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“Wisdom begins with the definition of terms.” ~ Socrates

T

he nurse-patient relationship will always remain pivotal to effective management of illness. Peplau (1952/1991) maintained that understanding was an essential component of the nurse-patient relationship. Consistent with Peplau’s assertion, Cleary, Edwards, and Meehan (1999) found that understanding significantly influenced nurse-patient interactions in acute psychiatric-mental health settings. Jackson and Stevenson (2000) cited understanding as a central theme

in their study about the reasons people with acute psychiatric illnesses need nurses. Although understanding is what patients want, studies suggest they do not experience it from nurses …ver más…

In addition, Maltby (1999) found that interpreters often edit out important aspects of patient communication, clarifying that interpreting is “more than moving words from one language to another” (p. 250). People tend to think culture or diversity as concepts pertaining only to people from other countries or people who are clearly different (Evans & Severston, 2001). However, even within one culture, tremendous diversity exists. Ca30

nales (1997) indicated that one must avoid stereotyping based on cultures and recognize individual differences within cultures. Misunderstandings can compromise quality of care. An example from our clinical practice involved a foreign-born physician who asked a patient on an inpatient psychiatric unit, “How did you sleep last night?” The

Understanding can be facilitated by one overarching communication principle: Nurses may not comprehend what patients mean.

patient replied, “I slept like a log.” The physician thought the patient was delusional (i.e., the patient thinks he is a log) and increased the patient’s antipsychotic medications. The physician, whose first language was not English, misinterpreted the patient’s response to his question, and rather than seeking clarification, accepted a concrete understanding of the phrase “slept like a log,”