Case Study #5
Heart & Neck Vessels, Lungs & Thorax
Mrs. Lee, 80 year old Asian American female
Admitted to the medical-surgical unit with a chief complaint of “breathing problems”. She speaks broken English & requests that her daughter be allowed to stay with her. She is on nasal cannula oxygen & sitting up in bed. At this time, she seems slightly short of breath, but is not in acute distress. You note that she is pale & has a petite frame. Her ankles are swollen. Her daughter tells you that she has been complaining of feeling more tired in the evenings & “unable to catch her breath”. While at home, she has been sitting up either in an easy chair or in bed with three pillows. Her daughter states that Mrs. Lee has not had to urinate as much in the last 2 days, but she gets up twice each night to use the bathroom. During your interview for the health history, you note that Mrs. Lee often just smiles & nods in response to your questions. She does not maintain eye contact. Her daughter does not provide additional information unless asked directly by you. 1.
Considering cultural perspectives, what can you do to facilitate the interview process? Keep in mind that politeness & formality are often valued by persons of Asian descent. Be sure to address her by her name & title (“Mrs. Lee”). In some cases, some Asians may expect the healthcare provider to intuitively know what is wrong with them. Nodding & smiling may occur even when the person does not agree with you. Encourage the person to respond openly & frankly to questions and to give them “permission” to disagree. You may also have to explain the purpose of asking the large number of personal questions needed during the interview If a family member or friend is with the patient, be sure to ask the patient’s permission for that person to remain during the interview & examination. When this person acts as an interpreter, take care regarding patient confidentiality. Ideally, an interpreter is...
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