Russian Patients
Communicating with  Your Russian Patient Perception of Illness   Patterns of Kinship and Decision Making   Comfort with Touch How does the Russian culture deal with illness? Explaining the Causes of Illness and Disease • Your patient and his or her family may believe that illness is caused by weather or social experiences, such as stress from the living situation or because of arguing with the family. - Ask your patient if they have experienced stresses or strains recently. • Your patient may not like to take excessive medications. When an option, ask your patients if they prefer over-the-counter or homeopathic medicine. • Spend time with the patient to show that the patient is cared for. Communicating with the Patient Experiencing Depression • Mental health does not receive due respect in the former Soviet Union. Even the word “mental” has negative connotations because it is connected with “mental illness.” - Use the term depression, not mental health or mental illness. - The social worker in your clinical area is a resource to help with referrals and other ways of addressing mental health issues. ****************************************************************************************** How are medical decisions made in the Russian culture? Making Decisions About Health Care • Often the extended family – a working-age couple, their children and parents – have immigrated together. They may have other family members who might have immigrated to the United States at other times. • There are strong kinship bonds and everyone in the family provides support and service during a crisis. • Decisions are made by the parents or the oldest child. • The elders are respected. • There are no major gender issues; decisions could be made by the mother, father, or eldest son or daughter.  - Ask your patient about whom they want to be included in medical decisions. Then meet with the identified family members to strategize how to communicate the medical news. If the patients do not want to make medical decisions for themselves, let them know they need to prepare a Durable Power of Attorney for health care. Managing Medical News • Bad medical news is often shielded from the patient by the family in the belief that telling the patient will only make the patient’s condition worse. - If the patient consents, meet with the designated persons to strategize how to communicate medical news so that you are sure of the patient’s informed consent for treatment. What are the Russian culture’s norms about touch? Understanding Norms About Touch and Body Issues - Direct eye contact with your patient is acceptable. - A handshake is welcome from the health care provider. Explaining Touching • Before touching your patient, always explain what will be done and why. • Your gender as the health care provider is not likely to be an issue for your patient when doing peri-care or assessing urinary catheters. • Your patient may prefer that opposite gender family members leave the room. - Find out if this is the case for your patient. • Female patients may prefer a female OB Gyn. - Ask your patient to learn about her preference. Understanding Concerns About Hygiene and Health • When sick, your patient may prefer sponge baths to daily baths or showers. • Your patient may not wash hair as frequently when sick, especially when in the hospital, for fear of catching a cold or headache. - Your patient may prefer to keep the room warm and the window shut. • Hygiene may be performed by the patient, family, or with the help of a nurse or aide. - Maintain modesty and privacy issues with patient’s opposite-gender family members present. What is unique about this patient and family that you will not learn from tips or information about their culture? Birth region, education, and income level make a difference about how your patient perceives illness and makes health decisions. What questions do you want to ask to learn more about this patient and their family? Check Out These Resources to Learn More About Health Care and the Russian Culture Ethnomed: Culture and Nursing Care, A Pocket Guide, J.G. Lipson, S.L. Dibble, P.A. Minarik, 1997, pp. 239-249

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