Abstract
America is a multi-cultural nation, and it is becoming even more diverse by the day. Every culture is different from another in some way, shape, or form. It is extremely crucial to be aware of these cultural differences. If one fails to educate themselves in this area, they are setting themselves up for failure. Without a general knowledge of various cultures, one may not be able to effectively communicate with other individuals. This presents a major problem for all individuals lacking this knowledge, especially healthcare providers. As a healthcare provider, one must be able to effectively communicate and care for all individuals. The general public is a very diverse group, and one must be prepared.

Appropriate Healthcare for Japanese Patients As a healthcare provider, one must be culturally competent. Being a culturally competent healthcare provider entails being aware of various cultural customs and beliefs. This is an extremely important matter that should not be taken lightly. Everyone deserves respect. Being a culturally competent healthcare provider is one way to show great respect to all patients.
Various cultures have contrary beliefs concerning healthcare and personal interaction. The Japanese are a very interesting culture. Most Japanese individuals consider it impolite to make prolonged eye contact (Purnell, & Paulanka, 2008). This is a very important thing to know when caring for a Japanese patient. One does not want to come off as ill-mannered when trying to gain a patient’s trust. Most Japanese individuals do not respond to verbal communication as well as they do to written instructions (Andresen, 2001). This bit of information could be extremely helpful when trying to communicate with a patient about an upcoming procedure. Having brochures or informational packets concerning healthcare could be most helpful to both the healthcare provider and the patient. Another option would be to have a translator in the room, if the patient does not bring someone who can do this for them. The patient may not be able to functionally communicate in English.
In the Japanese culture, it is not considered appropriate to express personal emotions such as pain or sorrow in public. Being able to keep a tight lid on one’s emotions is considered having great family honor (Purnell, & Paulanka, 2008). This lack of emotion can make it incredibly difficult to gain an accurate patient history. In addition to hiding their emotions, Japanese individuals will often use laughter to hide their unhappiness and embarrassment (Purnell, & Paulanka, 2008). This can be extremely misleading to the healthcare provider. Body language is a major part of communication. Without both appropriate verbal and non-verbal communication, messages are more likely to be misconstrued. One must take extra precautions during communication with patients from a different culture to ensure that the healthcare provider and patient are communicating effectively while addressing the real issues. The Japanese believe that the decision making process is a burden. It is considered an act of kindness to spare them choices. They also believe that social touch is not appropriate with people they are not closely acquainted with (Andresen, 2001). Japanese individuals greatly respect their personal body space. Clear communication and even visuals can assist with effectively making the patient more comfortable in this type of situation. As a healthcare provider, one should strive to make the patient feel as comfortable as possible. By being aware of various types of cultural behavior, one can provide a better healthcare experience for the patient.
Japanese persons are strong believers in both kampo (Japanese herbal medicine) and Western medicine (Bonder, Martin, & Miracle, 2008). They usually do not prefer one method of treatment over the other, but rather a combination of the two. Respect for their culture should be given regarding this aspect, while making sure that the patient is provided the best medical care possible. The Japanese are very open to the idea of blood donation. Actually, it is encouraged. However, organ transplants are considered taboo within the culture (Andresen, 2001). Japan has strict laws regarding organ transplants, especially if the organs are from a brain-dead donor. However, various individuals within this culture feel differently about this matter according to their religious background.
Japanese culture does not endorse sexual education. In addition to a lack of education, the Japanese do not approve of the use of oral contraceptives. Condoms are the only form of birth control that is regularly used. Due to this, it is not uncommon for a Japanese woman to have had several abortions throughout her fertile life (Purnell, & Paulanka, 2008). The reason that the Japanese rebuke oral contraceptive use and sexual education is because their culture views pregnancy as a woman’s life goal (Galanti, 2008). The healthcare provider should routinely check for pregnancy when addressing healthcare concerns, to ensure the female is not pregnant before exposing them to radiation or further testing. Knowing that Japanese patients are a lot less likely to practice safe sex can be extremely important information, especially when working in radiology or another area of healthcare that is unsafe for expecting mothers.
During pregnancy, the Japanese believe that by keeping the feet warm, one is promoting uterine health (Purnell, & Paulanka, 2008). Loud noise is considered a teratogen. The Japanese believe that the expecting mother should be pampered, in order to allow the baby to develop in a tranquil, peaceful environment. An expectant mother usually spends the last two months of her pregnancy and the first two months postpartum with her mother, no matter how far away she lives (Purnell, & Paulanka, 2008). It is not ordinary for Japanese husbands to attend the births of their children. In the Japanese culture, it is very uncommon for an expecting mother to have any sort of epidural or cesarean section. As stated earlier, enduring pain is a way to show great family pride. However, it is extremely rare for the Japanese to undergo childbirth at home. Following childbirth, the mother keeps the dried umbilical cord in a small box as a memento of childbirth for the remainder of her life. This box is usually buried with her (Galanti, 2008).
