Caution: These are broad generalizations and should not be used to stereotype any individuals.

In order to show respect, patients may:
agree to what the healthcare provider says, without having any intention of following through. Make sure the reasons for compliance are explained and stressed.

avoid direct eye contact. Do not assign other meaning to this.

Suggestions for better communication:
Avoid asking questions which require a "yes" or "no" response. Have the patient demonstrate understanding of any patient teaching.

Avoid hand gestures; some, such as beckoning with the index finger, is insulting to Filipinos & Koreans.

Offer things several times; patients may refuse at first in order to be polite.

•Anticipate patients' needs when possible. Do not wait for a request for pain medication or assistance since patients may feel it is inappropriate to take a health care provider away from other patients in order to attend to their personal needs.

Realize that since pronouns do not exist in most Asian languages, they will often confuse "he" or "she".

Family/Gender Issues
Allow family members to fulfill their familial duty by spending as much time with the patient as possible and by providing nontechnical care.

Accept that wives may defer to husbands in decision-making. Involve the family in decision-making.

Realize that sons may be valued more than daughters.

Recognize that Asian culture is hierarchical; tremendous respect is often accorded to the elderly.

Expression of Pain
Patients may not express their pain. Offer pain medication when the condition warrants it, even if patient does not request it. Insist upon giving it when necessary.

Pregnancy & Birth
Traditional birth partner may be mother-in-law or other female relative.

Women are generally stoic while giving birth.

Traditionally, new mothers avoid cold, bathing & exercise for one month post partum ("Doing the Month"). Respect post-partum prescriptions for rest. Sponge baths may be preferred.

Since pregnancy is thought to be a "hot" condition within traditional Chinese medicine, birth depletes the body of heat. Restoration of warmth is important. Offer liquids other than ice water, which may be deemed too "cold".

Parents may avoid naming baby for up to 30 days.

End of Life Issues
Family members may wish to shield a terminal diagnosis from the patient. Ask patient upon admission (or before the need arises, if possible) whom should be given information about his/her condition.

Health related practices
Coining & cupping are traditional medical practices in China, Korea & Viet Nam, not forms of abuse.

Fevers are often treated by wrapping in warm blankets and drinking warm liquids.

Avoid giving ice water, unless requested. May prefer hot liquids, such as tea.

Use of herbs common. Be sure to instruct on the use of western medication.

Avoid the number "4" -- it may signify death for Chinese & Japanese.

Mental illness is often highly stigmatized in most Asian countries. Patients with emotional problems are likely to somaticize them and present with physical complaints. Patients may be reluctant to discuss emotional problems with strangers.

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