, transcultural communication.
General Guidelines for Transcultural Therapeutic Communication
- Maintain an open attitude.
- Speak in a clear, slow manner.
- RRS: Restate, reflect, and summarize.
- Write important information, using drawings and pictures to increase understanding.
Communicating with Patients with Limited English Proficiency (LEP)
| Adapted from National Standards for Culturally and Linguistically Appropriate Services in Health Care. Prepared under contract No. 282-99-0039. Rockville, MD: IQ Solutions, March 2001. |
- Patients who cannot speak, read, or understand English at a level that permits effective interaction with clinical and nonclinical staff are considered LEP.
- In the absence of bilingual health-care providers who have sufficient language skills related to health-care issues, use medical interpreters (United States Department of Health and Human Services, Office of Minority Health. (March 2001)
- Speak directly to patients in English and allow patients to speak directly to you in their language. The interpreters will accurately translate exactly what you and the patients say. Do not speak about patients in the third person.
- Allow extra time for the interview. (Jarvis, 2000)
- Interpreters of the same gender as the patient are usually preferred.
- Do not use family members or friends as interpreters.
- Do not use minor children to interpret for LEP adults.
- Recognize the influence of religion in developing beliefs, values, and healing practices.
- Develop insight into your own attitudes, beliefs, and values.
- Avoid using your own values to judge others.
- Respect the patient's beliefs and values.
- Develop understanding of the role of the nuclear and extended families.
- Develop knowledge of cultural health beliefs, practices, and healers.
- Recognize that folk healing or traditional medicine may be practiced along with Western medicine.
- Avoid cultural stereotypes.
REMEMBER
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Concepts that Vary by Culture and Ethnicity*
- Conveys various meanings.
- Same-gender health-care provider may be preferred.
- Parental permission may be needed to touch a child.
- Varies greatly among cultures (e.g., looking at the floor, downcast eyes).
- Conveys different meanings.
- Value placed on space differs (e.g., territoriality).
- Size of one's intimate zone varies.
- Entry into intimate or personal space needs explanation.
- Values about past, present, and future vary.
- Values on promptness vary (e.g., following a time schedule).
- Uncomfortable for some.
- May convey understanding, respect, or agreement.
Formality/Informality
- Varies from expectations of an authoritarian approach of the health-care professional to a close, personal relationship.
Information Sharing
- People from some cultures wait to be asked about information rather than volunteer information.
| SOURCE: Adapted from Jarvis, C (ed): Physical Examination. Saunders, Philadelphis, 2000; and Kozier, B, Erb, G, Berman, A, & Snyder, SJ (eds): Fundamentals of Nursing, ed. 7. Pearson Prentice Hall, Upper Saddle River, NJ, 2004. |