Clinical Communication

Approaches to Enhancing Patient-Centered Communication In Caring For Hispanic/Latino Patients With Diabetes

Journal of Clinical Outcomes Management. 2018 March;25(3)

References

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Mrs. Rodriguez: Well, I am here to fix my numbers. I have everything I take in a box so I can bring that.

Medical Professional: Yes that would be great. (Collaboration) We can both talk about your daily routine and what have you learned about the supplement, any information or papers that you have, in addition to the medication I prescribed.

Mrs. Rodriguez: Yes I can do that.

Medical Professional: Thank you Mrs. Rodriguez. (Intervention) Also, I’ll have the nurse call you today or tomorrow and you can give her the name of the supplement and she’ll make sure the drug store has a refill for you. Would this work for you Mrs. Rodriguez?

Mrs. Rodriguez: Yes Doctor. You can call me. I’ll have the list ready.

BATHE

Unlike the BELIEF and ETHNIC instruments, the BATHE mnemonic (Lieberman 1999) is designed to specifically elicit the emotional and psychosocial context of a patient [37,38]. The goal of using this tool is to strengthen the provider-patient relationship and patient satisfaction. Given the cultural explanatory model within Latino culture, where emotions are integral in the development and progression of diabetes, this tool may be particularly useful or effective for Hispanic/Latino patients who hold this belief. The specific questions corresponding to the BATHE prompts are:

B: Background (What is going on in your life?)
A: Affect (How do you feel about what is going on?)
T: Trouble (What troubles you most?)
H: Handling (How are you handling that?)
E: Empathy (This must be very difficult for you)

Vignette 3

The last vignette features Mr. Gonzalez, who typically shows a positive outlook on life when visiting his doctor. He is a patient who would not necessarily discuss his emotions if not asked specific questions about his emotional well-being.

Medical Professional: Hello Mr. Gonzalez. (Background) How are you doing today? What’s new? What’s going on in your life lately?

Mr. Gonzalez: Hey, Doctor! I’m good you know just living day to day.

Medical Professional: Good. (Affect) So how is your diabetes treating you day to day? How are you feeling with life and managing your diabetes?

Mr. Gonzalez: Ah well you know, just dealing with it as best as I can.

Medical Professional: Ah okay. As best as you can. (Troubles) What troubles you the most about managing diabetes?

Mr. Gonzalez: Well you know the aches and pains. But what can I do.

Medical Professional: (Affect) How do you feel about those aches and pains?

Mr. Gonzalez: Well it does limit me. I can’t move as well as I use to.

Medical Professional: (Handling) Hmm. I see. How are you handling those aches and pains? What are you doing to relieve it?

Mr. Gonzalez: I do my best with pain cream.

Medical Professional: (Empathy) Pains and aches, that must be difficult. (Affect) How do the aches and pains make you feel?

Mr. Gonzalez: Ahh, Doc, it’s not the same. You know I can’t do the same things anymore.

Medical Professional: (Background) What do you mean? What is not the same anymore?

Mr. Gonzalez: This diabetes, I’m not the same person. I use to be able to be there for my family and community and now I feel like I can’t be there for them the way I use to. I use to be the strong one for my family, helping those in need, and now I’m limited, my body is limited.

Medical Professional: (Affect) How do you feel about that? How does it make you feel emotionally and physically?

Mr. Gonzalez: Bad. I feel bad about it.

Medical Professional: Bad emotionally or physically?

Mr. Gonzalez: Both

Medical Professional: I see. (Handling) How are you dealing with the emotional part of it?

Mr. Gonzalez: I don’t know. I don’t know how.

Medical Professional: (Empathy) Dealing with diabetes and how it makes your body feel can be very emotionally distressing. It is common to feel this way but I want to make sure we also work on how you feel emotionally or how your emotions is affecting your diabetes.