The six types of patient knowledge: Focus on Cultural knowledge

Published by Caroline Halford

Welcome to the final part of my blog series focusing on the patient voice, patient lived experience, and different types of patient knowledge. In this episode, I will be focusing on cultural knowledge – the shared beliefs and practices that guide how people, patients and communities interpret their world, including their health and well-being.    

The inspiration for this blog is from the Springer Nature journal Social Theory & Health (ref: https://link.springer.com/article/10.1057/s41285-024-00208-3) where the authors classified six different types of patient knowledge.  In other words, six ways that patients’ lived experience are unique and essential for healthcare professionals.    

• Embodied knowledge  

• Monitoring knowledge  

• Relational knowledge  

• Medical knowledge  

• Cultural knowledge  

• Navigational knowledge  

Cultural knowledge shapes what is considered right or wrong, acceptable or unacceptable, and shapes how people act in various situations, including when they are sick or seeking medical care. Cultural knowledge is specific to particular groups and evolves over time. 

In healthcare, cultural knowledge helps explain how different people understand their symptoms, make decisions about treatment, and interact with healthcare providers. For example, in some cultures, discussing health information might be reserved for certain family members based on kinship, age, or gender.  

Patients bring their cultural knowledge into every healthcare encounter. They understand how their cultural background influences their care, including what they consider respectful treatment and how they prefer to receive information. This awareness helps them navigate the healthcare system in a way that aligns with their identity and community relationships. For example, a patient might insist on being accompanied by a family member during consultations or prefer treatments that are consistent with their cultural practices.  Understanding these cultural nuances is vital for ensuring that care is respectful, safe, and aligned with the patient’s values.

Cultural knowledge: How does this impact on HCP/patient relationships 

Cultural knowledge is not just about understanding cultural codes; it is about HCPs recognizing how these codes influence patients' conceptions, preferences and behaviours regarding health and care. This knowledge can affect everything from how patients describe their symptoms, how they communicate with their doctor, to their expectations of treatment outcomes. For example, a patient from a culture that values holistic health might prefer natural remedies or be wary of certain pharmaceutical medications. In other dynamics, older family members may be attuned to ‘play down’ symptoms or not flag them for fear of being a burden. Furthermore, in some cultures, doctors are seen as ‘gods’ and patients (especially in the older populations) are reluctant to challenge or ask questions for fear of being disrespectful. These types of cultural nuances can lead to missed opportunities for open patient-physician dialogue and – worst case scenarios – lead to patients misinterpreting or ignoring their doctor’s advice.   

HCPs who are attuned to cultural nuances can offer care that is more aligned with the patient’s values, leading to better outcomes and greater satisfaction. 

Moreover, cultural knowledge helps patients identify which norms and values are central to their care. They can articulate what matters most to them in their health journey, whether it is maintaining dignity, ensuring family involvement, or adhering to religious practices. By acknowledging and respecting these cultural dimensions, healthcare providers can build stronger, more trusting relationships with their patients. 

How does this relate to medical education? 

Incorporating cultural knowledge into medical education for HCPs is essential. It ensures that content is not only informative but also culturally sensitive and relevant to diverse patient populations. By understanding and disseminating the role of cultural knowledge in healthcare, medical education can contribute to creating more inclusive and effective healthcare narratives that honor the diverse experiences and perspectives of patients. Furthermore, understanding and conveying the significance of cultural knowledge is essential to create content that resonates with diverse audiences and accurately reflects the patient experience. 

How can we incorporate this into medical education? 

• Consider the patient population of the condition when designing patient-tethered education.  Make sure that you tailor the format, content, and delivery to their needs.  For example, if your patient population is elderly with poor eyesight, or prone to migraine headaches, maybe don’t suggest gamified app education that is likely to be (1) ignored; or (2) contribute to a flare-up of the condition. This may sound obvious, but I have heard anecdotal evidence of this 😊 
• Ensure that you engage with a broad range of patient and physician advisors when investigating the patient unmet need.  Take into consideration the likely differences in cultures and practices.  Use this to create educational materials to take cultural differences into account, such as:

1. Patient-physician comms guides 
2. Tools to help HCPs navigate cultural barriers 
3. Education that facilitates HCPs in reaching populations where culture sometimes hinders engagement with the healthcare community 

• For populations and cultures where perhaps the patient may not be comfortable interacting with healthcare providers, consider education for HCPs to share with caregivers to facilitate information exchange at a pace/format that feels comfortable to the patient 

Thank you for reading my blog series on the different types of patient knowledge. I hope you’ve enjoyed it.  Please do send me any comments or questions – I would love to hear from you.