Cultural Sensitivity in Healthcare Decision-Making

Study Notes

In Vietnam, the eldest male is often the family spokesman, and older women may also have significant influence.
Decisions are often made by the eldest male, but if the patient does not want to make their own medical decisions, a Durable Power of Attorney for healthcare needs to be prepared.
Removal of life support may require extensive family discussion, placing the responsibility for the decision on the entire family rather than on one individual.

Patients may have a deep respect for elders and people with authority, which may lead them to be reluctant to say "no" to a doctor or healthcare provider.
Asking about "Do Not Resuscitate" orders and documenting these wishes can give patients and their families a sense of security.

Patients may accept pain and illness in a stoic manner, motivated by a strong desire to go home.
Patients may mask their pain, and surgery may be seen as a treatment of last resort.
Blood loss, including blood drawn for lab tests, may be believed to make patients sicker.

Most Vietnamese are Buddhist, with other religious preferences including Catholic, Evangelical Protestant, and Chinese Confucianism.
Patients may call a monk to give blessings, chant, and create an altar for prayer.
Catholic patients may ask for a priest for last rites at the end of life.

Food is considered important for health in Vietnamese culture, and family members may force food on patients when they are ill.
White is the color of mourning in Vietnamese culture.

Ask questions before entering the room to ensure a good time to talk, assess the patient's and family's needs, and avoid overwhelming them with information.
Use active attentive listening, nodding, and reflective statements to encourage communication.
Avoid giving advice unless asked, and build on the patient's responses to guide the conversation.

Give information in small amounts, using the "warning shot" principle to facilitate understanding.
Check understanding frequently and reinforce with plain language.
Emphasize empathic responses to the patient's emotions and reactions.

Managing physical and psychological symptoms alleviates distress and suffering.
Dyspnea is a common symptom in oncological patients, causing multidimensional distress and affecting quality of life.
Dyspnea can be caused by various factors, including direct tumor effects, treatment-related effects, cardiovascular disease, pulmonary disease, and anxiety.

Respiratory control involves input from various receptors in the chest wall, airways, and chemoreceptors in blood vessels.
Dyspnea arises from the awareness of a respiratory supply-and-demand mismatch.