Asian Cultures

Cambodian
Vietnamese
Japanese
Chinese
Korean
Laotian
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Cambodian Health Beliefs

Cambodians believe that imbalance can cause illness.  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:

 

*  coin rubbing

*  pinching and bruising the bridge of the nose, neck, or 

chest

*  cupping - placing a candle on the forehead and

covering it with a small jar to create bruises

*  herbs

* massage

 

General Statement for the Healthcare Provider

 
 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/)

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Vietnamese Health Beliefs

The diagnosis of illness is frequently understood in three different, although overlapping, models. They believe illness can come from spiritual causes, imbalance of „Amš and „Duongš(similar to the yin and yang in other Asian cultures), and western concepts of disease (i.e. germ theory).

 

Traditional techniques of healing include:

*  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.

*  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.

*  Pinching - Similar to coining and cupping, the dermabrasion is formed by pinching the skin, which allows the  causative force to leave the body.

*  Steaming - A mixture of medicinal herbs is boiled, the steam is inhaled, and the body bathed.

*  Balm - Various medicated oils or balms are rubbed over the skin.

*  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.

*  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.

*  Herbs - Various medicinal herbs are boiled in water in specific proportions or mixed with "wine" and consumed to restore balance.

*  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 don‚t 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.  Western medicines, especially oral medications, are seen to throw the body out of balance.  This could be seen as another  barrier to compliance.  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.  They believe that the dosages are too strong for their culture‚s 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/)

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Japanese Health Beliefs

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 „brain dead.š  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.  It could just be the patient‚s 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.   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.  Remember that patience is an important skill in dealing with Japanese. 

Resource (www.uncg.edu/phe/immigrant/japanese/japanharmony.html)

 

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Chinese Health Beliefs

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.

 

General Statement for the Healthcare Provider

 

Chinese medicine is a tradition, which treats the person as a whole using acupuncture, acupressure, and Chinese herbs. Dietary therapy, traditional herbal medicine, Western medicine and supernatural healing may also be used. Clients may be reluctant to reveal to their health care provider that they have been using alternative treatments. 

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.  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.  When healthcare is sought, a doctor of the same sex is preferred, especially by women.  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.  Remember their cultural norms of lack of eye contact, shyness, and passivity.  Due to the cultural norm of shyness, the Chinese will be reluctant to talk to an outsider about their health and psychosocial problems.  Many Chinese believe that saying „Noš is impolite so you should not mistake silence as agreement.  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)

 

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Korean Health Beliefs

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:

*  the use of herbs

*  acupuncture Ų insertion of thin steel needles into specific locations on the body. Each of these points has specific therapeutic effects on the corresponding organs.

*  cupping - A series of small, heated glasses are placed on the skin, forming a suction that draws out the bad force.

*  moxibustion - the burning of a soft material at specified spots corresponding to internal energy channels on the skin. 

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.   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/)

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Laotian Health Beliefs

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.  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:

*  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.

*  Pinching in a prescribed manner (rubbing the temples, pulling forward to the eyebrow and nose, and pinching the nose) is used to relieve headache.

*  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.

*  Massage and manipulation is performed by those with knowledge of healing techniques.

*  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.  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.  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 a  good idea to explain medications and dosing on an individual basis.  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 patient‚s head, and preferably not the shoulder either unless it is completely necessary.  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/)

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