Asian Cultures
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Cambodians
believe that imbalance can cause illness.Ê
This imbalance may be caused by natural forces or changes in the
environment. Cambodians also believe that illness can have spiritual Causes.
Traditional
healing may be performed by family members or traditional healers. This
may include:
Ê coin rubbing
Ê pinching and bruising the bridge of the nose,
neck, orÊ
chest
Ê cupping - placing a candle on the forehead and
covering it with
a small jar to create bruises
Ê herbs
massage
Ê
Cambodians are comfortable with Western medicine, but they are likely to
try more traditional methods of healing first. Cambodians are usually reluctant
to complain or express negative feelings, so it may be difficult for a
physician to identify the problem. Cambodians traditionally tend to focus
on the symptoms rather than the cause of an illness or disease, and therefore
may stop using medicines after symptoms disappear. Because of this focus,
Cambodians do not normally value adult immunizations, early disease detection,
or health screenings, but they do believe in childhood immunizations.
Resource (http://www3.baylor.edu/~Charles_Kemp/)
The
diagnosis of illness is frequently understood in three different, although
overlapping, models. They believe illness can come from spiritual causes,
imbalance of ãAmä and ãDuongä(similar to the yin and yang in other Asian
cultures), and western concepts of disease (i.e. germ theory).
Traditional
techniques of healing include:
Ê Coining - A coin dipped in mentholated oil is
vigorously rubbed across the skin in a prescribed manner, causing a mild
dermabrasion. This practice is believed to restore balance.
Ê Cupping - A series of small, heated glasses
are placed on the skin, forming a suction that leaves a red circular mark,
drawing out the bad force.
Ê Pinching - Similar to coining and cupping, the
dermabrasion is formed by pinching the skin, which allows theÊ causative force to leave the body.
Ê Steaming - A mixture of medicinal herbs is
boiled, the steam is inhaled, and the body bathed.
Ê Balm - Various medicated oils or balms are
rubbed over the skin.
Ê Acupuncture - Specialized practitioners insert
thin steel needles into specific locations known as vital-energy points. Each
of these points has specific therapeutic effects on the corresponding organs.
Ê Acupressure or Massage - Fingers are pressed
at the same points as with acupuncture, and together with massage, stimulate
these points to maximize their therapeutic effects.
Ê Herbs - Various medicinal herbs are boiled in
water in specific proportions or mixed with "wine" and consumed to
restore balance.
Ê Patent Medicines - Powdered medicines that are
mixed or boiled with water and taken for certain ailments.
General Statement for the Healthcare
Provider
Vietnamese
view American healthcare as a way to relieve symptoms. They expect to be
prescribed something to cure their illness immediately. Vietnamese frequently
discontinue medicines after their symptoms disappear because they feel that if
they donât experience any symptoms, there is no illness. Therefore, preventive,
long-term medications must be discussed in length using culturally pertinent
education. It is quite common for Vietnamese patients to save large quantities
of half-used prescription drugs so taking the full course of antibiotics must
be discussed in length.Ê Western
medicines, especially oral medications, are seen to throw the body out of
balance.Ê This could be seen as anotherÊ barrier to compliance.Ê In this case, alternatives like a balm may
better meet the patient's need while still considering their cultural values.
Vietnamese commonly believe that Western pharmaceuticals are developed for
Americans and Europeans.Ê They believe
that the dosages are too strong for their cultureâs body build so they might
readjust their dosage to what they consider to be correct.
Vietnamese
hold great respect for those with education, especially doctors. The doctor is
considered the expert on health. They expect doctors to diagnose and treat all
in one visit with little examination or invasive laboratory or other diagnostic
tests. In addition, laboratory procedures involving the drawing of blood are
feared and even resisted by Vietnamese, who believe that blood loss will
exacerbate their illness and that their body cannot replace what was lost.
Surgery is particularly feared for this reason and is used only as a last
resort.
