Cultural Barriers that Affect Healthcare Provider/ Patient Communication
Culture consists of the totality of values, beliefs and norms that shape the lifestyle of a people. Socio-cultural values spell out esteemed life style and routine aspirations cherished by a society. At the core of any culture is a system of values which defines what people live for and how they live. Culture consists of beliefs and values, and this could have implications on health communication.
Beliefs and values affect the doctor-patient relationship and interactions (Tongue et al., 2005). Divergent beliefs can affect healthcare through competing therapies, fears of the healthcare system, or distrust of prescribed therapies (Diette and Rand, 2007). The doctor-patient relationship is one of the most unique and privileged relations a person can have with another human being, just as having access to a well developed and effective association is important for the experience and objective quality of healthcare. Yet, over the past few decades, a number of cultural barriers have converged to reduce the ability of patients to have this archetypal relationship with physicians (Hughes, in Fowler, 2008). Fowler categorizes these cultural barriers into racial concordance of the doctor and patient, language barriers and medical beliefs. The author cautiously observes that another barrier to patient-physician communication, even if they speak the same language, is low health literacy of the patient which impairs ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex healthcare systems.
Of all these cultural barriers, the barriers of differences in medical beliefs are considered very fundamental to creating disharmony in the health care provider and patient communication relationship. As McLaughlin (1998) points out, each ethnic group brings its own perspectives and values into the healthcare system, and many healthcare beliefs and practices differ from those of the traditional American healthcare culture. The expectation that the patients will conform to mainstream values frequently creates communication and care barriers that are further compounded by differences in language and education between patients and providers from different backgrounds. Fowler (2008) maintains that when the two parties, comprising the doctor and the patient, have different views on medicine, the balance of cooperation and understanding can be difficult to achieve.
This perception gap may negatively affect treatment decisions, and therefore may influence patient outcomes despite appropriate therapy (Platt & Keating, 2007). Patients construct their own versions of adherence according to their personal worldviews and social contexts which result in a divergent expectation of adherence practice (Tongue et al, 2005; Sawyert & Aroni, 2003) & Middleton et al. 2006). Therefore, it is important to identify and address perceived barriers and benefits of treatment to increase patient adherence to medical plans by ensuring that the benefits and importance of treatment are understood (Platt & Keating, 200&).
According to reports, Bolivia’s healthcare system is particularly invaded by this cultural barrier. As Bruun & Elverdam (2006) put is, medical pluralism is a common feature in the Bolivian healthcare system, consisting of three overlapping sectors: the folk sector, the traditional sector and the professional sector. Whether in Bolivia, India, China or Africa, differences in medical health beliefs constitute a significant barrier to effective patient and provider communication which is absolutely necessary to giving and receiving adequate healthcare (Fernadez, 2004).
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