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hindus: taking a clinical history

When taking a clinical history from a Hindu patient, allow plenty of time to get all the information that is required. It will be considered disrespectful to rush the interview, and the patient is less likely to be so forthcoming. It is traditional to approach serious subjects indirectly; thus, asking personal questions about health issues without the exchange of some small talk beforehand will be considered by many Hindus (and many Asians) to be extremely rude.

When you enter the room, the patient may rise to greet you as a mark of respect. Young Hindu patients may show even greater respect towards their elders by bringing gifts, not speaking excessively and agreeing with everything regardless of their own opinions. Hindu women are expected to display the virtues of self-effacement, shyness and modesty, and may therefore be reluctant to voice opinions or concerns about their health and treatment.

It is unlikely that the patient will be alone during the interview. A young woman may be accompanied by her mother or sister, and possibly even her father or brother. A married woman will often attend a clinic with her husband or sister-in-law. Most Hindus will have members of their extended family with them: the eldest male will be expected to make decisions about his relatives' healthcare. All of these factors can make it more difficult to get to the root of a medical problem and may affect 'informed consent', especially if language is also a barrier to communication.

It may be necessary for an interpreter to be present at the interview; it is not acceptable to expect a family member to interpret except in an emergency.

Most Hindus will be reluctant to shake hands: their preferred greeting of namaste involves placing the palms together and bowing. This is usually reserved for those who are held in great reverence, such as holy men or elders, and is a great mark of respect.

It is important to be aware that a Hindu patient will prefer to deal with a healthcare worker of the same sex. If this is not possible and the patient's family are not present, a chaperone should be arranged. A chaperone will also be required when making a home visit to a female Hindu patient. As the patient will arrange this herself, it is important to give her notice of the visit and to stick to the appointment time as far as possible. Traditionally, a Hindu woman will not invite a visitor into her home if she is on her own.

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