Culturally Competent Professionals in Therapeutic Alliances Enhance Patient Compliance

Abstract

Medical training has traditionally focused on diagnosis and treatment of disease, with the notion that if these two factors are satisfactorily managed, the desired outcome will inevitably follow. When it does not, failure is often blamed on patient noncompliance. Failure of patients to return for follow-up visits or comply with medication regimens has been shown to be a major barrier to the delivery of effective medical care. However, effective clinical decision making requires that physicians skillfully address not only the biomedical aspects of diseases and their management, but also the sociobehavorial characteristics of patients. The authors maintain that patient participation is necessary for compliance and that a naturally occurring therapeutic alliance between physician and patient incorporates factors such as lifestyle, family, and living circumstances and an awareness of the culturally unique needs of minority patients. Integration of these factors into professional decision making and practical management plans will enhance patient compliance.

Cultural aspects of communication in cancer care

“…A culturally competent health care system must also consider social, racial, and cultural factors in their separateness and yet in their reciprocal influences. Studies suggest that culturally competent health care leads to improved therapeutic outcome and may decrease disparities in medical care [4,34,63]. Teaching cultural competence to western medical student and young oncologists involves the provision of relevant information about different cultures with respect to different health issues, such as different cultural practices of truth telling or different decision-making styles throughout the world [59].…”

“…Cultural factors influence the way patients, physicians, and communities deal with communication in the clinical setting, and major cross-cultural differences exist worldwide with respect to information and decision-making in oncology [41]. Cultural factors also play a role in the existing major disparities in access to health care and research for minority and underprivileged cancer patients [4,34].…”

Toward an Understanding of Health Care Delay Among Ethnic Minorities: Examining Health Care Behaviors Among Military Young-Adult Males

“…This includes the behavior of individuals, groups, and populations as well as the culture of institutions, both the formal and informal practices of organizations. Culture can be defined as a narrow set of guidelines (both explicit and implicit) that individuals inherit as members of a particular society, and tells them how to view the world, how to experience it emotionally, and how to behave in it in relation to other people, to supernatural forces or gods, and to the natural environment (Helman, 1990;p.10 (Anderson, 1995;Kumanyika & Morssink, 1997;p.82;Langer, 1999;Suarez & Ramirez, 1999 (Williams, 1998). There may be important cultural beliefs, behaviors, or attitudes related to health care.…”

Structured Psychosocial Stress and Therapeutic Failure

“…These factors may enhance the frequency of patient noncompliance as the duration of drug therapy is prolonged. Langer (1999) takes a view more in concert with current medical anthropology:…”