The Japanese are considered to be one of the longest living groups of people in the world. The average life expectancy for men is 78.5 years, while Japanese women have an average life expectancy of 85.5 years (Purnell, & Paulanka, 2008). Japanese people believe that their good health is a result of their healthy lifestyle. An important part of the daily lifestyle is the daily bath (ofuro). The ofuro is taken at the end of the day to alleviate both physical and spiritual ailments. Unlike a typical western bath, the goal of the ofuro is relaxation. One removes all impurities from the body prior to entering the tub by cleaning their body before entering the ofuro. The tub is very deep, allowing full body submersion. The water temperature is extremely warm. The ofuro is believed to increase one’s health and quality of life (Andresen, 2001). Due to this belief, the ofuro is gaining popularity here in the west. Another tribute to the longer lifespan of the Japanese is their diet. Japanese cuisine is mostly composed of rice, fish, vegetables, and green tea. The Japanese also eat from smaller plates, which create natural portion control. It is considered comforting for someone to dine with familiar food choices. Most Japanese people eat a bowl of rice with every meal, even breakfast (Purnell, & Paulanka, 2008). It is also important to remember that the Japanese are not fond of western brown tea. They much rather prefer green tea. Attention to small details like food preference can help make one more comfortable in an unfamiliar situation.
In the Japanese culture, it is considered ideal to be unaware of any serious medical conditions or ailments that one may exhibit. The Japanese would rather not know that they are sick, and would not feel comfortable discussing this topic. Illness and death are not openly conversed in this culture. In fact, Japanese hospice differs from that of western practice in that they do not give the patient either a diagnosis or prognosis (Bonder, Martin, & Miracle, 2008). The Japanese are very surreal in the fact that they like to pretend as if everything is okay. They will avidly go out of their way to avoid bad news. This is a very important fact to remember about Japanese when treating them in the medical profession.
Due to their inability to share their emotional burdens, the Japanese rank ninth in the world for suicide. Suicide is more common in this culture than our own. Japanese people greatly value their honor. If they feel as if they have dishonored their family or themselves, they believe that suicide is the best outcome. Something that the Japanese would view as dishonorable would be unemployment or depression. Japanese people are more shame-based than guilt-based people (Purnell, & Paulanka, 2008). Men are more likely to commit suicide than women (Galanti, 2008). It is often extremely difficult to detect suicidal patients. As stated earlier, the Japanese do not believe in expressing their feelings. They will often try to mask unhappiness with a smile.
The two leading religions in Japanese culture are Shinto and Buddhism. Most Japanese people are either Shintoist, Buddhist, or both (Andresen, 2001). It is not uncommon for Japanese individuals to associate with more than one religion.
“‘Shinto gods’ are called kami. They are sacred spirits which take the form of things and concepts important to life, such as wind, rain, mountains, trees, rivers and fertility. Humans become kami after they die and are revered by their families as ancestral kami. The kami of extraordinary people are even enshrined at some shrines. The Sun Goddess Amaterasu is considered Shinto's most important kami ("Shinto," 2008).”
The religion of Buddhism focuses on three main beliefs. These beliefs are reincarnation, dharma, and karma. Buddhists believe in reincarnation, which is the belief that the soul never dies. Instead, one’s spirit is reborn in either the body of an animal, human, or supernatural being (Galanti, 2008). Dharma consists of both the teachings of the Buddha and the deep-seated principles that arrange the universe. Karma is the belief that what goes around comes around. In other words, all of an individual’s actions (mentally, physically, and spiritually) will shape their future. Buddhists believe that you get out of life what you put into it (Galanti, 2008). Cultures in our world differ in many ways. As our world becomes smaller and cultures blend effortlessly into one another, we, as healthcare providers must ensure that we are aware of cultural differences and provide respect with every treatment. Being aware of these cultural differences can make a dramatic difference in how one perceives their healthcare experience. Everyone is worthy of quality care and respect. One of the easiest ways to be both a quality care provider and respectful is by being culturally competent. It is our responsibility, as healthcare providers, to ensure that we consider all aspects of the individual while providing excellent healthcare.
References
Andresen, J. (2001). Cultural Competence and Health Care: Japanese, Korean, and Indian Patients in the United States. Journal of Cultural Diversity, 8(4), 109-121. Retrieved from http://web.ebscohost.com
Bonder, Bette, Martin, Laura, & Miracle, Andrew. (2008). Achieving Cultural Competence: The Challenge for Clients and Healthcare Workers in a Multicultural Society. Generations, 25(1), Retrieved from http://generations.metapress.com
Galanti, Geri-Ann. (2008). Caring for Patients from Different Cultures. Philadelphia, Pennsylvania: University of Pennsylvania Press.
Purnell, Larry D., & Paulanka, Betty J. (2008). Transcultural Health Care: A Culturally Competent Approach. 3rd Ed.: Philadelphia F.A. Davis Company.
Shinto. (2008, May 31). Retrieved from http://www.japan-guide.com