Download - When_East_Meets_West
Emma Yee Y. Chong, RN, BSN March 18, 2014
When East Meets West - China
Most populous country (1,354,400, 000)-India #2, US #3, Indonesia #4 Another 2 million of Taiwanese Population growth rate: 4.95%Birth rate: 12.1% Death rate: 7.15%Net migration rate: -0.33/1,000 population
Country Profile
Life expectancy: 74.83 years (US: 79.86years) M:72.38 F: 77.37 Maternity mortality rate:
37 deaths/100,000 live births (21/100,000)Infant mortality rate:
15.2 deaths/1,000 live births (6.17 deaths/1,000 live births)Illiteracy rate: 4.96% (2012) M: 126,990,000 F: 339,200,000
Country Profile (Cont’d)
Age 0-14: 222,870,000Age15- 64: 1,004,030,000Age 65 & up: 127,140,000
Age Structure
GDP composition, by sector of origin:Agriculture: 9.7% -rice, wheat, potatoes, corn, peanuts, tea, millet, barley,
apples, cotton, oilseed; pork; fishIndustry: 45.3% -iron, steel, aluminum, coal; machine building; armaments;
textiles and apparel; petroleum; cement; chemicals; fertilizers; consumer products; food processing; transportation equipment; telecommunications equipment, commercial space launch vehicles, satellites
Services: 45% -hotel, tourism
Economy
Ethnic profile: Han Chinese 91.5% Chinese minorities and other nationalities 8.5%Dialects: 100+Religion: Daoist (Taoist), Buddhist,Christian 3%-4%, Muslim 1%-2%Also honor their ancestors during holidays
Ethnic groups & Religion
A Uyghur girl
Chinese immigrants go to churches & templesFor the best wishes of health and fortune
Chinese Churches in Chinatown, Quincy, LexingtonBuddhist temple in Braintree
Religion (Cont’d)
WWI & WWII Civil War right after until 1949 -The Republic of China Govt escaped to Taiwan
and The Communist Party formed the People’s Republic of China (PRC)
Cultural Revolution and The Great Famine -40+ Millions people died, people fled to Hong
Kong (Touch Base Policy, 1974)Hong Kong returned to China in 1997
Political Key Events
Asian American in MA: 349,768 /5.3%Chinese+ Taiwanese: 118,164 + 4502= 122,666Toishanese is the #1 dialect in BostonTop three cities with the largest Chinesepopulation: 1. Boston 25,9212. Quincy 14,979 3. Malden 6,926
What about Chinese Bostonians?
Pain/Disease processDietary
Death and Dying Decision Making
Custom
How do Chinese Patients view..
Mis-conception of narcotic addictionEmpowerment and education is the key
Wong-Baker scalePrefer quality description over 0-10 scale
Soreness May ask “Do you have discomfort?” instead
Pain/Disease Process
Breakfast: Tea, porridge (Rice soup), bread/steamed bun,
Dim Sum during weekends/holidaysLunch:
Rice/Noodles with cooked veggies and meatDinner
The biggest meal of the day: Soups before/after meal , 3-4 dishes with rice and fruits after mealSpecial teaching topic: Diabetes and rice intake.
Diet
The Chong’s dinner
My lunch before work
A Taiwanese snack: Scrambled eggroll with fried pork
Buddhist: Death = RebornWhole body burial preferred
Prefer dying in hospital as it brings bad luckDNR/DNI acceptable in Chinese Culture, but
HCP/family may disagreeFamily decision over autonomy in some families May ask for resuscitation until family comes over
from China for the final farewell
Death & Dying
Husband/Oldest son /Physicians/ ProfessionalsFemale patient may say:
“Don’t ask me, ask my son.”Group decision for the good of the family
Examples:Surgery
Code statusBlood Transfusion
HIV/STD testing
Decision making
Produced in 2005 by the Red Ribbon Centre,Hong Kong
Magic Johnson and Yao Ming playing basketball together
ttps://www.youtube.com/watch?v=Daiwejzw3TI
AIDS awareness video
Hot water, Diet ,Med interactionsNot touching their heads-VERY INSULTING
Therapeutic distancePrefers Provider of the same gender
Blood draws, IVFMental Health-A few Asian Clinics in MA
Ambulation/RestFamily involvement
Culture & Nursing care
To achieve quality in health care from the culturally
diverse patient’s perspective, the patient’s needs and expectations
must be met. In order meet that goal, a clinician must be culturally competent, and for me, that means
ASK (Assess) TEACH (Explain)
UNDERSTAND (listen)
Final Thought
Marie Guerrier, RN MSN, Mentor
Kathy Codair, RN, MSN, Nurse Director, 6 SouthBrigham and Women’s Faulkner Hospital
Collaborative Governance Diversity Committee
Thank You
Question & Answers
Alfred Health and Permissions. (2012). Management of a patient with a minor burn injury. Chart. Retrieved March 10, 2014, from http://www.vicburns.org.au/management-of-a-patient-with-a-minor-burn-injury/pain-management/pain-assessment.html
Central Intelligence Agency. (2014). The World Fact Book: China. Retrieved March 10, 2014, from https://www.cia.gov/library/publications/the-world-factbook/geos/ch.html
Central Intelligence Agency. (2014). The World Fact Book: United States. Retrieved March 10, 2014, from https://www.cia.gov/library/publications/the-world-factbook/geos/us.html
Chin, P. (1996). Culture & Nursing Care: A Pocket Guide. San Francisco, CA: UCSF Nursing Press.Joslin Diabetes Center. (2010). Why Do People of Asian Descent Get Diabetes? Retrieved March 17, 2014, from
http://aadi.joslin.org/content/asian/why-are-asians-higher-risk-diabetesLiu, H., Hu, Z., Li, X., Stanton, B., Naar-King, S. & Yang, H. (2006). Understanding Interrelationships Among HIV-related
Stigma, Concern about HIV Infection, and Intent to Disclose HIV Serostatus: A Pretest-Posttest Study in A Rural Area of Eastern China. AIDS Patient Care & STDs. 20 (2), 133-142
Lou, V.W.Q. (2011). Depressive symptoms of older adults in Hong Kong: the role of grandparent reward. International Journal of Social Welfare. 20, S135-S147
National Bureau of Statistics in China. (2012). Annual data. Retrieved March 10, 2014, from http://data.stats.gov.cn/workspace/index?m=hgnd
Tufts Medical Center. (2014). Asian Psychiatry Program. Retrieved March 14, 2014, from https://www.tuftsmedicalcenter.org/patient-care-services/Departments-and-Services/Psychiatry/Clinical-Care-Services/Asian-Psychiatry-Program.aspx
UMASS Boston. (n.d.). 10 Cities and Towns with Largest Population of Asian Americans by Subgroup in Massachusetts. Retrieved March 10, 2014, from http://www.umb.edu/iaas/census/2010/10_cities_towns_largest_population_of_asian_americans_in_ma
Wu, B., Guo, M., Chi, I., Plassman, B.L. (2011). Social network and health: a comparison of Chinese older adults in Shanghai and elderly immigrants in Boston. International Journal of Social Welfare. 20, S59-S71
References