Board Nursing Program

Florida National University

Nursing Program

NUR 3655 – Culture in Nursing Practice

1.  Discuss the health care beliefs of the Chinese and Guatemalan people and mention if there is any similarity in their beliefs.

2.  How the beliefs of these two cultures differ from the beliefs in the health care in United States.

3.  Give an example of how the healthcare beliefs of these two cultures affect the delivery of evidence-based nursing care.

Chinese philosophies and religions strongly influence the Chinese way of living and thinking about health and health care. Nurses must combine information about culture with clinical assessment of the patient to provide cultural sensitive care. A better way may be to combine both western and Chinese values into the Chinese health care system by negotiating between the traditional values while at the same time, respecting an individual’s choice. The foundation of China’s philosophical and aesthetic tradition, in combination with western science is important to the future advancement of nursing research that will be beneficial to the Republics, Asia, and the world.

Chinese philosophies and religion include Confucian principles, Taoism, theory of “Yin” and “Yang”, and Buddhism. Beliefs and values include the way of education, practice of acupuncture, herbal treatments and diet therapy. How people value traditional Chinese medicine in combination with western science, and the future direction of nursing and nursing inquiry are also briefly addressed. Traditional Chinese Medicine originated out of Taoist beliefs established over 4,000 years ago. Today TCM has been refined and adapted, but many of the practices are performed as they have been for thousands of years.

Central to TCM is the belief in an energy, known as qi, which is roughly translated as “life energy.” Qi is believed to flow through a number of channels, or meridians, throughout the body, many of which follow major veins and arteries and connect to the internal organs to circulate qi throughout the body. Qi can be described in many ways, according to the source, the location and the role it plays in the body. Regulating and stimulating the flow of Qi is a basic tenet of understanding the role of disease and health in the body.

The terms yin and yang are used to describe the opposing conditions in the body and come from the Chinese belief that all things have two aspects, which are at once opposite and interdependent. Practitioners believe that a balance of yin and yang is necessary for health. Yin describes qualities that are dark, passive, feminine, receptive, and associated with the night. Yin is often symbolized by water or earth and Yang describes qualities that are light, bright, active, masculine and associated with the day. Yang is symbolized by fire or air.

Within the body, each organ has qualities of both yin and yang, though some organs and functions may have more of one quality than the other. For instance, the heart is considered a yin organ, while the stomach is considered a yang organ.

The basic concepts of treating patients with respect, compassion, and honesty are still what are most important to patients, regardless of cultural/ethnic background. A better understanding of a person’s cultural beliefs can improve patient compliance and the relationship.

As a nurse one should know that the Chinese culture takes medication different than in the USA.  Chinese stop taking their medications when the symptoms go away, and they save the leftovers and give it to someone else with the same symptoms. It is considered disrespectful to stare into another person’s eyes. A nurse should not look at the Chinese person in the eyes when explaining a procedure or giving them instructions.  The Chinese avoid eye contact in crowded places to give themselves privacy. when caring for the Chinese culture it is important to know that the Chinese have a high respect for authority.  This could cause some communication in healthcare, when the nurse is explaining something to the patient, and the patient nods.  The nurse may think that the patient understands, but the Chinese patient may just be trying to be respectful to someone they see as an authority figure.  It is important that the nurse of the patient express that they understand and get a medically certified translator if needed.

The indigenous population in rural Guatemala has access to a variety of treatments from both the traditional and biomedical realms. Guatemala has some of the highest maternal and infant mortality rates in Latin America with a maternal mortality rate of 190 deaths per 100, 000 live births and an infant mortality rate of 43 deaths per 1000 live births. These high mortality rates are partly due to the frequent use of traditional midwives in the highlands. These high death rates illustrate the urgent need for improving the health care system and increasing utilization levels. It appears that when seeking treatment, Maya Indians in the Guatemalan Highlands act in the manner they believe is most likely to improve their health in a setting of significant resource constraints by considering severity of the illness, cost of treatment, quality of services, and their trust in the provider. The Maya have access to three sectors of care; the popular sector, the folk sector, and the professional sector [5]. In the popular sector, individuals may self-treat by using herbal preparations that they obtain from nature or by purchasing medicines from a store or a “pharmacy” run by a drug vendor. Drug vendors in the Guatemalan Highlands prescribe and dispense treatments including injections, but they typically lack formal training. Given the varied options in the biomedical and traditional realms, Maya have many options to consider when seeking treatment. Those who are ill typically use self-treatment strategies. In a treatment-seeking study, 64% of the illness episodes were treated with home remedies or over-the-counter medicines without seeking outside advice throughout all stages of the illness.

Mayan traditional beliefs generally attribute illness to a lack of balance in the body. A sick person was thought to be in a state of disequilibrium. Many factors could bring about this disequilibrium such as working too hard, being overtired, or committing a sin such as a sexual transgression.  Hot and cold qualities apply to foods as well as activities, such as touching cold ground, emotions such as anger, and physical states such as pregnancy. Remedies typically involve restoring balance through the consumption of proper foods, herbal treatments, or by using sweat baths. Illness can also be attributed to mountain spirits. Shamans were traditionally sought to communicate with these spirits to intervene on behalf of the sick. Although, seeking healers was common in the past, as Western medicine becomes more accessible and word of its effectiveness diffuses into Maya society, use of healers has declined.

References

Transcultural Health Care. A Culturally Competent Approach (4th ed.)

Purnell, L.D

Amir A. Hadi Alakaam, Campus Support Services, Programs, and Policies for International Students, 2016, 99

Encyclopedia of Healing Therapies by Anne Woodham and Dr. David Peters.

‘Cultural Values of Asian Patients and Families’ was written by Marcia Carteret. Copyright © 2011.

Weller SC, Ruebush TR, RE Klein (1997) Predicting Treatment-Seeking Behavior in Guatemala: A Comparison of the Health Services Research and Decision-Theoretic Approaches. Med Anthropol Q. 11(2): 224-45. Accessed 2012 Apr 6.