In
conclusion, Vietnamese people will combine treatment elements from all
resources in order to get the maximum health benefits.
Resource
(http://www3.baylor.edu/~Charles_Kemp/)
RELIGION and HEALTH BELIEFS
The Japanese believe
that the body is as holy as the mind. In fact, Japanese tradition views
the mind and body as one. Japanese people are very reluctant to accept
the term ãbrain dead.ä Pronouncing such a person to be "dead"
could be viewed as disrespectful.
Many Japanese are unwilling to alter the dead body of a person who could
influence their lives in the future. Agreeing to donate one's organs
could cause concern that the oneness of body and soul might be destroyed.
Accepting the organs of a dead person could be seen as disrespectful by some
Japanese and could trigger anxiety.
General Statement for Healthcare Providers
Japanese individuals will
probably listen well during health education, but they may be reluctant to ask
a question or add a comment since individual assertion is highly discouraged in
their culture. They do not bring up anything they believe would cause a
conflict such as expressing a differing opinion. Therefore, silence
should not be interpreted as agreement initially.Ê It could just be the patientâs way of avoiding a conflict.
Japanese culture does not place an
emphasis on personal control so they will be more likely to view an
illness as something outside their own control. Therefore, healthcare
providers will need to keep this in mind when educating Japanese-Americans about
risk factors for a particular disease (such as a fatty diet being a risk factor
for heart disease).
Most of western medicine is based
on individual choice. Individual choice is a culturally bound issue and
one that the Japanese will not always share. Therefore, they will greatly
appreciate guidance from healthcare providers regarding health-related issues.
Japanese immigrants
will likely prefer a formal, structured intervention, where roles are clearly
defined and may feel uncomfortable in informal and unstructured
gatherings. Healthcare providers should therefore plan interventions
using structured, planned activities where roles and expectations are clearly
defined. Professionals should avoid physical touching, which may cause
anxiety in the Japanese. Since the Japanese view health professionals as
authority figures, physical touching may cause role confusion.
A more directive
approach should be utilized when working with Japanese patients. Ê Japanese typically prefer to be guided
through the world of western medicine.
Healthcare providers should
always avoid intense or long-term eye contact to show respect to the Japanese
culture.Ê Remember that patience is an
important skill in dealing with Japanese.
Resource (www.uncg.edu/phe/immigrant/japanese/japanharmony.html)
HEALTH
BELIEFS AND PRACTICES
Food, illness and medications are classified, according to the perceived
effects on the body, as "hot" or "cold". Health is believed
to be a balance of positive (yang) and negative (yin) energy in the body.
Ê
General
Statement for the Healthcare Provider
Many Chinese people will assume a "sick role" when
they are ill where they depend heavily on others. If a healthcare provider
seems demanding they may be viewed as uncaring by the Chinese patient.Ê One way to seem caring, and still illicit
the response desired, is to stand close to the patient, speak sympathetically,
take an interest in the patient, and verbally encourage them.
The use of hospitals and health care professionals
is very low in the Chinese culture.Ê When healthcare is sought, a doctor of the same sex is preferred,
especially by women.Ê Most Chinese people
will expect to be given a prescription when they go to the doctor so going to
the doctor when they are not sick might be considered strange.Ê Remember their cultural norms of lack of eye
contact, shyness, and passivity.Ê Due
to the cultural norm of shyness, the Chinese will be reluctant to talk to an
outsider about their health and psychosocial problems.Ê Many Chinese believe that saying ãNoä is impolite
so you should not mistake silence as agreement.Ê Sometimes when a healtcare provider is assertive
it may be interpreted as aggressive or hostile behavior.
Resource
(http://www.health.qld.gov.au/hssb/cultdiv/cultdiv/chinese.htm)
Among the tradition-minded Koreans, illness
is often seen fate and hospitalization may be seen as sign of impending death.
