Health literacy among Māori

Summary

The speaker addresses health literacy issues within their community, emphasizing the challenges in doctor-patient communication. They recount experiences where medical explanations were too complex, leading to misunderstandings and frustration. The narrative highlights the importance of breaking down information and using translators to ensure comprehension. A specific case is discussed where a Pacific Islander patient's limited English led to confusion about her cancer diagnosis and treatment options. The story underscores the need for clear, visual communication and the right to explore all treatment possibilities, regardless of cost.

Takeaways

• 😷 Health literacy is a significant issue for the whanau, where basic medical communication can be challenging.
• 🗣️ The narrator often acts as a mediator to simplify medical jargon for patients, ensuring they understand their conditions.
• 👩‍⚕️ Doctors sometimes struggle to convey complex medical information in a way that is accessible to patients.
• 🏥 The narrator's role includes advocating for patients, particularly from Pacific Island groups, to ensure they receive clear information.
• 🌐 Language barriers can lead to misunderstandings in medical settings, highlighting the need for effective communication.
• 🔍 The narrator had to arrange a whanau hui (family meeting) to address misunderstandings due to limited English proficiency.
• 💬 A translator was crucial in providing clarity and ensuring the patient was fully informed about her condition and treatment options.
• 🚫 The patient felt judged and limited by the doctor's assumptions about her financial situation and cultural background.
• 💪 The whanau's support and the patient's determination to explore all treatment options were emphasized, despite the doctor's advice.
• 👀 Visual aids, such as drawings and x-rays, were essential in helping the whanau understand medical conditions and make informed decisions.

Q & A

What is the main issue the speaker identifies with their whanau?

The main issue is health literacy, specifically the communication gap between doctors and patients, where medical terms and diagnoses are not easily understood.

How does the speaker try to bridge the communication gap?

The speaker acts as an intermediary, asking doctors to simplify their explanations until they understand, and then relays that information to the whanau.

What is the significance of the phrase 'break it down' in the context of the script?

The phrase 'break it down' refers to the need to simplify complex medical information into terms that are easily understood by the patient and their family.

Why does the speaker feel the need to go back to the doctor after speaking with the whanau?

The speaker goes back to the doctor to clarify and understand the medical information better so they can accurately convey it to the whanau in a simplified form.

How does the speaker describe the initial reaction of the doctor when asked to simplify explanations?

The doctors often look puzzled and unsure of how to make their explanations simpler, indicating a lack of training in communicating complex medical information effectively to laypeople.

What role does the speaker play in working with the Pacific Island groups?

The speaker acts as a liaison, helping to interpret medical information for Pacific Islander patients and advocating for their needs.

Can you provide an example of a situation where a translator was crucial in the script?

Yes, a Pacific Islander patient misunderstood her medical status as 'all clear' due to limited English proficiency. A translator was brought in to clarify that she needed further treatment, leading to a better understanding and decision-making.

What was the patient's initial reaction to the consultant's advice about treatment options?

The patient felt confused and angry because the consultant suggested she was 'all clear' previously but then presented different, potentially expensive treatment options, which she could not afford.

How does the speaker feel about the consultant's suggestion that the patient should go home and enjoy her family instead of pursuing expensive treatment?

The speaker is critical of the consultant's suggestion, arguing that the patient should be given all treatment options and not be dismissed based on cost or cultural assumptions.

What is the significance of the term 'whanau' in the script?

The term 'whanau' refers to the extended family in Maori culture and is used to emphasize the importance of family support and collective decision-making in health matters.

How does the speaker describe the Maori and Samoan whanau's approach to understanding medical information?

The speaker describes them as very visual, preferring to see diagrams, pictures, or x-rays to better understand their medical conditions rather than just hearing verbal explanations.

Outlines

00:00

🩺 Health Literacy Challenges and Doctor-Patient Communication

The speaker discusses the significant issue of health literacy within their community, highlighting the communication gap between medical professionals and patients. They describe their role in simplifying complex medical information for patients and their families, ensuring they understand their conditions and treatment options. The speaker also emphasizes the importance of breaking down medical jargon into layman's terms and the need for doctors to communicate effectively with patients. They recount a specific instance where they had to mediate between a doctor and a patient's family to clarify a diagnosis, illustrating the challenges faced by non-English speaking patients and the role of cultural liaison in bridging this gap.

