NDLI: Ethical and cultural considerations in delivering psychiatric diagnosis: reconciling the gap using MDD diagnosis delivery in less-acculturated Chinese patients.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yeung, Albert Kam, Raymond
Description	Country affiliation: United States Author Affiliation: Yeung A ( Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. ayeung@partners.org)
Abstract	Talking to patients from diverse cultural backgrounds about their psychiatric disorders requires knowledge of one's own culture, the patients' cultures, and the ways in which they might interact, both in positive and unexpectedly negative ways. In this paper, we discuss the issues raised by discussing psychiatric diagnoses with Chinese-Americans who hold traditional illness beliefs and are not familiar with Western conceptions of psychiatric disorders. We explore how cultural values influence this aspect of medical practice, and suggest practical approaches to communicating the diagnosis of major depressive disorder in a culturally sensitive manner. Our clinical approach is to develop co-constructed illness narratives with patients, and to aid this process by reframing different elements of the clinical process into more culturally resonant forms. The following steps are suggested: 1) elicit patient's illness beliefs; 2) understand and acknowledge multiple explanatory models; 3) contextualize depressive symptoms into patient's physical health and social system; 4) introduce Western psychiatric theories in ways that reflect assumptions shared by Traditional Chinese Medicine (TCM); 5) involve patients' families whenever possible; and 6) use terminology that avoids unintended stigma.
File Format	HTM / HTML
ISSN	13634615
Issue Number	4
Volume Number	45
e-ISSN	14617471
Journal	Transcultural Psychiatry
Language	English
Publisher	Sage Publications
Publisher Date	2008-12-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Psychiatry Acculturation Asian Americans Psychology Communication Depressive Disorder, Major Ethnology Ethics, Medical Psychiatry Ethics Cultural Competency Culture Diagnosis Parasitology Humans Medicine, Chinese Traditional Patient Education As Topic Physician-patient Relations Sick Role Social Values Journal Article
Content Type	Text
Resource Type	Article
Subject	Health (social science) Psychiatry and Mental Health

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