Prevent Implicit Bias in Patient Care With These Cultural Conversation Starters
Each clinical encounter with a patient brings together three different cultural perspectives: the patient’s, the nurse’s, and health care’s own culture. Patient-centered care acknowledges and responds to the unique needs and preferences of each patient in the context of their culture. As we approach our patients with respect, humility, and curiosity to learn more, we must ask questions to help prevent assumptions, generalizations, and implicit bias from influencing our interactions.
Carrillo et al. identified five core cross-cultural areas that healthcare providers should explore with their patients. Here are some suggested questions and conversation starters to facilitate understanding.
- Many people have concerns about chemotherapy’s side effects. What worries do you have?
- When your lab results are completed, I would like to let you know what they say. Some patients prefer to hear the information right away over the phone, whereas others like to discuss the results at an in-person visit. Which do you prefer?
- What do you hope we can accomplish during today’s visit?
- You mentioned that you don’t want any extra tests or procedures. Have you had previous experiences when you felt something was ordered that wasn’t necessary?
- We have a few options on how to best to treat your condition. I will review each one, and then we can discuss which one you think sounds the best for you.
- My goal is to explain our treatment plan in a way that makes sense to you. Please let me know if I can review or explain something differently to be clearer.
Decision-Making and Family Dynamics
- Is there someone else you would like to include in this decision or who you would prefer we talk with about your health?
- Could you introduce me to the guests you’ve brought with you today? It is helpful for me to know who will be supporting you through your treatment and what their role will be in your care.
- Thank you for describing the symptoms your wife has experienced, Mr. Smith. It would be helpful for me to also hear your wife describe how she experiences those symptoms so I can be sure I fully understand the concerns before we decide on the best method of treatment.
Traditions, Customs, and Spirituality
- How important is religion or spirituality in your life?
- Some patients have beliefs that prevent them from using certain medicines or receiving certain treatments. Do you have any specific concerns?
- Do you use any certain customs, traditional remedies, or food as part of healing?
- Are there spiritual or cultural practices that you routinely use as part of achieving good health?
- Who helps you when you are sick? How do they help you? How would you like them to help you during this time?
Sexual Health and Gender
- My pronouns are she/her. What are your pronouns?
- Our routine is to ask guests to step outside during your physical exam for your privacy. Is this okay, or would you prefer them to remain with you?
- Sexual health can be uncomfortable to talk about, but it is a common concern and an important part of intimate relationships for many patients. Do you have any worries or questions you or your partner would like to discuss today?
Identifying and exploring those core cross-cultural issues will better position nurses to successfully establish and maintain a therapeutic relationship with their patients by incorporating meaningful aspects of each patient’s culture into their plan of care.