05:00

🌐 Language Barriers and the Need for Translators in Healthcare

In this paragraph, the speaker recounts an incident where a patient misunderstood her medical status due to limited English proficiency, leading to confusion and anger. The speaker had to arrange a family meeting to address the communication breakdown and realized the necessity of a translator. The introduction of a translator significantly improved the patient's understanding of her condition and treatment options. The speaker also criticizes the consultant's assumption about the patient's financial situation and their ability to afford treatment, advocating for a more inclusive and empathetic approach. The narrative underscores the importance of clear communication and the role of translators in healthcare, especially for patients from non-English speaking backgrounds.

10:02

🖼️ The Power of Visual Aids in Enhancing Communication with Patients

The speaker highlights the importance of visual aids in healthcare communication, particularly for Maori and Samoan communities who are very visual. They share examples where doctors used drawings and visual representations to explain complex medical conditions, which helped patients and their families better understand their health issues. The speaker emphasizes that showing visual aids can be more effective than verbal explanations alone. They also mention the emotional impact of seeing medical images, such as X-rays, which can provide hope and clarity to patients and their families. The speaker encourages healthcare providers to utilize simple visual tools like drawings and PowerPoint presentations to improve communication with patients from diverse cultural backgrounds.

Keywords

💡Whanau

Whanau is a Māori term that refers to an extended family group. It is central to the video's theme as it highlights the importance of family support and communication in healthcare. The speaker often refers to 'whanau' when discussing the need for doctors to communicate effectively with patients and their families, as seen when they say, 'i'll go back to the whanau and go, this is what the doctor meant da da da, da da da'.

💡Health literacy

Health literacy refers to an individual's ability to understand health information and services in order to make informed decisions. In the video, the speaker emphasizes the challenges faced by patients and their families in comprehending medical terminology and diagnoses, which is a significant part of the narrative as they discuss the need for simplified communication from healthcare providers.

💡Communication

Effective communication is highlighted as a key issue in the video, particularly the need for doctors to explain medical conditions in a way that patients can understand. The speaker gives an example of asking doctors to 'break down' complex medical terms, illustrating the importance of clear and accessible communication in healthcare.

💡Interpreter

An interpreter is a person who translates spoken or signed languages. The video discusses the critical role of interpreters in ensuring that patients with limited English proficiency can fully understand their medical conditions and treatment options, as demonstrated when the speaker arranges for a translator to help a patient: 'i requested a translator for this patient, and the translator went in, it was the best move they could ever do'.

💡Pacific Islander

The term 'Pacific Islander' is used in the video to refer to individuals from the Pacific Islands. The speaker discusses their work with Pacific Islander communities, emphasizing cultural sensitivity and the importance of understanding their perspectives within the healthcare system, as seen when they recount an interaction with a Pacific Islander patient and her family.

💡Cultural sensitivity

Cultural sensitivity is the awareness and respect for the cultural practices and beliefs of different ethnic groups. The video underscores the importance of cultural sensitivity in healthcare, as the speaker describes how they work with different cultural groups, including Pacific Islanders, to ensure that healthcare is delivered in a culturally appropriate manner.

💡Visual learning

Visual learning is a method of learning that involves using visual aids to understand complex concepts. The video emphasizes the value of visual learning in healthcare, as the speaker describes how patients and their families often prefer to see diagrams or images to better understand medical conditions, as illustrated when they say, 'show me a picture' and 'a picture says a million words'.

💡Miscommunication

Miscommunication refers to the failure to convey or understand the meaning of a message. The video discusses instances of miscommunication between doctors and patients, particularly due to language barriers or the use of complex medical jargon, which can lead to confusion and frustration, as seen in the patient's reaction to the consultant's diagnosis.

💡Advocacy

Advocacy in healthcare involves speaking up for patients to ensure they receive the care they need. The speaker in the video acts as an advocate for patients and their families, ensuring that their voices are heard and their needs are met, as demonstrated when they challenge a doctor's assumption about a patient's ability to afford treatment.

💡Treatment options

Treatment options refer to the various medical interventions available to patients. The video touches on the importance of presenting all available treatment options to patients, regardless of cost, and allowing them to make informed decisions about their care, as seen when the speaker questions a doctor's decision not to discuss certain treatments due to their expense.

Highlights

Health literacy is a significant issue for the whanau, particularly in doctor-patient communication.

The need for doctors to simplify medical explanations for patients is emphasized.

The role of a mediator in breaking down complex medical information is discussed.

The importance of ensuring patients understand their medical conditions before making decisions is highlighted.

A personal account of navigating medical explanations for a whanau is shared.

The challenge of health professionals understanding the cultural context of patients is noted.

An incident where a patient misunderstood 'all clear' to mean cancer-free is described.

The role of a translator in clarifying medical information for a patient with limited English is explained.

