Cao gio means to “catch the wind” in Chinese and is used to draw off and release excess wind in the body. Respiratory infections are referred to as wind illnesses and are responsible for fevers, muscle aches, low energy, and chills. If the marks that are left after coining are very light, then the illness or imbalance is considered mild. If the marks that are left after coining are very dark, then there is an excessive amount of wind and the illness is severe. These are all types of healing interventions associated with the yin and yang belief system. When the yin and yang are not balanced, it is believed that it can cause illness.
The nurse can determine if the complementary or alternative healing modalities are working by assessing if the problem is getting worse. If these modalities are not healing the patient, then the patient should seek other methods of care, such as pharmacological measures. It is always best to start with non-pharmacological measures, such as complimentary and alternative medicine, because they are seen as least invasive and harmless for the patient. The positive motivations for trying complimentary and alternative medicine are that it has a non-invasive nature and it is safe (Ernst, 2000). The nurse should assess the patient’s healing/recovery as you would with any other treatment and evaluating the effectiveness of the therapy. When a certain therapy is not effective, then you should try something else.
Asian Americans have a higher risk of developing the following conditions: lactose intolerance, Hepatitis B, Nasopharyngeal carcinoma, Tuberculosis, sensitivity to beta-blockers, and osteoporosis. It is important that healthcare providers are aware of these conditions in this cultural group so that they can educate patients about risk factors and prevention strategies. Treatment considerations for lactose intolerance in Asian Americans can be to remove lactose from the diet to see how the patient tolerates it before starting any further testing (Harrah, 2013). Other treatment options are milk substitutes such as almond milk, coconut milk, and soymilk. There is also a dietary supplement that can be consumed, which contains lactase, an enzyme that helps to digest lactose. Since Asians are at a high risk for developing lactose-intolerance, they are also at a high risk of developing osteoporosis. They are consuming less calcium, which puts them at risk for having a lower bone mass and density. To prevent osteoporosis in these patients they are recommended to take a calcium and vitamin D supplement, avoid smoking and alcohol consumption, and participate in aerobic exercises such as weight bearing exercises to strengthen bones and muscles. It is also recommended that women age 65 and older have a bone density test done to test if they have osteoporosis and how at risk they are for developing the disease. For Hepatitis B, if an Asian patient has a hepatic lesion or cirrhosis, “an alpha-fetoprotein measurement and MRI scan of the liver should be included” (Harrah, 2013). If Nasopharyngeal carcinoma is suspected in an Asian patient, then further evaluation should be made and possibly chemotherapy or radiation depending on the findings. For patients suspected of having Tuberculosis, a PPD skin test should be done as well as a chest x-ray and sputum culture. If test results are positive, then further medications should be given to treat the condition. Chinese patients are at a high risk for developing a sensitivity to beta-blocker medications and having a reaction to it, so caution should be implemented when patients are on this medication, as well as lowering the dosage of the beta-blocker.
Mental health problems are often masked in Asian American patients. According to the book, “Transcultural Concepts in Nursing Care”, there are 3 components to the reason mental health issues are masked in Asian Americans and why they feel ashamed. The three components are, “they were external shame or a belief that an individual will be viewed negatively for mental health problems; internal shame that is evaluating oneself negatively; and reflected shame, a belief that having mental health problems could bring shame to an individuals family or community” (Andrews & Boyle, 2016). For this reason, Asian Americans often do not seek help or mental health services in fear that they will be ashamed or not accepted by their family. Having a mental illness is seen as a weakness in their culture. Since Asian Americans value family and kinship so greatly, it is hard for them to admit they have an illness because they are afraid they will be seen as weak and they will risk their family members not accepting them. Understanding and having knowledge of the Asian American cultural values, “particularly the importance of maintaining harmony, will help transcultural nurses plan care for patients with mental health problems in a culturally competent manner” (Andrews & Boyle, 2016). It is important for healthcare providers to recognize cultural barriers in these patients such as language barriers in order to communicate effectively with these patients and develop positive patient outcomes. Recognizing these cultural barriers will assist healthcare providers in being culturally aware and noticing these hidden symptoms of mental health problems.
There are some nursing interventions used in the clinical setting to help meet the cultural needs of these patients. The nurse should assess whether there are any language barriers between the patient and the nurse. If the nurse and the patient speak different languages, then it is best for the nurse to obtain an interpreter to assist with communication. The nurse should give the patient enough time to answer when using an interpreter so that the patient is able to translate the information. The nurse should also be aware that it might take the patient awhile to become comfortable with the nurse in sharing personal information. Be patient and let the client know that the information provided is confidential. The first intervention that should be made is to establish trust and a welcoming environment for the patient. This will enhance effective communication between the nurse and the patient, as well as provide patient-centered, individualized care. Assess the patient’s cultural beliefs, traditions, practices, and values in order to incorporate the patient’s culture into the plan of care for the patient. Since family is a major component in Asian Americans culture, the family should be actively involved in the patient’s plan of care and the nurse should be able to determine who the primary decision maker is of the family. The nurse should ask about any alternative medicine used such as herbs, and if not, always suggest it as an option. The nurse should incorporate traditional practices into the patient’s plan of care such as tai chi, relaxation exercises, acupuncture, etc. depending on the patient’s diagnosis. Always ask open-ended questions to allow the patient to express themselves and so that you are able to gain the most information from them.
There are a number of ways to promote awareness of this cultural group in the clinical setting. The hospital can provide classes on cultural awareness of different cultures in the clinical setting, including the Asian culture. Staff education should be provided to meet the cultural needs of the community. An educational training program can be provided to enhance cultural awareness of this cultural group. Health care providers can do research on the cultural group and provide tips to other healthcare providers on ways to be culturally mindful of this group. The hospital can provide modules for staff to complete on cultural competence for the Asian American community. The modules can include how to do a cultural assessment on a patient, tips on providing culturally congruent care, how to use an interpreter, etc.
Cultural awareness is necessary when dealing with patients of a diverse culture. This is an essential component in achieving culturally competent and congruent care. Completing a cultural self-assessment and gaining knowledge of the patient’s cultural values, beliefs, and traditions will help the healthcare provider to provide patient-centered, holistic care. Some of the cultural sensitivities to be aware of with Asian American patients are their stoic personalities when it comes to pain management, they are more reserved and private so they may take time to be comfortable, they tend to not trust Western medicine so it is important to establish a trusting relationship with them, they prefer naturopathic treatments such as herbal remedies rather than pharmacological treatments, mental health problems tend to be masked so it is important to be able to recognize masking symptoms, they value familial relationships so we want to promote family involvement in the plan of care, and we want to educate them on certain risk factors for conditions they are prone to such as osteoporosis. The Asian American population is continuing to grow in America, so we want our healthcare providers to be mindful of this culture and how to approach them to provide the best care for these patients.