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A guide to assist health service providers when dealing with patients from linguistically and culturally diverse backgrounds

It is important to be aware of your own values, beliefs, expectations and cultural practices, and consider how these impact on the care you give to people from cultures different from your own. This will include being sensitive to your patients whose preferred language is other than English.

Individuals vary in many ways. Historically Australians have expected people to assimilate into the dominant Anglo-Australian culture. We now celebrate cultural difference, and are becoming more attuned to the needs of individuals from different cultural backgrounds. Experiences of health and illness vary widely, as a result of different beliefs, behaviours, past experience in Australia and experiences prior to migration. Good health care depends on our sensitivity towards these differences.

In many cultures, the patient and their family make up a single client group with which you need to interact. There are some general principles:

• Do not assume English proficiency
• Do not make assumptions about patient levels of understanding
• Respect beliefs and attitudes
• Take the time to explore any issues
• Speak clearly and slowly
• Listen and observe
• Note differences in meanings of words
• Exercise sensitivity when using interpreters

There is enormous diversity in populations of all cultures, we should all recognise that difference and diversity exists. It is important to reveal the awareness of cultural issues that conveys interest, concern and respect. Identifying these will enhance rapport with your patients, as long as you don't assume that you now what they think and believe. Ask your patient: they are their own cultural experts.

In addition, much is common across cultures. For example, most patients are nervous of clinical environments and are reluctant to question their doctors-regardless of their educational status, occupation or ability to speak English. You need to be aware of your own cultural assumptions and of the cultures of hospitals, as well as its impact on people for whom this is unfamiliar.