Communicating with Mexican-American Clients

Abstract

This is the first of a series of three columns on communication and care in regard to Mexican-American clients. Dr. Loretta Heuer, associate professor at the University of North Dakota, works and does research with migrant Mexican-American farm workers. She offers some suggestions to help rural nurses in their communication with those clients. Out of respect, Mexican Americans frequently avoid direct eye contact with authority figures such as health care providers, particularly if they may perceive the provider to differ in class from themselves. Communication is strongly influenced by "respecto" (respect), which family members may demonstrate by standing when the provider enters the room. Mexican Americans are usually very warm and expressive with family and close friends, and embracing is common. Touch by strangers is generally unappreciated and can be very stressful or perceived as disrespectful. Silence sometimes shows lack of agreement with the plan of care. Nevertheless, handshaking is considered polite and usually welcome. Tone of voice should be respectful and polite, although it is usually reserved in the formal setting. Phrases used are frequently complimentary. It is considered respectful to address individuals formally; the formal Spanish "usted" should be used, especially with elders and married women. Children should be included in introductions. With the establishment of rapport over time, providers may be permitted to be less formal. Mexican Americans are traditionally present-oriented, with social time more present-oriented than business time. In fact, time is viewed as relative to the situation (which allows for their feeling of punctuality even when 15-20 minutes late). The most sensitive issues, including health issues, are kept within the family, and immediate family members may serve as referents for individual concerns. Males disclose less often, and self-disclosure to the same gender individuals is usually more comfortable.
The next issue’s column will focus on the various issues involved in using or not using an interpreter.