Bridging the Communication Gap in Health Care: Challenges and Opportunities in Hierarchical and Collectivistic Cultures

This book discusses how hierarchical and collectivist cultures contribute to the challenges and opportunities in communication in health care. Failures in communication may result in threats to patient safety. The work is structured around the Hofstede theoretical framework, focusing on two of the six domains of culture, namely hierarchy and collectivism. To date, guidelines on communication practices in health care have been primarily based on Western evidence and thus do not satisfy the needs of other cultural contexts. Existing studies have shown that strong hierarchical and collectivist cultures, transnationally, have different communication practices, with shared characteristics between several countries in Asia, Africa, and South America. Furthermore, when people migrate, they bring their communication styles - which reflect their cultural characteristics - to their new host environment. When not well managed, these differences can yield problematic communication gaps affecting patient care. Building on their extensive work focused on healthcare communication in Southeast Asian cultures, the authors propose remedial approaches and discuss future initiatives for practicing doctors, nurses, pharmacists, and other healthcare practitioners who encounter the daily struggle of cultural miscommunication in their clinical practices. They also address the ways in which patients experience hesitancy when communicating with healthcare providers, owing to cultural barriers. The book proposes how healthcare providers might tackle these communication challenges. It is relevant to educators and researchers in medical and health professions education and public health, and for all patients’ advocates, who are looking to enhance their communication skills to improve patient care and safety.

Dr. Mora Claramita is Professor and Head of the Department of Medical Health Professions Education and Bioethics in the Faculty of Medicine Public Health and Nursing at the Universitas Gadjah Mada in Yogyakarta, Indonesia. She has been practicing as GP for more than 20 years and has published books on intellectual property rights in addition to several medical publications. She has received international and national awards in the area of medical education and primary care, such as the Lyn Clearihan Award and The University of Iowa Award. She was Fulbright Senior Scholar, FAIMER-Fellow, and Fellow in the Australia Fellowship Program.

Astrid Pratidina Susilo, MD, MPH, Ph.D, is an anaesthesiologist and a researcher in health professions and medical education. Astrid graduated as a Medical Doctor from Universitas Airlangga, Indonesia, pursued her Master of Public Health and a Ph.D in health professions education from Maastricht University the Netherlands. She did her residency training in Anaesthesiology and Intensive Care in Universitas Indonesia. Astrid has received awards from STUNED (the Netherlands) for her master study and a grant from The Prince Leopold Institute of Tropical Medicine in Belgium to strengthen her research skills. She is currently an academic staff in the Department of Medical Education and Bioethics in the Faculty of Medicine Universitas Surabaya Indonesia. She is actively engaged in the teaching and learning of communication skills, and has conducted several studies on communication skills training, patient safety, and pain education. She has published her work in national and international journals, as well as in books and book chapters. As a clinician, she also has extensive experience working in different cultural contexts nationwide such as in Java, Sumatera, Sulawesi, and Kalimantan, which contributed to her perspectives in teaching, learning, and researching communication skills.