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