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Cultural Assessment: Chinese American

Claudia Leal Gonzalez

Miami Regional University

Cultural Assessment: Chinese American

Culture is essential because it influences not only a community or country’s national identity but also psychology. The opinions of people and values of citizens are conveyed through cultural values. However, culture is dynamic; thus, it varies from one community to the other. These disparities in cultural practices trigger different healthcare behaviors and challenges that have a profound impact on the delivery of healthcare services (Li et al., 2016). Ideally, the increased diversity of the healthcare workforce and complex customers who have different cultural backgrounds have led to various challenges and barriers to healthcare access in multinational organizations (Li et al., 2016). This paper identifies and analyzes multiple transcultural beliefs, including religious practices, end-of-life practices, risk behaviors, and dietary preferences among Chinese Americans. Also, the identifies healthcare behaviors, challenges, and barriers to healthcare and outcomes related to these challenges. The paper concludes by providing an evidence-based plan that could be used to improve healthcare outcomes and access.

Many Chinese Americans are from either Taiwan or mainland China; thus, they have common religious, ethnic, and racial backgrounds. However, theirs is a great diversity in their cultural contexts. According to Albougami et al. (2016), over 3.4 million Chinese residents in the United States have increased rapidly from the previous years. In other words, Chinese Americans contribute to 1.3 % of the United States population. Culturally, Chinese Americans have larger households despite their low birthrates because their family living is extended (Albougami et al., 2016). Notably, Albougami et al. (2016) state that 69% of the Chinese Americans are born outside the United States because of several immigrations in the previous years.

Based on social economics, there is economic diversity among the Chinese American population. According to Li et al. (2016), more Chinese Americans are in poverty than the poverty level nationally. This diversity in the economic status of Chinese Americans can be well explained by the fact that this group has different origins from where they migrated. Most educated people from the mainland of China have little exposure English language (Li et al., 2016). As a result, it becomes difficult for most professionals and educated people who are foreigners in the United States to use English. The difficulty in changing makes them unable to find well-paying jobs but instead go for jobs that require low skills. On the other hand, the Chinese Americans from Taiwan were more exposed to American culture and had a higher opportunity to learn English. As a result, changing into better professional careers are comfortable in the United States (Li et al., 2016). Besides, those who have their origin in Hong Kong have a high chance of using English and adapt to the American lifestyle and culture quickly.

Considering language, Chinese Americans who originated from Taiwan and the mainland are fluent speakers of Mandarin Chinese. However, they have a Cantonese dialect that is different from Mandarin even though the way these languages are written is similar and understandable for both speakers (Li et al., 2016). On the other hand, Chinese Americans have diversity in healthcare practices.  The first generation of Chinese foreigners in America use the Traditional Chinese Medicine (TCM).  The idea behind the TCM is to achieve harmony and balance within the body. Among the TCM used is the herbal medicine and other modalities to restore body balance (Li et al., 2016). Those immigrants who understand and make effective use of TCM do not have health insurance covers, and most of them have low paying jobs. Ideally, social, economic status among Chinese Americans plays an integral role in healthcare practices, with the recent foreigners being unaware of healthcare programs such as Medicaid and Medicare. Besides, they are unaware of the process they can undergo to utilize the benefits of these government programs in the United States. Comparatively, TCM is cheap for especially for the Chinese Americans who have low wage jobs; thus, becoming the best alternative for 66% of the immigrant (Li et al., 2016). However, there are healthcare conditions that the Chinese Americans consider to use new treatment options such as diabetes and surgery, which cannot be treated using TCM. Most importantly, Chinese Americans first use TCM before seeing a doctor. They often integrate TCM into their care delivery, including end-of-life care, whereby they can change their diet, design therapies, and seek practitioner assistance regardless of whether they are licensed or not (Li et al., 2016).  Finally, doctors and elders are respected by the Chinese Americans, whereby doctors are regarded as the essential people in society as the elders are considered as people who deserve help from the youth and other family members who will protect their health.

Finally, Chinese Americans exhibit various end-of-life practices and religious beliefs. Life events are considered inevitable and unpredictable; a condition referred to as fatalism. According to the research conducted by Li et al. (2016), indicates that Chinese American elders have higher fatalism rates concerning the end-of-life. As a result, they have a belief that planning in advance care cannot have any significant impact in the future. Considering the Chinese American religion, Confucians are not afraid of death, and Buddhists believe in life after death. Finally, the Taoists believe that death is a natural process (Albougami et al., 2016).  These cultural practices pose challenges to healthcare access and become barriers to adequate healthcare outcomes. Undoubtedly, cultural aspects have been proved to cause insecurity when engaging with patients. Chinese Americans consider TCM rather than modern medical treatments, thus, feeling insecure when they are involved by American doctors (Storr, 2017). Also, most patients misunderstand information and healthcare instructions because they are not exposed to the English language. Thus, healthcare communications amid the doctors and patients are impacted by the language barrier. As a result, the delivery of quality care practices is limited. Furthermore, the communications take more time than expected; hence, it can impact the delivery of emergency services.

Interdisciplinary members can be used to provide education and training about the end-of-life care among Chinese Americans. The patient’s knowledge of advance care planning is significant in pain management and other health conditions. Education programs can be incorporated among family members and communities of Chinese Americans to create awareness and the importance of advance care planning (Storr, 2017). Finally, a community advisory committee can be formed to bring many professionals together to accomplish a common goal.  Hiring of bi-lingual medical staff can also play a massive role in enhancing useful and timely healthcare communications (Storr, 2017). Besides, universal healthcare symbols can be used to help those that are not exposed to American culture understand better.

Conclusively, cultural practices have a considerable impact on the delivery of quality healthcare services. Chinese Americans have a range of diversity in religious, social-economic, language, and end-of-life practices. These cultural practices and perceptions trigger numerous barriers and challenges that impact the delivery of quality care services. Among the significant challenges are communications problems and end-of-life. However, crucial evidence-based planning, such as educating families and communities on the advantage of advance care planning, can help. Finally, hiring of bilingual medical staff will be essential in minimizing language barriers.
References

Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2(3), 1-5. Retrieved from https://pdfs.semanticscholar.org/f1b7/48b664e1236fc0841a6c33259403e3f4f5e9.pdf

Li, J., He, Z., Luo, Y., & Zhang, R. (2016). Perceived transcultural self-efficacy of nurses in general hospitals in Guangzhou, China. Nursing Research, 65(5), 371. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008044/

Storr, J., Twyman, A., Zingg, W., Damani, N., Kilpatrick, C., Reilly, J., … & Allegranzi, B. (2017). Core components for effective infection prevention and control programs: new WHO evidence-based recommendations. Antimicrobial Resistance & Infection Control, 6(1), 6. Retrieved from https://aricjournal.biomedcentral.com/articles/10.1186/s13756-016-0149-9

FAAN, J.N.G.E.R.A. B. (2017). Transcultural Nursing: Assessment and Intervention. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9780323399920/