 had not understood key issues relating to the results, that she was unable to name most of her medications, and that her understanding of their actions was completely different from the biomedical explanations she was given. The absence of shared understanding of key concepts relating to results and medications was seen as an important source of miscommunication.
Consequences for clinical management: Both participants had perceived the communication to be effective. The discrepancy between perception and reality became evident only through triangulation of the data. Standard assessments of quality of care by the measurement of staff and patient satisfaction, in this case relating to education and staff–patient interaction, would not have revealed the miscommunication. This has important implications for clinical management. Best outcomes in the management of end-stage renal disease require adherence to a complex treatment regimen of regular dialysis, repeated tests, dietary restriction and daily medications.
4: Strategies for improving communication between non-Aboriginal healthcare staff and Aboriginal patients
Train staff in intercultural communication. It is the staff's responsibility to make this accommodation to enable Aboriginal people to make informed choices in the context of their own language and cultural environment.
Train Aboriginal interpreters to prepare them for work with healthcare workers.
Promote strategies to monitor the effectiveness of communication and to repair miscommunication.
Develop educational resources to facilitate a shared understanding of (a) physiological processes and treatment options; and (b) cultural, social and economic realities confronting Aboriginal patients and their families.