Contributor: Lorena Drago, MS, RDN, CDN, CDE
In partnership with
Preparing for a doctor’s visit is a good practice that many patients have not fully implemented. Health provider visits are usually short and fast-paced leaving patients with limited time to address all of their health concerns. In addition, culture brings another level of complexity especially if the health provider is not familiar with the cultural practices, beliefs, and traditions of the different Hispanic subgroups. Patients need to find smart ways to make each visit count. These are three fool-proof ways to bridging the cultural gaps that often occur in healthcare.
- Symptoms not Stories: A year ago, I became very ill and was referred to a specialist. At that moment, I changed from a Hispanic health care provider to a Hispanic patient. When asked what brought me to the visit, I recited how I felt, “terrible” “horrible” “so sick” and the doctor interrupted me and asked for my symptoms. I realized that many Hispanics share how they feel “muy mal” “muy enferma” “no muy bien” while doctors have been trained to focus on symptoms so they can assess, diagnose, and treat. Hispanics also share stories as a prelude to discussing their health concerns. For example, “On Tuesday, it was raining very hard and I encountered many accidents on the road on my way home. When I arrived, my son was not home and I was unable to reach him and I was very worried. I tried calling him and texting him and I did not hear from him. That evening, my blood glucose was 250. I know it was stress.” When there are time constraints, the best way to communicate is to focus on the symptoms.
TIP: Write your symptoms in descending order of importance. Share the list with your provider. This will help you address your most important health concerns.
- One Word, Multiple Meanings: If you interact with individuals from different Hispanic countries and regions, you know that “mi Español” is different from “su Español.” Often these words cause nothing more than a chuckle such as when an English speaking provider confused the words “embarazo” (pregnancy) with “abrazo” (hug). Others may have more serious consequences such as when a Spanish speaking patient was admitted to the emergency room stating that he was “intoxicado” (food poisoning) which was interpreted as intoxicated (affected by alcohol or drugs). Education materials in Spanish may also be confusing if a word has different meanings in different regions. A diabetes meal planning booklet suggests having an afternoon snack (bocadillo); in Colombia, bocadillo is guava paste. Many guava paste lover may welcome the suggestion but it was clearly not the intended message.
TIP: Use a medical interpreter. Define words that are not used in all Latin American regions. For example, “in my country, “habichuelas” are green beans, how do you call them in your country?”
- Share not Conceal: Which foods do you eat (or drink) to better manage your diabetes?” “Which foods do you avoid now that you have diabetes? “What non-prescribed medications do you take to manage your diabetes?” I include these questions on the patient questionnaire form because the answers are key a productive conversation. Persons with diabetes may not be forthcoming answering these questions because they are afraid that their practices may be discouraged. Sharing information allows health professionals to discover if these treatments are effective or if they are interfering with your current treatment. Nopal (cactus) has hypoglycemic effects. Depending on how much you and how often you eat nopal, it might enhance the effect of your blood glucose lowering medications leading to an unintended and unexpected hypoglycemic episode. You might be spending money unnecessarily buying herbs and supplements that have not been proven effective in reducing blood sugar levels.
TIP: Consult with your health team before buying or taking non-prescribed medications or embarking on diabetes diets or miracle foods. Write the name of the product and ask: how effective is this treatment? What is the research behind it? How much? How often? Are there any contraindications?
Remember, the next time that you visit your health care team: walk prepared!
Lorena Drago, MS, RDN, CDN, CDE is a multi-cultural nutrition education expert, specializing in the multicultural aspects of diabetes self-management education. She is an expert in developing culturally and ethnically-oriented nutrition and diabetes education materials. Lorena serves on the DiabetesSisters faculty as part of our Minority Initiative Program. Find her at online at www.lorenadrago.com, and on Facebook, Twitter @lorenadrago and Instagram @lorenadragomsrd.