Cultural Diversity in Health Care Kristi

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Cultural Diversity in Health CareCultural Diversity in Health Care

Chinese HeritageChinese Heritage

Practical Nursing: HumanPractical Nursing: HumanGrowth and Development Growth and Development

44--2828--20102010



Basic Rules for InterculturalBasic Rules for Intercultural

Interactions in MedicineInteractions in Medicine

Culture directly influencesCulture directly influencesinterpretation and responseinterpretation and response

Assess Language fluency Assess Language fluency

Use an interpreter if neededUse an interpreter if needed

Ask how they should be addressed Ask how they should be addressed

Identify who will make medicalIdentify who will make medicaldecisionsdecisions

Be open minded, accepting, andBe open minded, accepting, andwillin to learn.willin to learn.



Chinese Culture and its effectsChinese Culture and its effectson Health Careon Health Care Love Food and DrinkLove Food and Drink

Associate organs with symbolic functions. Associate organs with symbolic functions.Example: lung = worryExample: lung = worry

Buddhism predominant Buddhism predominant fear of bringingfear of bringingshame to family by admitting health issues.shame to family by admitting health issues.

Deference to authorityDeference to authority nodding innodding inresponse to discussionresponse to discussion

Saving FaceSaving Face difficult to admit problems,difficult to admit problems,question, or disagreequestion, or disagree



Language andLanguage and

CommunicationCommunicationLanguageLanguage: Chinese: Chinese Many dialectsMany dialects Written language very complicatedWritten language very complicated

CommunicationCommunication: Healthcare workers/Medical: Healthcare workers/MedicalPersonnel are people of authorityPersonnel are people of authority

Use formal greetingUse formal greeting Avoid direct eye contact/invasion of space Avoid direct eye contact/invasion of space Limit touchLimit touch*As authority figure you should make decisions*As authority figure you should make decisions

and give instructions. Maintain trust, be caringand give instructions. Maintain trust, be caringand willing to help.and willing to help.



Family Structure and RolesFamily Structure and Roles

Strong respect and deference to eldersStrong respect and deference to elderscan cause issuescan cause issues

Decision makers = Husband or eldest son.Decision makers = Husband or eldest son.



NutritionNutrition

Chinese cuisine is famous in its diversity.Chinese cuisine is famous in its diversity.

Theyll eat anything with four legs except Theyll eat anything with four legs except a tablea table

Regional Staples:Regional Staples: Beijing/Mandarin & ShandongBeijing/Mandarin & Shandong Steamed bread andSteamed bread and

noodlesnoodles

Cantonese and ChaozhouCantonese and Chaozhou Lightly cooked meats andLightly cooked meats andvegetablesvegetables

ShanghaineseShanghainese red cooking and wuxi spare ribs red cooking and wuxi spare ribs

SichuanSichuan spicy, lots of chilispicy, lots of chili



Spirituality and DeathSpirituality and Death

RitualsRituals An Elder should never show respect to someone An Elder should never show respect to someoneyounger. This can affect death rites.younger. This can affect death rites.

Prescribed form of rites befitting status, age,Prescribed form of rites befitting status, age,

etc. MUST be performed irregardless of cost,etc. MUST be performed irregardless of cost,other issues.other issues.

Preparation for the funeral often begins beforePreparation for the funeral often begins beforethe death occurs.the death occurs.

RitualsRituals deities in house covered with red,deities in house covered with red,mirrors removed, white cloth over doorway,mirrors removed, white cloth over doorway,gong placed.gong placed.

Corpse Treatment Corpse Treatment Also ritualized. Also ritualized.



Death and DyingDeath and Dying

Many Chinese may be reluctant to discussMany Chinese may be reluctant to discussthese issues due to the belief that if youthese issues due to the belief that if youtalk about something bad, it couldtalk about something bad, it couldoccur(Karma)occur(Karma)

Resistance to organ donation may result Resistance to organ donation may result from the belief of keeping the body wholefrom the belief of keeping the body wholefor the afterlife, and out of respect for the afterlife, and out of respect



Health CareHealth Care

Practices/BeliefsPractices/Beliefs Acupuncture Acupuncture

CuppingCupping

HerbologyHerbology

Yin/Yang Concept Yin/Yang Concept

Meditation/ExerciseMeditation/Exercise



Acupuncture Acupuncture

Acupuncture meridians are pathways of energy, or

³chi´ which lead to various organs

Acupuncture is a technique to balance the flow of

energy by inserting thin needles into the body.

