Family Cultural Assessment

Giger and Davidhizar’s Transcultural Nursing Assessment (De Ruiter et al., 2016, p. 162).

Responses for each of the 6 areas (use bullet points)

Communication:

· The communication within Chinese family culture is simple in conversation but complex in language and dialects used. All the family members speak Chinese, Cantonese, and Mandarin while YM, EM, ST all speak English.

· YM and ST learned English at a young age through pop culture in China and here in America as well as through grade school and taking extra classes on English as Second Language.

· The parents understand and speak simple greeting of “Hello”, “Bye”, “Yes”, and “No”. YM explained her parents never had a strong desire to learn English fully as their work and personal life were center around their own family as well as others that could translate for them when needed.

· The parents however are careful in reading and observing nonverbal communication attributes of those around them such as physical stance, facial expressions, and hand gestures.

· When communicating with them myself, I waved to them as a part of my greeting and they responded with “Hello”. Otherwise throughout the interview, they did not speak much, although paying much attention.

· In their culture they speak in a fast pace in either a quite or extra loud volume. When asked about eye contact YM explained it took some getting used to and noted that in China is can be inappropriate towards the elders. When observing the family, it was challenging at times to read the facial expressions of the parents as they are minimal whereas the daughters were much more expressive and outgoing.

Space:

· It is common to be close in proximity and space as a family, especially when cooking and eating together. The family is close with one another and comfortable but are also independent in their activities.

· It is common in their culture to have the oldest son be the caretake of the parents, however, if there is no son in the family, the expected duty is then passed on to the oldest daughter.

· For this family, YM is the oldest daughter and the parents live with her, her husband EM, and daughter as their one son had an unexpected death at a young age. YM and her family live in a four-bedroom suburban home here in which the parents have the lower them to themselves, kitchen, dining, and living room as common space, and the upper level for YM, EM, and their daughter. This layout YM explained was a reason they bought the home so there would be some separation and space for each of them.

· When I have been over to their home in the past and the parents were home, they would mostly stay in the lower level and only come up for food.

Social Organization:

· The family is originally from East China in a small village almost three hours from the city Guangzhou. YM’s grandparents and an uncle still live there today.

· Both parents work at one of the family’s restaurants generally Tuesday through Saturday while on Sunday they practice Dim Sum, which is a family gathering in the late morning of a buffet of foods consisting of many versions of dumplings for example.

· Most foods are usually bite size, there is large variety, and the foods are either fried or steamed. XU the father cooks more at home than the mother, as she helps more with taking care of the grandchild, gardening, and helping around the house, when not at the restaurant. Food is a center of many gatherings with family in Chinese culture and it is common for all foods to be shared and tried amongst one another. This family noted that in their culture they are not as big on celebrating birthdays or anniversaries as they are with weddings and births.

· With regards to their spirituality, they participate in Buddhist practices, have statues and pictures of the Buddha in their home. YM reminisced about going to Buddhist temples in China with her parents and extended family members as a young child but that they have not done that much since being here.

Time:

· The family explained that although time is important, in daily life, they do not follow strict schedules and simply work until the job is done or take as much time as they need to do a task right.

· They value hard work and their jobs in providing for their family in which time to them often correlate time to money.

· YM noted however that she sees differences in this throughout her family though there are different values in time between the generations. For example, YM is more punctual than her parents as with her cousins when it comes to daily tasks and will stop working on something due to a schedule regardless if the task is complete.

Environmental Control:

· In America, the Chinese generally live where their work is or where the adult children have chosen to settle.

· They like to provide for themselves with gardening many of their vegetables and herbs, while cooking from fresh food sources. T

· hey values time with family and loyalty, wisdom and respect of authorities, being courtesy in care taking, as well as showing respect and love through gift and services. The family all practice the use of teas, herbal medicine, and broths.

· In Chinese culture, children are brought up with high level of discipline and requirement to practice patience at a young age. YM and EM mentioned how this has caused frustration between each other as they are raising their first child together and discussing future parenting methods.

· The parents use acupuncture routinely and tend to withhold from western medicine methods. YM and ST however since they have become more adjusted to American culture, are more following of western medicine. YM learned the most about American health practices when learning to become a registered nurse.

Biological Variation:

· In the Chinese culture, most have dark hair, brown eyes, fair skin, and many are thin in nature in comparison with their incorporated American culture, even though they are not as driven to be physically fit. YM mentioned she has a “flat nose” which is common in her culture but has always been self-conscious about it since living here.

· In their family, there is a history of type 2 diabetes, high blood pressure, high cholesterol, stroke, as well as breast and skin cancer. YM also explains she has had struggles with depression since her brother had a sudden death at a young age and she since has felt pressure in taking on his family duties.

