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The Model to Practice Dialogues™

Mental Health Across Cultures

Ensuring safe and quality healthcare for all patients requires doctors to understand how each patient’s sociocultural background affects his or her health beliefs and behavior.

Overview

Doctors are increasingly faced with providing care to a multicultural society complicated by literacy and language issues. Ensuring safe and quality healthcare for all patients requires doctors to understand how each patient’s sociocultural background affects his or her health beliefs and behavior.

A Romanian doctor would exercise the art of medicine (trust, compassion, care, empathy) before applying the science (body systems, their diseases and treatment – and the applied practice of that knowledge) before addressing sensitive issues such as death, sexuality and depression. Such prohibitive conversations are approached in an extremely subtle way. That is because Romanians deal with hierarchies and higher power distance in society, so there is a considerable need for creating a safe dialogue and environment for patients. At the same time, Romanian culture is one of restraint in which desires and impulses, such as sexuality, are still prohibitive to discuss.

Elderly patients often prefer to be treated with a higher power distance, and expect the doctor to hold the power. They want to rely on the competence and decision making of the doctor, and be guided through their treatment without doubting the doctor. Younger patients often show the opposite preference when it comes to power distance to their doctor. They would like to give feedback, contribute their own ideas, and sometimes show skepticism about the doctor’s choices. Even so, the start of the relationship with a patient plays an important role in the overall diagnosis and healing process.

However, when treating new patients, it is not always possible to accurately predict the preferred power distance that the patient would like to see within his or her treatment.

Hofstede Dimensions https://tcps.institute/cultural_bridges_tool.html

Outcome

This case model investigated Dutch health care practices, in particular, psychiatry.  It was noted in the interview that Dutch doctors tend to apply the practice of always treating their patients initially with a low power distance. When starting a new patient relationship, the psychiatrics attempts to explain all the options that the patient has. They strive to partner with the patient and encourage input and ideas from the patient. If the doctor notices that a patient is not used to or not comfortable with working together with a professional and giving their own input, they will start to take over the decision making, naturally increasing the power distance.

Key language

Psychiatry, medicine, health care, Romania, The Netherlands, language, culture

Authors

Iulia Rusu

Student Author Romanian: International Student Iulia Rusu LinkedIn profile Block 4, semester 2 – 2019/2020

Tarik El Baghdadi

Student Author: Dutch Student Block 4, semester 2 – 2019/2020