Illness is sometimes attributed to disharmony in the natural forces (yin and
yang). Treatment of illnesses is through the use of the opposite force to
achieve balance.
Common health
related practices include:
Ê the use of herbs
Ê acupuncture ö insertion of thin steel needles
into specific locations on the body. Each of these points has specific
therapeutic effects on the corresponding organs.
Ê cupping - A series of small, heated glasses
are placed on the skin, forming a suction that draws out the bad force.
Ê moxibustion -
the burning of a soft material at specified spots corresponding to internal
energy channels on the skin.Ê
General Statement for the Healthcare
Provider
Withdrawing
blood, sweating and sex are seen as reducing the kior chi force, which is the
life-force of the body.ÊÊ The Korean
population believe in Do Not Resuscitate orders since prolonging life is seen
as unacceptable. Discussing a person's terminal status is also viewed as
unacceptable. Organ donation and transplantation are seen as a disturbance in
the integrity of the body. Most of patient care is provided by the family, but
the physician is seen as powerful and trustworthy.
Resource
(http://www3.baylor.edu/~Charles_Kemp/)
Illness may be
attributed to the loss of one of the thirty-two spirits thought to inhabit the
body and maintain health. Health is also related to a person's ability to sleep
and eat without difficulty. In general, Laotians who are ill will look to the
family and/or community for understanding of the problem and treatment first.
Traditional treatments may be tried.Ê If
the loss of spirit is thought to be the cause of the illness, a ceremony may be
performed. The last resource is to seek treatment through western medicine.
Traditional practices are often continued while utilizing western medicine.
Traditional treatments include procedures
such as:
Ê Coining
- the use of a coin and mentholated medicine to rub the chest, back, upper
arms, or neck in one direction with resulting ecchymosis. This releases the
"wind" that may be causing the illness.
Ê Pinching in a prescribed manner (rubbing the
temples, pulling forward to the eyebrow and nose, and pinching the nose) is
used to relieve headache.
Ê Cupping is performed by fixing a piece of
cotton in the bottom of a glass, lighting the cotton on fire, and placing the
open mouth of the glass on the sick person's back. This creates suction and a
resulting bruise. In one session, the procedure is carried out three to four
times bilaterally down the back on either side of the spine with six to eight
circular contusions resulting.
Ê Massage and manipulation is performed by those
with knowledge of healing techniques.
Ê Traditional Chinese medicine is also used.
General Statement for the
Healthcare Provider
Health histories may be hard to obtain
within the Laotian culture mostly because of a reluctance to volunteer
information. This stems from the cultural value of privacy in personal matters.
Trust or its lack is a major issue.Ê
Trying to complete the health history over the course of a couple of
visits might be better because you will have established a relationship with
the patient. When a personal question is necessary, the healthcare provider
might want to assure the patient that the question and answer will be kept
confidential.Ê Some Laotians value the
relating of symptoms more than the health history so explaining links between
questions or problems will help in gaining information.
Respect for individuals, families, and the
culture is critical. Respect includes being polite and respecting the privacy
of individuals, families, and the culture. Respect also includes explaining all
procedures and medicines to patients in detail. Traditional medicines in their
culture are mixed, dosed, and prepared according to individual patient needs.
That same model may be expected of Western medicines so it might be aÊ good idea to explain medications and dosing
on an individual basis.Ê Laotians tend
to be reserved in all health care interactions so remember that expression of
any type of strong feelings is not valued.
When there is a terminal illness, it is
usually a good idea to ask the patient how much he or she wants to know about
the diagnosis and prognosis. The entire family will want to be present for the
patient's last days.
The head of the body is considered sacred.
Therefore, the healthcare provider should not touch the Laotian patientâs head,
and preferably not the shoulder either unless it is completely necessary.Ê It is generally understood by the culture
that it is necessary to touch the head during the course of some physical
examinations. Also remember that modesty is highly valued, especially in women.
Resource
(http://www3.baylor.edu/~Charles_Kemp/)
