‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

Abstract

Abstract. Although successful communication is at the heart of the clinical consultation, communication betweenAboriginal patients and practitioners such as doctors, nurses and allied health professionals, continues to be problematic and is arguably the biggest barrier to the delivery of successful health care to Aboriginal people. This paper presents an overarching framework for practitioners to help them reorientate their communication with Aboriginal patients using 'clinical yarning'. Clinical yarning is a patient-centred approach that marries Aboriginal cultural communication preferences with biomedical understandings of health and disease. Clinical yarning consists of three interrelated areas: the social yarn, in which the practitioner aims to find common ground and develop the interpersonal relationship; the diagnostic yarn, in which the practitioner facilitates the patient's health story while interpreting it through a biomedical or scientific lens; and the management yarn, that employs stories and metaphors as tools for patients to help them understand a health issue so a collaborative management approach can be adopted. There is cultural and research evidence that supports this approach. Clinical yarning has the potential to improve outcomes for patients and practitioners.

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“…Some qualitative studies have highlighted the negative outcomes of ineffective communication of health information by health professionals to Aboriginal and Torres Strait Islander people living with chronic diseases in remote areas of Australia, and suggested some useful communication strategies when providing information (Cass et al 2002;Anderson et al 2008;Davies et al 2014). Lin et al (2016) describe a culturally meaningful communication Our convenience sample of English-speaking Aboriginal and Torres Strait Islander participants attending one Indigenousspecific primary healthcare clinic limits generalisability of the study findings. Accessing primary health care in this environment may reduce the demand on patients to possess adequate health literacy to understand health information.…”

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