Guidelines for developing trust and rapport

The following are suggested approaches to develop trust and rapport with CALD patients:

• Greeting with warm smiles, a slight bow/nod to show respect especially for initial engagement.
• Acknowledge the patient’s status, in particular, for adult or older CALD patients, by addressing them using a formal title and surname, especially for initial engagement (and asking if they are happy with being addressed in this way), not assuming.
• Showing an interest in the patient’s cultural heritage.
• Exploring the patient’s and his/her family’s cultural orientation or level of acculturation.
• Assessing English fluency (spoken and written).
• Using professional interpreters when required (ensuring a gender-matched interpreter where appropriate).
• Understanding family structure and relationships.
• Understanding patient’s attitudes towards sensitive issues (example advance care plan, advance directive, end-of-life issues, elder abuse, etc.).
• Understanding religious and spiritual belief systems.
• Understanding views on suffering and the afterlife.
• Not assuming patient’s understanding of the New Zealand health and legal system and health professional roles.
• Involving families, if they are available.
• Exploring the locus of decision making.
• Exploring the patient’s understanding of confidentiality.