The patient's perception of being 'abused' by consultants due to miscommunication is mentioned.

The impact of a doctor's narrow-mindedness on patient treatment options is critiqued.

The importance of visual aids in communicating medical information to Maori and Pacific Islander patients is discussed.

A specific example of using a drawing to explain a heart condition to a patient is provided.

The significance of showing medical images, like X-rays, to patients for better understanding is highlighted.

The power of visual information in giving patients hope and motivating them to seek treatment is discussed.

The preference of Maori and Pacific Islander patients for visual and tactile learning methods is noted.

A call for health professionals to use simple visual aids, like PowerPoints, when explaining medical concepts is made.

Transcripts

there's

lots of issues that our whanau come up

against

but um one that probably stands out for

me

is the health literacy so

i mean some of the basic things like

communication between the doctor and the

patient

um

i don't how do i how can i describe it

like i always

see um you know like i'm always talking

with a doctor or

with a nurse and saying um

can you break the can you break the

cordal down can you break what you've

just said to the patient can you break

it down some more

and they'll look at me like um

i know what you're saying but i don't

know how to make it any simpler and so

what what we normally do is or what i

normally do is

i'll go to the doctor can you tell me

what's wrong with the patient

and so he or she the doctor will say

well he's got a this this and this

and i go yep and what does that mean

and he looks at me and he'll go that

means he's got this this and this

and i'll go yeah

so does it mean this and the doctor will

go no

okay okay well i still don't get it so

what i'm trying to explain is

what i say to the doctor is i'm not dumb

and i don't get what you've just said to

that family

so how do you expect them to you know

how do you expect them to understand

what you've just told them and so

um we break it right down so he'll break

it right down until i say yeah i got it

so if i went to the whanau and said

that would be correct he'd go yes so i

normally go back to the whanau and go

this is what the doctor meant da da da

da da da and so

um i don't do that unless the whanau

asked me

so what normally happens is i'll go to

the whanau and they'll say

what did the doctor say to you what did

you get from his corridor

nine times out of ten they'll go i don't

know

i don't know he he said it's got

something to do with my my leg or my arm

or

you know my back and i'll go oh do you

want to know what's wrong with you

yeah do you want me to go find out

yes please and so that's that's where it

starts from so i'll go

back to the doctor to the nurse and say

can you explain to me

what went on with what went on with you

know horny or what went on with

deepeker or whatever yeah and so that's

part of the health literacy is a big one

so also in my role i i work with um

the pacific island groups and i'll work

with anybody if they request

that i help them out so one day i was

on the ward and i had this uh

pi pacific islander come up and ask me

if i'd work with her whanau and i said

yeah okay

what do we need to do she goes well

we're gonna go see the consultant and

he's gonna

um tell us what's going on i said oh

yeah well you fill me in a bit and so

she says

well she's all clear and i says oh what

do you mean

well she's come back from parmesan and

she's told the whanau that

we're all she's all clear so she's just

got to go see the doctor

today and he's just going to i don't

know fill her out i'll say oh yeah

sweet so went across and we saw the um

the consultant

and i was sitting in the in the so there

was about

six seven of us and myself included

whanau you know her brother and his wife

and

a sister and what have you in the

patient and she had her child with her

was out playing out in the waiting room

so we go into the room and it's a small

room

so you know even that is it's like

you know a whanau are coming you know

whanau is coming

why don't you have enough seats for

everybody but

not even so we're in this little

surgeon's room and

he starts talking and then um

all of a sudden the patient just turned

off him she was like

wrong she just wouldn't you know say say

you're the doctor you're on the patient

you're talking with me and and she's

just

she just went just turned off him and um

later on when we got out of the out of

the um

the meeting i said what went on in there

and um she said he told me i was all

clear

before this was before this was when she

was down in palmerston the doctor said

to

it's all clear there's nothing no more i

can do for you that's that's it there's

no more i can do for you

well the patient took that as

i'm all clear i'm fixed i haven't got

cancer so she was

all excited come back here to see this

consultant

who told us something else and so she

got really confused and she got quite

angry

and so from there i had to

arrange whanau hui and figure out what

is the breakdown

how much english does she understand and

it was very limited her

english and um but she would talk to me

and i could talk to the whanau and she

would talk to me and so

from the i i knew we had to get a

translator and for her to be

fully informed of what was going on with

her she needed a translator so

i um requested a translator for this

patient

and the translator went in

it was the best move they could ever do

she was so clear you know she was

informed fully informed

so what had happened was

from her words these are her words i

don't want to see that a

consultant again he abused me this is

