Advice and guidance on the health needs of migrant patients for healthcare practitioners.
Health beliefs and values vary between cultures and individuals within those cultures. This can impact on health and behaviour to health and health services.
Awareness and understanding of differences in health beliefs and values between the practitioner and the patient is necessary to achieve desired health goals for any patient. For patients from cultures unfamiliar to the practitioner, these differences may need more exploration.
Spirituality means different things to different people and is expressed in varied ways. Migrants to the UK have a diverse range of beliefs and health providers should be aware of the role and impact of spiritual and religious beliefs in the person’s life and on their health.
Be aware that religious belief may affect the acceptability of aspects of medical care, for example diagnostic procedures and certain types of treatment, and also of the potential impact of religious observances on health and treatment plans such as periods of fasting.
It is good practice to explore with all patients for whom you are prescribing medication whether anything (religious requirements or indeed any other factor) might interfere with their ability to comply with your recommendation.
Beliefs, rites and rituals around pregnancy and birth, ‘coming of age’, menstruation, marriage, and death are highly variable between religions and cultures, and may all impact on health/health seeking behaviour. Explore your patient’s beliefs and understanding of these issues where appropriate to the context of the consultation.
Beliefs and cultural perspectives on health
Beliefs about health (and illness) and health-associated values can vary considerably, within any given cultural group and between cultures.
Expressed beliefs lead to differences in response to illness and disease, influencing health seeking behaviour, interpretation, and ultimately diagnosis by health care practitioners.
People’s cultural perspectives can be influenced by a range of factors, including ethnicity and place of origin, education, religion, values, gender, age, family and social status.
When dealing with any patient, even one who shares the same broad culture, it is very important to recognise that their beliefs and values about health and healthcare may be quite different from that of the healthcare provider. It is also important to explain the National Health Service to new patients.
Patients whose cultural background differs to your own, you may find that, in order to fully understand their perspective you have to ask more questions.
Recognize your own preconceived ideas that you may bring to professional encounters and aim not to make assumptions about anyone’s beliefs or values, no matter what culture they belong to. Instead, ask patients about their own understanding and about what is important to them regarding their health issues, and why.
Establish what is acceptable to them in terms of diagnostic investigations, or proposed treatments; aim for joint management plans.
The e-GP online e-learning resource, jointly developed by the Royal College of General Practitioners and e-Learning for Healthcare, has been created for NHS General Practitioners and doctors undertaking specialty training for UK general practice
The Health Care Needs Assessment (HCNA) includes a chapter on Black and minority ethnic groups; Culture, Health and Illness, 4th edition. By Cecil G Helman. London, Arnold. 2000