Cultural Diversity in Health Care

Chinese Heritage

Practical Nursing: Human

Growth and Development
4-28-2010
Basic Rules for Intercultural
Interactions in Medicine
 Culture directly influences interpretation
and response
 Assess Language fluency
 Use an interpreter if needed
 Ask how they should be addressed
 Identify who will make medical decisions
 Be open minded, accepting, and willing to
learn.
Chinese Culture and its effects
on Health Care
 Love Food and Drink
 Associate organs with symbolic functions.
Example: lung = worry
 Buddhism predominant – fear of bringing
shame to family by admitting health issues.
 Deference to authority – nodding in
response to discussion
 Saving Face – difficult to admit problems,
question, or disagree
 Language and
Communication
Language: Chinese – Many dialects –
Written language very complicated

Communication: Healthcare workers/Medical

Personnel are people of authority
 Use formal greeting
 Avoid direct eye contact/invasion of space
 Limit touch
*As authority figure you should make decisions
and give instructions. Maintain trust, be caring
and willing to help.
 Family Structure and Roles
 Strong respect and deference to elders
can cause issues
 Decision makers = Husband or eldest son.
Nutrition

Chinese cuisine is famous in its diversity.

“They’ll eat anything with four legs except a table”

Regional Staples:
 Beijing/Mandarin & Shandong – Steamed bread and noodles
 Cantonese and Chaozhou – Lightly cooked meats and vegetables
 Shanghainese – “red cooking” and wuxi spare ribs
 Sichuan – spicy, lots of chili

Beverage of Choice - Tea

 Spirituality and Death
Rituals
 An Elder should never show respect to someone
younger. This can affect death rites.
 Prescribed form of rites befitting status, age, etc.
MUST be performed irregardless of cost, other
issues.
 Preparation for the funeral often begins before the
death occurs.
 Rituals – deities in house covered with red, mirrors
removed, white cloth over doorway, gong placed.
 Corpse Treatment – Also ritualized.
 Death and Dying
 Many Chinese may be reluctant to discuss
these issues due to the belief that if you
talk about something bad, it could
occur(Karma)
 Resistance to organ donation may result
from the belief of keeping the body whole
for the afterlife, and out of respect
Health Care
Practices/Beliefs
 Acupuncture
 Cupping
 Herbology
 Yin/Yang Concept
 Meditation/Exercise
Acupuncture

•Acupuncture meridians are pathways of energy, or

“chi” 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 to
stimulate nerves, muscles, and tissue.
Cupping

 The use of heated bamboo cups to

reduce stress, congestion, colds
 Modern understanding is it relieves
aches and pains through
relaxation/massage
 Herbology
 The use of plants or animal parts in
treatment of illnesses, deficiencies, and to
stimulate the “chi”
 Medicine is “tailored” to fit the individual
and their needs/deficiencies.
 Unlike western medications the balance and
interaction of all ingredients more important
than the effect of individual ingredients.
 EVERY patient is an individual. No one size
fits all remedy.
Yin/Yang Concept

 Sympathetic vs. Parasympathetic

correspond to the Yin-Yang circle.
 Sympathetic – mobilizes body to respond
to stress. Fight or flight = Yang
 Parasympathetic – replenishes and
supports body in rest = Yin
 Must exist in balance to be healthy.
 Certain foods are believed to help restore
the balance
High Risk Behaviors

 Risk of Drug Interactions

 Healthcare Practices
 Same sex healthcare provider is strongly
preferred by women
 May seek traditional, alternative treatment
before accepting Western medicine
 References
Health and Healthcare for Chinese Americans
Linda Ann S.H. Tom. M.D.
Dept. of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii
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 INTERNET RESOURCES http://www.stanford.edu/group/ethnoger/chinese.html
 http://www.mocmonline.com/-Bamboo-Cupping-Jars
 http://www.mayoclinic.com/health/acupuncture
 http://www.crystalinks.com/herbology.html
 http://health.indianetzone.com/acupressure/1/yin_yang_concept.htm
 http://engnet.jiangnan.edu.cn/culture/ChinaCulture/ChinaCulture/en_chinaway/2004-
03/03/content_46092.htm