Netherlands: Turks, Moroccans need different approach to medical care
Medical personnel should keep in mind that Turkish and Moroccan patients don't need to know everything.
Providing all information is so important for Dutch medical personnel, that they're sometimes forced to withhold information, according to the study "Communication and decision making in palliative care for Turkish and Moroccan cancer patients" (NL PDF) by NIVEL. Moroccan cancer patients and their families often have different view about communicating the diagnosis, prognosis and treatment, according to the report.
Dutch medical personnel feel (and are) obligated to inform the patient about the diagnosis, treatment and prospects. But many families of immigrant-origin patients want to withhold the bad news from the patient. "The decision making is more of a collective or family matter, where the interpreting son or daughter acts as a representative of the family. The family often strives for a cure, also in the case of fatal illnesses, and feels strengthened in that by faith," according to NIVEL.
Dutch care providers often disagree with Turkish or Moroccan families about what is good care, how it should be discussed and who makes the decisions. If the Dutch care provider doesn't play in on that and forces the 'Dutch way', the family might withdraw. Or the nurse, doctor or care provider might leave too much to the family. In both cases, this leads to a worse quality of care.
Researcher Fuusje de Graaff says in the NIVEL press release that care providers should try to find a way in the care-provider, patient, family triangle. Some can put themselves in the shoes of those involved as regarding communication needs, put aside the 'Dutch' idea of one-on-one communication with the patient, and keep in mind the role of the family. Older, experienced doctors and nurses seem more inclined to go along with the wishes of the family. For example, they explain how things go in the Netherlands, or bring in a translator early on, mostly to ask the patient what he wants to know and what he wishes for. It's very important to make a connection with the patient and with his family.
Over 33 cases were researched for the qualitative study, and 83 people interviewed: 6 patients, 30 family members and 47 care-providers.
Source: Nursing (Dutch)
See also: Amsterdam: Clinic for Turks