these are her words not mine

he abused me they abused me that's what

she called the two consultants abused me

and said i was like

whoa that's quite harsh words to use

but um i think because of her limited

english

that's the only word she could think of

to to label these

consultants so we got a translator run

now this woman is thinking of um doing

chemo when she

she said no to the consultants no i

don't want clemo

and the consul consultant says well you

know it's a bit expensive

you've got a choice of this treatment

and that treatment and that treatment's

really expensive so

um you know it's probably time you just

go home and enjoy your family

and you know you do this and you do that

and

just enjoy life and enjoy your family

and oh you know i was thinking

who are you to tell her because it costs

this much

you take this you take this option and i

sort of

i do say that you know i sort of said

that to um

his nurse

yeah so i can get into some challenging

situations myself you know whereby it's

like

uh-uh you why are you judging this

family

because you know because they're they're

pacific island you naturally assume that

they've got no money

he didn't look at because they talked

about their belief they were very

you know right into the church they're

very um

their god is powerful you know how they

believe in god

and they they wanted to look at all

these other options

you know they they didn't need this

doctor saying

well you can't afford that one so we

won't look there or he didn't even give

them

these this service that you can look at

because it was

in his mind too far you know too far

fetched for the whanau to

to be even looking at paying that much

money for um

the service well anyway to cut a long

story short when the translator come in

she told the whanau take the option of

treatment you know she advised

treatment and it's like

what you got a doctor saying blah blah

blah and you've got this

translator translator believing

you know you have every right you know

it's like she's young this woman's only

40

42 wouldn't you want to fight she's got

to she's got a child

you know she's got a husband who wants

to die

who wants to go home and and give up you

know you're going to go for every option

she's got a big whanau who can support

her financially

it's just it's just sad that sometimes

we

um uh sometimes

people are just narrow-minded you know

and just

yeah i don't know how to put it any

other way i just see them as

you may be a doctor

and yes you have your rights as a doctor

but we we we

are a whanau who can make decisions who

can

come together as a group as a as a

whanau and offer each other and support

each other to get through these

these hard times you know i mean it

wouldn't be

easy for me to say yep okay i accept

that

i'm gonna no way i'm gonna i'll fight to

the bitter end you know if it was

me in in that position i'd go to the

next person and go to the next person

and go to the next person

help me help me help me i don't want to

hear that

i don't want to hear go home creator and

die i want to hear let's try this

let's try that because i bet you if it

was his his wife or his daughter

and i actually challenged the the

newsletter if it was your wife or your

daughter sitting in that seat

would you let her just walk away and say

okay

he told me go home and die i doubt it

i'd be fighting for it

another thing that that helps working

with whanau is

maori are very visual so don't just go

da

da da da da show me a picture

you know there's been times when i've

been into a

a consultancy corridor you know when the

consultant is talking with the patient

and the consultant is going

this and this and this and this and this

and i'm trying to keep up with the

consultant

and then i'll go can you draw us a

picture so we had a woman come into

maternity and she had a

her heart is stuffed but she was

pregnant

and so they were they were concerned

that her heart might not hold out when

she had this baby

so it was a lot of talking so in the end

i said can you draw a pitch and she goes

i'm not a very good drawer says

doesn't matter i'll draw your heart so i

just drew a circle you know so

she drew the circle of she drew a heart

and then i says now just show her what's

happened

you know because this girl thought she

had this and this

but actually when the doctor drew it and

you know and we went through it with her

so what part of the heart is not working

well she says well actually the heart is

bigger i says well there you go you know

she said enlarged heart i knew what a

large heart

was but the patient didn't so you know

just all that sort of stuff we're very

visual and so this the samoan whanau

they asked if they could see the x-rays

from when it was first diagnosed to the

last x-rays

and in in between so this was from the

whanau the whanau said to me

in between they thought there was this

big mess of cancer on her lungs

and then when they saw the x-rays last

week

it was like a dot and a dot and a dot

and that gave them hope that was like

whoa you know it was that was that was

just

awesome for them to see so visually we

always go

it's like show me show me show me and i

can do it if you show me i can do it

don't tell me show me and i get that

doctors and nurses are real busy but

that does help i'm

when i talk to you know other groups

like the psychiatrist or the

psychologist

that i'm working with i says when you

when you're working with maori

powerpoints make it simple as powerpoint

show us what's going on show us what

what the alcohol does to the um

to the baby you know just show me a

picture

and a picture says a million says a

million words i say

very visual marty and what's that word

textile or whatever

touchy feely yeah

we are pity