Cultural Competency - Multicultural Health Generalizations: Chinese
Geriatric Chinese Patients
- Health and Health Care for Chinese-American Elders
- Chinese Americans and Dementia
- Screening for Depression in Immigrant Chinese-American Elders: Results of a Pilot Study
Ying & Yang - Chinese Health Practices
- Chinese medicine is based on the concept that health is achieved through balance of different kinds of energy (Yin & Yang) that affect the life force (Qi or Chi) of each person.
- Diagnosis of imbalance is described in terms of energy (Chi) deficiency or excess - "hot or cold," "dry or damp," or a combination of these.
- These conditions refer to energy properties of the body, foods, and activities - rather than actual temperatures or moisture levels.
- The Chinese concept of balance, represented by Yin & Yang, is reflected in many Asian traditional healing practices.
- Foods are used as therapeutic treatments.
- Foods are either "hot or cold" - depending not on their temperatures but on their use in balancing the body's basic energies.
Source: Henry Ford Health System (1999). Ethnic Resource Guide. Workforce Development and Diversity Strategies Division, Corporate Human Resources, Henry Ford Health System. Detroit, MI
Chinese Medicine and the Rule of Five Elements (Wu-Xing)
- Traditional Chinese medicine is based on the balance of two opposite forces, Yin and Yang, and a philosophy that regards the harmony of nature and its correspondents which are intimately associated with Wu-Xing (Five Elements).
- According to this philosophy, everything (including organs of the body) corresponds with the five elements. These five elements, which are earth, wood, water, metal, and fire, are related to each other by the Rule of the Five Elements.
- The Rule of the Five Elements states that each of the elements has an effect on the others in a controlling and generative cycle.
- The balance of Yin and Yang determines the state of the body; this balance also determines the direction of the five elements' cycle.
- One of the assumptions inherent in traditional Chinese medicine is that diseases are due to an imbalance of Yin and Yang, and therefore the degeneration of the five elements' cycle.
- Although the qualities of Yin and Yang oppose each other, they complement and cannot exist without each other.
- Disease can be treated by correcting the Yin and Yang imbalance, and thereby returning the body to a healthy state, according to traditional Chinese medicine.
Source: Essential-China.net. Chinese Health http://www.essential-china.net/07_health.main.htm (disabled) (2004, Aug. 2) and an Interview with Master Wasentha Young http://www.peacefuldragonschool.com/
Alternate source:Five Element Theory in Traditional Chinese Medicine. Internal Healers. (Online).
http://www.sacredlotus.com/theory/elements/index.cfm
Chinese Buddhist Beliefs about Death and Dying
- According to Chinese Buddhist beliefs, death is not always a one-way passage but sometimes a revolving door. Death may be considered a revolving door through which the consciousness departs from one's life and begins the journey to another new life.
- Another Chinese Buddhist belief is that human life is concurrent and inseparable from two factors: consciousness and warmth. Dying is a gradual process whereby the consciousness gradually separates from the body. Death occurs when the body has completely lost its consciousness and warmth.
- A dying Chinese Buddhist should stay in a peaceful and comfortable environment, preferably accompanied by the chanting of Amitabha, which may be sung by people or played by audio tapes.
- When a person's pulse and brain waves have ceased, traditional U.S. Practice is to pronounce the person dead. However, the Buddhist belief is that the person is still actively dying; the consciousness is still in the process of separating from the body.
- During active dying, it is very important to avoid movement of the body or abrupt environmental changes. Therefore, it is preferred to not disturb the body in any way for at least eight additional hours, preferably until the body is cold all over.
Source: Lin, Y. (1995, Jun. 17). Crossing the Gate of Death in Chinese Buddhist Culture. (Online). Buddhist Yogi C. M. Chen's Homepage.
http://www.yogichen.org/efiles/mbk16.html
Chinese Dietary Practices
The Chinese diet is generally vegetarian, although meat is still served. Little information is available about dietary deficiencies in the Chinese diet. However, the life span of Chinese is long enough to suggest that severe dietary deficiencies are not common. Periodically, some deficiencies such as rickets and goiters have occurred. The Chinese government has added iodine into the water supplies and encouraged the eating of fish rich in iron to enhance the diets of people with goiters. Furthermore, Native Chinese generally do not drink milk or eat milk products because of a genetic tendency for lactose intolerance. However, their selection of green vegetables limits the incidence of calcium deficits. Healthcare providers might consider screening newer immigrants for these deficiencies and assist patients in planning a culturally sensitive and healthy diet as necessary. In addition, most Chinese do not eat desserts high in sugar content. Their desserts are usually peeled or sliced fruits or desserts made of bean and bean curd. The higher death rate from diabetes in Western countries may be due to a change from the typical Chinese diet with few sweets to a Western diet with many sweets.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis Company.
Chinese and the Patient-Provider Relationship
- Physicians and nurses are viewed as people who can be trusted with the health of a family member.
- Healthcare providers usually receive the same respect as elders in the family.
- Healthcare providers are recognized by Chinese children as authority figures.
- While the physician makes decisions about the type of treatment, the family is expected to oversee the direct care.
- Although Chinese patients may rely on the physician to make medical decisions, if they disagree with the physician, they may not follow instructions.
- Chinese patients might not outwardly contradict healthcare providers because of fear that either they or the provider may suffer a loss of face.
- Chinese patients may question Western practices because of the invasiveness and pain of some treatments.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural health care: A culturally competent approach. Philadelphia, PA: F. A. Davis Company.