Nursing Action(s): must be family & culturally oriented, use bullet points

Why Chosen: use bullet points, include 3 or more peer-reviewed citations to support

· During the family interview, YM, EM, and ST spoke the most whereas the parents were quiet in voice but participated in nonverbal communication. As the nurse with no knowledge of their native language, focusing on nonverbal cues such as facial expression, physical appearance, and voice characteristics was helpful to be prepared to observe throughout (Vargas-Urpi, 2013).

· Providing suggestions and guidelines for meal planning to help with ease and health of diet. Provided information about the DASH diet as well as provided suggestions on alternatives for ingredients of their typical foods.

· I further helped in encouraging the father check his blood pressure regularly at home as well as demonstrated proper technique as he was diagnoses with high blood pressure this year. I suggested taking his blood pressure 3 times a week to start and to keep a log of the date, time, blood pressure and pulse for at least 2 weeks.

· We also talked about incorporating more physical activity in the daily lives of the family. I suggested taking family walks outside, going to the community park near by more often for picnics and then maybe going on the trail. YM and ST mentioned they enjoy swimming and do water aerobics in which they then invited their mother to join them sometime. Physical activity would be beneficial for the whole family. It would help the mother with her diabetes as well as help with YM’s depression symptoms.

· An example of this as noted by Vargas-Urpi (2013), when interviewing, noticing that in Chinese culture they may not be making eye contact, but they are smiling. I thought of this concept in anticipation of the interview as I was at first nervous, however the assumption was accurate and having learning about it ahead of time, made it easier to understand the nonverbal cues and be more comfortable in the setting.

· This intervention was chosen as the mother has a difficult time with managing her diabetes as she enjoys sweets and feels if she cannot have her favorites foods, then what would she eat. This is common is patient who have not been provided with the proper diet education on what food are important to eat and which are to be avoided.

· Monitoring one’s blood pressure at home is a beneficial way to provide their doctor was data to show trends in their measurements. This suggestion is correlated with Roy’s adaptation model in setting short goals to then develop positive behavior changes and acceptance of the change (Blais and Hayes, 2016).

· As a part of one’s whole well-being, regular physical activity is important for mental and physical health. Physical activity can help manage the progression of diabetes, prevent it from developing as well as help alleviate symptoms of depression (Yamashita, Yamashita, Sato, & Takase, 2019)

Result of Nursing Action(s): (What was the family’s reaction to nursing action(s)

Describe your thoughts on experience of doing the assessment.

· The family mentioned upon arriving to their home, they were looking forward to the event. They were willing to share their stories, thoughts and ways of life. I feel that in conversation it was equal in participation and conversation without any moments of awkward silences or uncertainty, which helped keep the dialog smooth.

· The family was opening towards the alternative food options and ingredient alternatives I suggested. For example, trying to steam as much food as possible versus frying the food. Not adding breading to meats, limiting salt in food preparation, using fruit and other natural sugars in making desserts and choosing sweats. YM noted she is guilty of facilitating the making desserts as she follows in the attribute after her mother in enjoying sweets.

· The father seemed interested in the blood pressure machine following my demonstration of it and told his daughter he was in agreeance of the plan. He also mentioned he is getting used to his changes for his new diagnosis, but it still has been challenging. He was thankful for the assistance and YM also noted she would be helping him going forward.

· The family together expressed interest in the ideas of physical activity but explained that it is something they have never thought about or made an extra effort to do more of. YM noted she has wanted to become more physically fit recently but has not know where to start and did not want to try it on her own. YM and ST continue to look forward to their swimming and hopes their mother will join them.

· I enjoyed doing this assignment and the overall experience. YM is someone who I do not see much at all anymore, so it was nice to have a reason to be in contact and visit. I felt lucky to have known her as her and her family were so welcoming in my visit and were willing to engaging in conversation about their culture. I fell I have a better understanding of what the Chinese culture is like not only in China but also the transition and incorporation with American cultures. I did not realize how much of YM’s preferences were stemmed from her culture and how different her life was in China compared to here.

What have you learned about analyzing & responding to conditions of marginalized populations through this unit?

How will you respond to conditions of marginalized populations in your nursing practice?

· In marginalized populations, I have developed a further understanding of what it means as there are social injustices, disadvantages, and discrimination in healthcare services and resources available for certain groups of people (Blais and Hayes, 2016).

· Nurses need to be advocates for their patients without regard to their cultural difference but also while making note of the cultural individualities, practices and societal resources so they can provide the appropriate care (Blais and Hayes, 2016).

· As I have learned more about marginalized population, I will make forth the effort to further understand the perspectives of these populations in their daily lives and health conditions. I will incorporate more the use of empathy in their cultural challenges and provide support in a culturally competent and individual manner. I hope to continue to learn about these populations and how to best understand their needs as well as what resources can I best provide them with.