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For other articles and previous issues click here. April 12, 2004 Communicating
With Mexican Patients According to the 2000 census, more than 20 million Mexican Americans live in the United States, comprising 7.3% of the total population—making them the largest subgroup of the biggest minority group in this country.1,2 The Mexican American population is also growing rapidly, having doubled between l980 and 2000, after nearly doubling from 1970 to 1980.3 As patients, Mexican Americans often require a different approach from an imaging staff. Unlike Europeans, who tend to quickly assimilate to the dominant culture in the United States, many Mexican Americans tend to retain their language and cultural identity. Thus, Mexican Americans have separated themselves from other groups. Traditional gender and family roles, as well as culturally related beliefs about illness and treatment, have frequently been maintained.4 Differences in skin color, language, a Spanish accent and surname, and less formal education are just a few of the factors that have caused some Mexican Americans to have difficulty adjusting to the mainstream culture. It is important for radiologic technologists and other imaging staff to understand differences that may be present in Mexican American patients and their families to provide culturally appropriate care.5 This column describes communication aspects of providing care to Mexican American patients, drawn from the Giger-Davidhizar Assessment Model. Simple, Yet Formal In a department or facility where Mexican American patients who do not speak English are served, it is ideal to have a staff member who can speak Spanish. When this is not possible, a translator should be available and utilized. A patient’s family members may also be enlisted to serve as translators. Having someone who can speak to the patient and explain what is going to happen during the exam or procedure can dramatically decrease the patient’s anxiety and increase his or her cooperation. When the patient is a child or is confused, it may be essential to have a person who can speak with the patient to complete an exam or a procedure. When talking with a patient who is not totally conversant in English, limit conversation to words that will be easily understood. Culturally relevant patient education materials can be very helpful in both explaining the procedure and giving the patient instructions. For example, pamphlets in Spanish on the benefits of a mammogram can assist in communicating the importance of the test. Rather than objecting to something, Mexican Americans tend to use silence. The patient may appear to agree because of the cultural value of courtesy and respect8; communicating respect is very important for the Mexican American when meeting someone. He or she also expects to be treated with respect until rapport is established over time and a less formal approach is acceptable.9 Using the first name of a person you don’t know well would be considered inappropriate by most Mexican Americans. Tone of voice is also important for the Mexican American patient in communicating respect. A patient who is not familiar with the American healthcare system may find the radiology setting frightening. Giving reassuring information about what is happening and what is going to happen in a language the patient understands provides important support. For many Mexican Americans, support is most appropriately provided by family members. Imaging department staff should consider incorporating family members whenever possible and allowing them to be present whenever possible. Eye behavior is significant to many Mexican Americans. Direct eye contact will generally be avoided with healthcare professionals or those perceived as authority figures.10 Eye contact may be avoided out of respect but may also be related to evil spirits. Some illnesses are attributed to an individual being given the “evil eye” by another. Respecting Space If a male radiologist is performing a procedure on a female patient, a female nurse should assist and ensure against unnecessary exposure of body parts.13 Nonessential persons should stay out of the examination room, especially during a procedure the patient may consider delicate.14 Family and Faith Between 80% and 90% of Mexican Americans belong to the Roman Catholic church.17 Many direct their prayers and religious promises to the Virgin of Guadelupe, the popular religious figure to Mexican Catholics. Exam patients may wish to have a religious symbol such as a rosary or other special amulet. The radiology staff should not be surprised if the Mexican patient brings personal articles to the radiology department that have a special meaning, such as ensuring the success of the examination procedure.18 While America has been called “the great melting pot,” not everyone who lives in the country has been so thoroughly assimilated. Given the large number and rapid growth rate of Mexican Americans, a basic understanding of their preferred communication patterns will promote better care and a more comfortable healthcare environment for everyone involved. — Ruth Davidhizar, RN, DNS, ARNP, BC, FAAN, is the dean of nursing at Bethel College in Mishawaka, Ind. — Steven Dowd, EdD, RT(R)(QM)(MR)(CT)(M), is an associate professor in the School of Health Related Professions at the University of Alabama at Birmingham. — Joyce Newman Giger, EdD, RN, ARNP, BC, FAAN, is a professor of graduate studies at the University of Alabama at Birmingham. References |
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