Cross-cultural aspect

The client/patient, regardless of age or gender, has the right to medical care that respects their principles, values, and customs. During the interview, you can establish a diagnostic-therapeutic action plan with them. If the client/patient does not fully accept your proposal for cultural reasons, it is good practice to emphasize that you respect their worldview and are open to making changes with mutual consent. You should present alternative possibilities, which may include adjusting the examination room, providing additional explanations about the rationale for introducing touch as a diagnostic-therapeutic tool, specifying the area of touch, or suggesting alternative forms of treatment. It is important for the client/patient to consciously accept the planned treatment. Explain that touch is an integral and essential part of the physiotherapist’s profession, playing a crucial role, and the ability to apply appropriate touch is linked to the practical experience of the physiotherapist. Not only may the client/patient have difficulty with this, but also an inexperienced physiotherapist. Touch should not be too aggressive, but intense enough to achieve the intended diagnostic or therapeutic goal. You must obtain consent for the application of touch and indicate the specific area to be touched and the goal you intend to achieve. Starting the diagnosis with an observation of the patient’s silhouette, abdominal position, spine, ribcage, and pelvic alignment is a common practice. However, it’s essential to acknowledge that in some cultures, this approach may pose challenges or discomfort. Therefore, it’s important to have an initial conversation with the client/patient about the diagnostic process, explaining its significance.

It is even emphasized that touch is one of the fundamental ways of social and sexual communication, so contact with a physiotherapist can sometimes evoke sexual connotations.

During collaboration with the client/patient, you must establish positive relationships and gain their trust. Support them  by beginning with positive comments, highlighting errors with constructive criticism, and concluding with positive feedback. Emphasize what they are doing correctly, for example, “You are holding your head correctly, but pay attention to maintaining your breath; your pelvis is positioned correctly,” “You breathe diaphragmatically excellently; adjust your pelvis to a neutral position, you engage your abdomen well,” “You corrected your posture well; work on endurance, you’ve already improved your position.” Through positive support and an appropriate attitude, not from an evaluative position, you will achieve desired results more quickly. Your interaction must align with cultural norms.

 The client/patient should be dressed in appropriate sportswear (a snug-fitting shirt, shorts, socks, and athletic shoes) for performing tasks. If this poses a cultural issue, they should have attire that allows task execution. This should be mutually agreed upon, respecting cultural differences. You should also obtain approval for the location where diagnostic tests and exercises will be conducted. If the client/patient requires a separate room, you should respect that.

Additional materials are available in the e-manual.

Cultural Considerations (Polish Context):

• Older persons typically adhere to modest dress codes. Be mindful of this during the assessment and offer modifications to the testing procedures.
• Polish culture can be more indirect in communication. Be patient and allow the patient to express herself comfortably.
• Physiotherapists are considered healthcare professionals and deserve respect. However, avoid overly assertive communication, especially with a religious figure.

1. What similarities have you noticed in your culture?

2. What differences have you noticed in your culture?

3. What should you pay attention to when caring for a patient with different cultural values?