Chinese Culture and Clinical Care

Location

China is located in South East Asia, and is the nation with the largest population on earth. (1,306,313,812). Pakistan, Iran, and India are it’s neighbors.

Language

Cantonese and Mandarin are the two most common languages. Chinese language is very expressive and often sounds loud to non-chinese. They are often shy, especially in an unfamiliar environment, socializing and friendly greetings are helpful. Clinician should address older patients using Mr. Mrs. or title and last name. Shaking hands is appropritate, but some just nod their head or make a slight bow.

Family Relationships

Traditional Chinese values place family and society above the individual. Extended families are common. Two or three generations often live in the same household. The wife is expected to become part of the husband’s family. When it comes to decisions making the eldest male makes most decisions. Males are more highly respected and valued than females. Men are expected to be the breadwinner and women are expected to stay home and raise the children if another family member is not available to babysit.

Religious Practices

Chinese have four major religions in China. Confucianism, Buddhism, Taoism, and ancestor worship. Depending on which religious beliefs Chinese pray alone or in a shrine or church. Many maintain ancestor tables or shrines in their homes where pictures of loved ones are displayed and food is left for special events like birthdays or holidays. Incense burning and eating special foods usually occur on special occasions. They may display good luck symbols, such as statues of Chinese gods in the home.

Eye Contact/Touch

The Chinese usually avoid direct eye contact with authority figures as a sign of respect especially with the older generation. Eye contact is more common among family members and close friends. Eye contact with the opposite gender may be viewed as flirtatious. Touch is relatively uncommon, it to is more common among family members and close friends, though touching someone’s head, particularly that of an older person is viewed as disrespectful. Clinicians should explain the need to touch for health care purposes, which is acceptable. Men and women do not touch affectionately in public.

Orientation to time

Traditional Chinese societies do not value being on time; they focus instead on completing present activities. They must be reminded of the importance of being on time for medical appointments.

Food Practices

Chinese meal patterns consists of three meals a day with dinner being the largest. They prefer to eat with chopsticks if available. They consider food important for maintaining the body’s balance of yin (which is cold) and yang (which is hot). Yin foods include fruits, vegetables, cold liquids and beer. Yang foods include meat, eggs, hot soup and liquids, and oily and fried foods. Believe that the imbalance of yin-yang causes illness. They use food to treat illness and disease. Example would be an illness caused by yang excess would be treated with yin foods and vice versa. Rice and noodles are also important, they usually do not eat lots of meat and if so they prefer well done beef. Frequently mix vegetables with meat to maintain yin-yang balance. They prefer cooked vegetables, not raw. They drink lots of hot liquids, especially tea, when sick. Prefer hot beverages believe that cold water shocks the system. When taking care of Chinese patient, nurse should ask before putting ice in drinks or water pitcher.

Health Care Beliefs

Chinese believe that the imbalance of yin and yang in the body causes most physical illnesses. Family is expected to care for patient who takes passive role during his or her illness, including leaving health care decisions to others. They believe that preventing illness and promoting good health is accomplished by exercise and eating a diet that balances yin and yang foods. Many refuse diagnostic tests they consider to be invasive or dangerous like amniocentesis or glucose tolerance test. They also fear having their blood drawn, believing it will weaken the body and thus reduce vital energy. But do accept immunizations. Some home and folk remedies include, ginseng root which is a commononly used to treat anemia, colic, depression, indigestion, impotence, and rheumatism. Deer antlers for strengthening bones, turtle shells to stimulate weak kidneys and remove gallstones, and snake flesh for healthy eyes and clear vision.

Birth and Death Rituals

During pregnancy Chinese use regular prenatal care and take childbirth classes if they are second generation Chinese. They hold traditional beliefs about the effect that certain activities will have on the baby. For example, believe that going to the zoo will cause baby to look like one of the animals, listening to beautiful music and thinking good thoughts will foster a happy, healthy baby. They consider pregnancy a cold condition so yin foods should be avoided. Prefer vaginal delivery but will accept cesarean if medically necessary. Have no special labor practices. Prefer male child to carry on family name, most females are put up for adoption. They prefer breastfeeding over bottle and the mother is expected to ingest hot (yang) foods to strengthen baby’s health. During the first 30 days postpartum, it’s believed that the mothers pores remain which can cause illness so a new mother is forbidden to go outdoors, shower, or bath.

Many Chinese believe death is part of the life cycle and believe in afterlife. Traditional families may prefer that head of household be told first that the patient is dying. They believe that people should go to the hospital to die because dying at home will bring bad luck. After death family may request that a window be opened to free the spirit. Chinese do not believe in organ donation they feel that the body should be kept intact otherwise the spirit may not have a place to go when it visits earth. After death it is common to honor ancestors by leaving food at the grave site or by displaying a portrait in the home.