Western practitioners view these points as ways tostimulate nerves, muscles, and tissue.



CuppingCupping

The use of heated bamboo cups toThe use of heated bamboo cups to

reduce stress, congestion, coldsreduce stress, congestion, colds Modern understanding is it relievesModern understanding is it relieves

aches and pains throughaches and pains through

relaxation/massagerelaxation/massage



HerbologyHerbology The use of plants or animal parts inThe use of plants or animal parts in

treatment of illnesses, deficiencies, and totreatment of illnesses, deficiencies, and tostimulate the chistimulate the chi

Medicine is tailored to fit the individualMedicine is tailored to fit the individualand their needs/deficiencies.and their needs/deficiencies.

Unlike western medications the balanceUnlike western medications the balance

and interaction of all ingredients moreand interaction of all ingredients moreimportant than the effect of individualimportant than the effect of individualingredients.ingredients.

EVERY patient is an individual. No one sizeEVERY patient is an individual. No one size

fits all remedy.fits all remedy.



Yin/Yang Concept Yin/Yang Concept

Sympathetic vs. ParasympatheticSympathetic vs. Parasympatheticcorrespond to the Yincorrespond to the Yin--Yang circle. Yang circle.

SympatheticSympathetic mobilizes body to respondmobilizes body to respondto stress. Fight or flight = Yangto stress. Fight or flight = Yang ParasympatheticParasympathetic replenishes andreplenishes and

supports body in rest = Yinsupports body in rest = Yin

Must exist in balance to be healthy.Must exist in balance to be healthy. Certain foods are believed to help restoreCertain foods are believed to help restore

the balancethe balance



High Risk BehaviorsHigh Risk Behaviors

Risk of Drug InteractionsRisk of Drug Interactions



Healthcare PracticesHealthcare Practices

Same sex healthcare provider is stronglySame sex healthcare provider is stronglypreferred by womenpreferred by women

May seek traditional, alternative treatment May seek traditional, alternative treatment

before accepting Western medicinebefore accepting Western medicine



ReferencesReferences Health and Healthcare for Chinese AmericansHealth and Healthcare for Chinese AmericansLinda Ann S.H. Tom. M.D.Linda Ann S.H. Tom. M.D.Dept. of Geriatric Medicine, John A. Burns School of Medicine, University of HawaiiDept. of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii

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Conference of HealthProblems Related to the Chinese. July 1Conference of HealthProblems Related to the Chinese. July 1--3, 1994.3, 1994. Dai, Y., & Dimond, M. (1998, March). Filial piety: A crossDai, Y., & Dimond, M. (1998, March). Filial piety: A cross--cultural comparison and its implications for the well being of oldercultural comparison and its implications for the well being of older parents.parents.

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GallagherGallagher--Thompson (Eds.), Ethnicity and the dementias. Washington, DC: Taylor & Francis.Thompson (Eds.), Ethnicity and the dementias. Washington, DC: Taylor & Francis. Jung, M. (1998). Chinese American family therapy: A new model for clinicians. San Francisco: JosseyJung, M. (1998). Chinese American family therapy: A new model for clinicians. San Francisco: Jossey--Bass.Bass. Huff, R., & Kline, M (1999). Promoting health in multicultural populations: A handbook for practitioners. Thousand Oaks, CA:Huff, R., & Kline, M (1999). Promoting health in multicultural populations: A handbook for practitioners. Thousand Oaks, CA: SagSage.e. Lassiter, S. (1995). Multicultural Clients: A professional handbook for health care providers and social workers (pp. 35Lassiter, S. (1995). Multicultural Clients: A professional handbook for health care providers and social workers (pp. 35--49). We49). Westport, CT:stport, CT:

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Thousand Oaks, CA: Sage.Thousand Oaks, CA: Sage. Lum, O. (1995, February). Clinics of geriatric medicine: ethnogeriatrics 11(1), 53Lum, O. (1995, February). Clinics of geriatric medicine: ethnogeriatrics 11(1), 53 67.67. McBride, M., MoriokaMcBride, M., Morioka--Douglas, N., & Yeo, G. (1996). Aging and health: Asian and Pacific Islander American elders (2nd ed). SGECDouglas, N., & Yeo, G. (1996). Aging and health: Asian and Pacific Islander American elders (2nd ed). SGEC

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03/03/content_46092.htm03/03/content_46092.htm

Cultural Diversity in Health Care Kristi

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