Good Practice Guidelines: Privacy And Modesty

dress

• Many cultures and groups have rules about the clothing they should wear and which areas of the body should be covered up. If in doubt, err on the side of caution and offer gowns that cover as much of a person as possible.
• No matter what culture or group a person comes from, many patients feel exposed and vulnerable in back-opening hospital gowns. Allow patients to wear shawls or dressing gowns over them to help them to feel more secure.
• If the test, examination or appointment that requires the wearing of a hospital gown is pre-booked, then provide the patient with information beforehand about what they can expect, and any additional clothing they may wish to bring – or a companion.
• When a patient is in a state of undress or in a gown that they feel exposed in, make sure they are in an area that is secure, so that no one can burst in unexpectedly.
• Ritual items of clothing or personal belongings – for example, a Sikh's turban or a marriage bangle – must be properly respected, cared for and kept safe if they are removed from the patient. Put them into a bag or container and place in a safe place such as a lockable cupboard.
• Never place any ritual item of clothing or possessions directly onto the floor, or near to someone's feet or shoes. In many cultures, this is considered to be an insult.
• Women of many cultures (and some men) will not expose any more of their body than they need to, and so will uncover only the part that is affected. Do not force them to expose more of themselves because this will cause offence and deep distress. Do not ask for the removal of items of clothing, head coverings, jewellery, make-up or any personal items unless absolutely necessary.

behaviour

• Perhaps the most important bit of advice here is that many cultures have a taboo against being touched or touching members of the opposite sex or strangers. If in doubt, do not touch a patient. This includes shaking hands, sympathetic pats on the back and hugs.
• In some cultures, women are not meant to look directly into the eyes of a stranger or a man. Try not to get defensive about this, or stop listening to them, but accept that they are simply showing modesty.
• Modesty is a big facet of many cultures, especially for the young and for women, who may not talk directly to a doctor, even if they are capable of doing so. Women may often feel more comfortable with a chaperone in the room, or with the doctor in their traditional place behind a desk.
• This modesty may also lead patients to play down the importance of their symptoms or dismiss pain as unimportant, for fear of bringing attention to themselves. Try to build a relationship with patients to encourage them to be more open with you about their conditions.