Hey guys,
Thought I might share with you some specifically remote experiences i have had that i have found challenging. I know we did a section at uni on indigenous health adn have designed various programs "culturally sensitive" for various assignments, but it is not until you get out and make a few mistakes that those lectures etc. kick in!
A fair few of my patients are indegenous and my best advice... your subjective and objective ax is NOT the priority. For practitioners to establish rapport with our patients we are taught how important body language, eye contact and communication. Well i tried it and failed miserably, a thorough history is important, but sometimes you dont have to retrieve it so formally, or even in one session. In fact, the most success i had was talking about the footy, looking at the gorund, having a play with the affected areas and discovering patellofemoral symptoms. Specifics abou pain, mechanism of injury, past history of similar things, aggravaitng factors were just not attainable, and holding their attention was short. Also, management through exercise was what i wanted to achieve, but i have discovered promoting this striaght up with education ++ is too much and I was more successful with hands on manual therapy and as they got to know me, then introduce simple exercises (one at a time) was amore successful approach.
Does anyone else have any advice about cultural sensitivity? do you agree/disagree with my approach?
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On my third year placement I treated a middle aged aboriginal man on a gen med ward. I found prescription of exercises really hard as I could not get the patient to follow simple commands very easily and then once I finally was able to teach him about 3 exercises, I would go back over them immediately only to have him back at the start not remembering how to do any of the exercises even with prompting. I specifically made an exercise sheet of pictures to explain each of the exercises and this didnt help either. I found it very hard to explain the importance of these exercises, build any sort of rapport or get the patient doing anything by himself. This meant that all I could do was try to remind him not to rest the soles of his feet on anything (due to healing ulcers) whenever possible and come in a couple of times a day to simply get the patient to move his legs. Not very productive but better than nothing. Much harder than most of our classes suggested
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