Table 1 Modified cultural formulation guide used in cultural assessments

Patient’s cultural identity

• Cultural reference group(s)

• Languages spoken

• Religion/spirituality

• Schooling, professional experience

• Migration history

• Level/type of integration (with cultures of home and host countries)

Patient’s social context

• Work, income, legal status

• Sources of stress

• Sources of support and health information

• Social networks and activities

• Impact of illness on social functioning

Patient’s explanatory model

• Main complaint

• Meaning, explanation and perceived severity of current illness

• Treatment–seeking for current illness

• Previous illness and health care experiences (self and others)

• Treatment expectations

• Worries, concerns, priorities with regards to current illness

Provider/patient relationship

• Patient/provider ethnic, social and cultural differences

• Value conflicts

• Possible sources of prejudice and bias (of patient and provider)

• Differences in understanding of medicine and the health care system