Table 5.

Suggestions for Care Providers of Patients of Hispanic Ethnicity

Common Problems	Suggested Instruction
Logistical barriers to care (eg, arriving late to appointments)	Be aware of the challenges that Spanish-speaking patients face while navigating complex hospitals and clinics Allow for culturally competent instructions while scheduling
Racial-language assumptions	Do not assume patients are not fluent in English based on their physical appearance (or surname) and vice versa Attempts at personal 1:1 communication with not-so-perfect Spanish from the provider or not-so-perfect English from the patient are appreciated by Hispanics as the provider stepping outside of their “cultural” comfort zone
Aggregation and stereotyping of Hispanics	Don’t be satisfied with the term Hispanic; explore cultural background better Be aware of the important cultural and physical differences within the Hispanic community
Lack of accurate communication during patient interaction with Spanish-speaking patients	Be aware of lack of direct translation of many common medical symptoms Clarify important symptoms asking in different ways and requesting feedback from patients Assess the medical competency of the translator in the particular area being investigated When using a translator, speak directly to the patient, not the translator
Patient use of alternative/folk medicine	Specifically ask for use of alternative treatments Be open to the potential cultural value of folk medicine when suggesting treatment decisions
Impact of personalismo and respeto	Be aware of these important cultural values Politeness and respect may not necessarily imply satisfaction or intention to comply with interventions
Impact of familism	Use family values and bonds to the welfare of the patient Encourage adherence to treatment for the good of the family Praise family presence at visits
Delivering medical news and end-of-life decisions	Involve family members as much as possible With patient approval, consider meeting with family first Avoid euphemisms, which are poorly translated Be respectful of prayer and other rituals
Counteracting fatalism during healthcare decisions	When appropriate, counteract with familism (“do it for the family”) If the patient wants family present during consultation, then open discussion of accurate prognosis with patient and family members