One of my previous placements was in the Women’s Health area, whereby a big part of it involved educating patients that had undergone gynae surgeries involving prolapse repairs amongst others. A huge part of the subjective questioning involved quite personal issues about their pre-op status including bowel and bladder symptoms and reasons why they developed a prolapse. Detailed questioning were carried out to determine patient’s risk factors so that the education given could be tailored to target individual cases. It can be a straightforward process if the patient is comfortable with the questioning. The majority of them were quite happy with the session even when they had family or friends around. Therefore, at some point I got use to the idea that people are generally quite unconcerned about having family or friends around for the education session that I sometimes overlook asking prior to the session.
I then came across one patient, a Moroccan lady who had just undergone a gynae surgery for repair of her bladder and bowel prolapse. Upon walking into the room, she had family there with her and I just assumed that it would be all right for me to start the session. I gave her a brief run of what the session was going to consist off and she appeared consenting at the start. She spoke very simple English and I checked regularly that she understood what I had meant. Midway through the questioning she appeared very uncomfortable and her answers was muffled and barely audible. Still, I just passed it as she did not quite understand me and I continued reiterating the question about her prolapse. Few moments later, her family started walking out one at a time. That is when I realized that I had generalized every patient and assumed that patients are generally comfortable around their family when issues concerning women’s health were discussed. I felt bad about my assumptions and apologized for being so insensitive. I then decided to just do part of the session that day and continue the other part the next so that she is not too overwhelmed with information that she is not used to taking in. The next day when I went to see her, she had no one with her. The difference in response and compliance was amazing. She even asked clarifying question, which surprised me, as she was quiet the day before when I saw her. I’m happy that I broke the session up into two parts as she appeared to be the type that needs a bit more time to open up on personal issues possibly due to her cultural background.
WHEN I LOOK BACK ON THIS INCIDENT, I HAVE LEARNT THAT NOT EVERY CULTURE IS READILY OPEN TO DISCUSSION ABOUT THEIR PERSONAL HEALTH ESPECIALLY IF THEY HAVE FAMILY MEMBERS OR FRIENDS IN THE ROOM. IT IS IMPORTANT FOR US TO REALISE THIS SO THAT WE DO NOT COMPROMISE ON PATIENTS COMPLIANCE TOWARDS OUR TREATMENT OR EDUCATION. WE MUST LEARN TO ACCOMMODATE FOR DIFFERENT CULTURAL NEEDS SO THAT WE HAVE SUCCESS IN OUR TREATMENT GOALS OF INDIVIDUALS.
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I also find it hard to remember that for each patient, it may be their first encounter with the concepts in our educations. Although we are familiar with the content, it usually has to be directed toward patients as brand new information. Each patient will also respond uniquely, to which we must adjust. It was good idea to split up the session.
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