7
Fitzgerald Health Education Associates, Inc., January 2015 fhea.com
Certification Q&A;
nese patient's desire to maintain harmony can lead to
problems with communication, since a patient who
does not understand a request or disagrees with a di-
agnosis or treatment is often reluctant to express this,
as doing so could show disrespect or disrupt harmo-
ny.
2
Another Chinese value or tradition that can lead
to miscommunication is deference to authority. Pa-
tients who nod their head to show they understand
or agree with a treatment could be simply deferring
to authority. When talking with Chinese patients,
avoid yes/no type questions and instead ask open-
ended questions to ensure they understand, encour-
age them to ask questions, and ask them to describe
what they've been told using their own words.
3
The emphasis on the family over the individual
means that family members often take part in
healthcare decision making concerning the patient.
Chinese patients also will at times make healthcare
decisions based on what they consider is best for the
family. It is important to determine which family
members are involved in decision making and, when
possible, to involve them in decisions about care.
Patients who prefer to have a family member make
healthcare decisions for them must prepare a
durable power of attorney for healthcare.
4
Patient Care
Many patients of Chinese ancestry are comfortable
using a combination of Chinese traditional practices
and western healthcare. In addition, reliance on or
belief in Chinese traditional practices varies widely,
depending on age, country of origin, religious beliefs,
migration wave, length of time away from China, or
ethnicity of patient.
4
New Chinese immigrants typi-
cally combine traditional and western practices. It is
important to determine when traditional practices
are harmful, neutral, or beneficial and to incorporate
beneficial or neutral practices into the care plan.
4
Herbal therapy, in particular, is an important part
of traditional Chinese practices. When caring for all
patients, regardless of ethnicity, NPs should ask if
they are taking any traditional medicines or herbs
and consider potential drug interactions.
Diet plays a major role in traditional Chinese
health practice, both in promoting good health and
treating illness. Changes in diet suggested by clini-
cians or caused by a hospitalization often conflict
with traditional dietary practices. NPs should keep
in mind the importance of diet in maintaining har-
mony when discussing dietary changes with Chi-
nese patients.
A belief common among Chinese patients is that
western medications are designed for westerners,
who are generally larger in stature, and that the
medications are too strong for them to take at the
full dosage.
3
As a result, they often take less than the
prescribed dose. NPs should explain that the dose is
appropriate for their height and weight and that it is
necessary to take the full dose even if the patient
feels better soon after starting the medication.
Several treatments used in traditional Chinese health
practices are sometimes mistaken for abuse; these in-
clude coining and pinching, cupping, and moxibustion.
3
Coining involves rubbing a hot metal coin over the
skin, producing welts. Both coining and pinching are
used as a way to draw out illness. With cupping, heated
small cups are applied to the forehead or abdomen.
Cooling results in a negative pressure within the cup,
creating a suction that causes circular bruising. Moxi-
bustion is a form of fire heat treatment in which
burning wormwood is applied to stimulate acupunc-
ture points, resulting in superficial burns.
3
•
References
1. United States Census Bureau. The Asian population. 2010
Census Briefs. March 2012. http://www.census.gov/prod/
cen2010/briefs/c2010br-11.pdf.
2. Centers for Disease Control and Prevention. Chapter 2. Over -
view of Chinese culture. http://www.cdc.gov/tb/publications/
guidestoolkits/EthnographicGuides/China/chapters/chapter2.pdf
3. Culture-Sensitive Health Care: Asian. From What Language
Does Your Patient Hurt In? A Practical Guide to Culturally
Competent Care. Diversity Resources, Inc. Amherst, MA. 2000.
http://diversityresources.com/health/asian.html
4. Communicating with Your Chinese Patient. University of
Washington Medical Center. http://depts.washington.edu/
pfes/PDFs/ChineseCultureClue.pdf
C
ontinued from page 5