|
AREAS OF CULTURAL VARIATION
|
POINTS TO CONSIDER
|
SUGGESTIONS
|
|
Gender roles
|
- Gender roles vary and change as the person ages (i.e. women may have much more freedom to openly discuss sexual issues as they age).
- A patient may not be permitted to visit providers of the opposite sex unaccompanied (i.e. a woman’s husband or mother-in-law will accompany her to an appointment with a male provider).
- Some cultures prohibit the use of sexual terms in front of someone of the opposite sex or an older person.
- Several family members may accompany an older patient to a medical appointment as a sign of respect and family support.
|
- Before entering the exam room, tell the patient and their companion exactly what the examination will include and what needs to be discussed. Offer the option of calling the companion(s) back into the exam room immediately following the physical exam.
- As you invite the companion or guardian to leave the exam room, have a health professional of the same gender as the patient standing by and re-assure the companion or guardian that the person will be in the room at all times.
- Use same sex non-family members as interpreters.
|
|
Sexual health and patient cultural background
|
- If a sexual history is requested during a non-related illness appointment, patients may conclude that the two issues – for example, blood pressure and sexual health are related.
- In many health belief systems there are connections between sexual performance and physical health that are different from the Western tradition. Example: Chinese males may discuss sexual performance problems in terms of a “weak liver.”
- Be aware that young adults may not be collecting sexual history information is part of preventive care and is not based on an assumption that sexual behaviors are taking place.
- Printed materials on topics of sexual health may be considered inappropriate reading materials.
|
- Explain to the patient why you are requesting sexually related information at that time.
- For young adults, clarify the need for collecting sexual history information and consider explaining how you will protect the confidentiality of their information.
- Offer sexual health education verbally. Whenever possible, provide sexual health education by a health care professional who is the same gender as the patient.
|
|
Confidentiality preferences
|
- Patients may not tell you about their preferences and customs surrounding the discussion of sexual issues. You must watch their body language for signals or discomfort, or ask directly how they would like to proceed.
- A patient may be required to bring family members to their appointment as companions or guardians. Printed materials on topics of sexual health may be considered inappropriate reading materials.
- Be attentive to a patient’s body language or comments that may indicate that they are uncomfortable discussing sexual health with a companion or guardian in the room.
|
- It may help to apologize for the need to ask sexual or personal questions. Apologize and explain the necessity.
- Try to offer the patient a culturally acceptable way to have a confidential conversation.
For example: “To provide complete care, I prefer one-on-one discussions with my patients. However, if you prefer, you may speak with a female/male nurse to complete the initial information.”
- Inform the patient and the accompanying companion(s) of any applicable legal requirements regarding the collection and protection of personal health information.
|