Cross-cultural rapport

I am currently on prac in a rural area with a large proportion of indigenous patients. Whilst treating a 22 year old indigenous woman for her chest symptoms following an acute bout of pancreatitis, I learnt first hand that rapport is often more difficult to establish, and certainly at least as important when treating patients with a different cultural background to my own.

The first time I saw this young lady I did not allow a lot of time to see her as she did not need too much intervention from a physiotherapy perspective. Although I had several communication strategies in my mind for this particular patient to avoid any perceived disrespect, such as being aware that she may prefer to avoid eye contact, I missed the most important element of communication: building rapport.

I felt I was being culturally aware, explained rationale for what I was asking her to do and (I believe) instructed her effectively. Despite this she appeared very disinterested and barely said a word, even when I asked her questions. After some thought, the next day when I saw her again I allowed more time, and for the first 15 minutes I just asked her about what she likes to do and generally made conversation. After this, although she still did not speak a lot, she appeared much more interested in what I was saying, and was able to do her breathing exercises more effectively.

What I learnt from this scenario was that I can’t expect a patient to be interested in what I am telling them if I don’t show interest in them as a person as well. Sometimes patients are eager to understand their condition and how to manage it, whilst others need to be interested in what you have to say in general rather than the specific information you are giving them. I found that I naturally establish good rapport with patients who I can identify with more easily, and so need to be more conscious of doing this when interacting with patients of other cultures or vastly different personalities to my own.