Lifelong Learning Programme

This project has been funded with support from the European Commission.
This web site reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

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Training of Lecturers

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This training package is addressed to lecturers and trainers in the field of paediatrics on how to assist paediatric undergraduate and resident students in developing and consolidating their soft skills for improving the quality of paediatric services.

Communicating in a multilingual environment

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5 Cultural Core Discussion: Pain and Suffering
Healthcare professionals often deal with issues around pain and suffering. In children, the experience of these feelings is often amplified through their young bodies and is much harder to control and to communicate than when dealing with adults. Additionally, talking about pain, suffering or end-of-life care is a difficult topic for many healthcare providers, let alone in a multicultural setting. Language and culture barriers can make pain assessment and treatment particularly challenging for practitioners. On top of that, cultural beliefs including distrust of doctors or medicine per se can present additional barriers in providing pain management and even palliative care (Davidhizar & Barlett, 2000). Knowing, understanding and appreciating cultural concepts of pain and suffering different from one’s own can assist pediatricians to communicate more effectively, elicit the desired response, adapt the form of treatment to the patient’s needs and exercise patience when necessary.

For example, in some cultures (Chinese, Korean, Vietnamese) it has been observed that asking for medication or treatment to assist with or mitigate symptoms of pain is viewed as an expression of disrespect. Similarly, it has been observed that in many Asian cultures, saying no to a person of authority is viewed as showing disrespect. A child’s caretaker might thus continually agree with the pediatrician's view and expressions without actually consenting on the inside. Within this cultural context, medical practitioners are viewed as experts in their field and are not to be corrected. Other cultures have been observed to avoid pain reporting altogether, making pain management challenging or even impossible (OIsen et al. 2007).

Some ethnic groups might seek medical help from a trusted traditional healer before using standard medical service provided by the state or government. Others turn to alternative forms of medical support before considering consultation with a professional who practices standard forms of medicine. Whatever the case, pediatricians must avoid blaming cultural or traditional views for a lack of medical treatment and work with the child and his family to the best of their ability and circumstance.

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This project has been funded with support from the European Commission. This web site reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.