In these sections, we highlight several aspects that can help clinicians promote culturally responsive care in working with Hmong American older adults.
Eliciting the patient’s perspective is a key aspect to cross-cultural understanding. Without asking, providers are only guided by their assumptions. Since assumptions are based on generalities and stereotypes, they invariably will be incorrect.
Asking and Listening
Asking questions and listening to responses requires patient-centered communication skills.
Examples of questions that can be used to elicit patient’s thoughts, beliefs, desires and reactions to health care providers’ recommendations include (Kleinman, Eisenberg. & Good, 1978):
- What do you think is wrong?
- What do you think has caused the problem?
- What are you afraid this might be?
- What have you done to relieve the problem? Have you tried traditional Hmong treatments?
- Have you seen other health care professionals?
- What do you think would help you? How can I help you?
- What do you think about what I have recommended? Do you think it will help? What problems do you see in doing it?
- Who will help you make a decision? Do you want me to talk with those people?
An increased understanding of the patient’s perception can facilitate communication for the establishment of a plan of care. These interactions may be straightforward or they may become complex. In the latter, nurses may need negotiation skills to identify the key points of disagreement, find common ground, propose alternative approaches, and identify a plan that both parties can agree to.
