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