Brown, EA, Bekker, HL orcid.org/0000-0003-1978-5795, Davison, SN et al. (2 more authors) (2016) Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making. Clinical Journal of the American Society of Nephrology, 11 (10). pp. 1902-1908. ISSN 1555-9041
Abstract
Historic migration and the ever–increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo–American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients’ responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient’s specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 by the American Society of Nephrology. This is an author produced version of a paper published in Clinical Journal of the American Society of Nephrology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | End of life; advanced kidney disease; decision-making; communication; cultural competency; decision support techniques; ethics; medical; ethnic groups; humans; minority groups; chronic kidney disease; physician-patient relations |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research 12/188/05 Cancer Research UK C22090/A7329 British Council, Netherlands PPS WS56 NIHR National Inst Health Research RFPB: PB-PG-0107-12048 NHS Lothian NOT GIVEN Kidney Research UK SP2/CHOICES/2010 Foundation For Informed Medical Decision Making 0171-1 Yorkshire Cancer Research 142491 Multiple Sclerosis Society Award Ref: 30 |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Jul 2016 14:29 |
Last Modified: | 04 Jul 2018 15:28 |
Status: | Published |
Publisher: | American Society of Nephrology |
Identification Number: | 10.2215/CJN.13661215 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:102025 |