...Cultural and clinical issues in the care of Asian patients s A B S T R AC T Special problems of Asian patients have considerable impact on diagnosis and treatment, and the number of persons of Asian ancestry seen in primary care in the United States is increasing. Knowledge of how to provide optimal care despite language barriers, low socioeconomic status, different health beliefs and practices, and medical issues unique to this heterogeneous group is crucial to competent health care. with Asian patients include language barriers, low socioeconomic status, traditional health beliefs and practices, and epidemiologic issues. This article presents three case studies that illustrate how these problems can affect the health care of Asian patients, and describes ways to deal with them constructively. We also discuss what diseases are more common and what conditions have unique clinical aspects in this population. Asians: The fastest-growing minority Asians and Pacific Islanders are the fastest growing ethnic minorities in the United States, and are predicted to number more than 17 million by 2010.1 This heterogeneous population is from many cultures and speaks many languages—the 1990 US Census identified 25 distinct Asian ethnic groups (TABLE 1).2 Due to space limits, this article focuses on cultures more populous in the United States: East Asian (China, Japan, Korea) and Southeast Asian (Vietnam, Cambodia, Thailand), but recognizes that cultures differ widely within and among these countries...
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...Promoting Cultural Sensitivity A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos U.S. Department of Health and Human Services Centers for Disease Control and Prevention Hla dej yuav hle khau; Tsiv teb tsaws chaw yuav hle hau. “When you cross a river, take off your sandals; when you emigrate from one country to another, take off your hat.” –Hmong Proverb Promoting Cultural Sensitivity A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos Female elder. © Frank Carter. U.S. Department of Health and Human Services Centers for Disease Control and Prevention 2008 For Additional Information For more information or for a list of available guides, please contact: Division of Tuberculosis Elimination National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention 1600 Clifton Road, NE, Mailstop E-10 Atlanta, GA 30333 Phone: (404) 639-8120 Web site: http://www.cdc.gov/tb Suggested Citation Centers for Disease Control and Prevention. (2008). Promoting Cultural Sensitivity: A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos. Atlanta, GA: U.S. Department of Health and Human Services. 2 Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Intended Audience . . . . . . . . . . . . . . ....
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...Tuberculosis (TB) is an infectious disease that usually infects the lungs, but can attack almost any part of the body. Tuberculosis is spread from person to person through the air. When a person with TB in their lungs or throat coughs, laughs, sneezes, sings, or even talks, the germs that cause TB may spread through the air. If another person breathes in these germs, there is a chance that they will become infected with tuberculosis. It is not easy to become infected with tuberculosis. Usually a person has to be close to someone with TB disease for a long period of time. TB is usually spread between family members, close friends, and people who work or live together. TB is spread most easily in closed spaces over a long period of time. If it is not treated, TB can be fatal. But TB can almost always be treated and cured if you take medicine as directed by your healthcare provider. Once you begin treatment, within weeks you will no longer be contagious. That means you can't spread the disease to others. If you take your medicine just as your healthcare provider tells you, all the TB germs should be killed. Tuberculosis, MTB, or TB (short for tubercle bacillus) is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis.[1] Tuberculosis typically attacks the lungs, but can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or...
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...Health Promotion Among Diverse Populations: Asian Americans Courtney Rasmussen Grand Canyon University February 15, 2015 In 1849, the Chinese were some the first ethnic group that many refer to as Asian Americans and later as Asian American/Pacific Islanders (AAPI). (Kem B. Louie, 2001) “Asian” however, refers to a very diverse group of people that come from over fifty (50) different countries, that speak more than one hundred (100) different dialects, which practice a broad range of different religions, and lead a variety of lifestyles. People from as far east such as Southeast Asia, Thailand, Vietnam, the Philippine Islands, Japan, the Indian subcontinent including for example Cambodia, Indonesia, China, Korea, Pakistan, Nepal, Taiwan, and Malaysia. (Office of Minority Health and Health Equity, 2013) Asian Americans are often stereotyped as the “model minority,” and are perceived to be in tiptop health and have financial security. Therefore, their health concerns are often overlooked or quite frankly, often times, a language barrier is what stands between them and their health. Heart disease and Cancer are the leading causes of death in AAPI. (Office of Minority Health and Health Equity, 2013) And, approximately two million AAPI are uninsured in this country. While AAPI’s are less likely to live in poverty and more likely to graduate from college and have a management position, there remain still, several startling health disparities for this population of people. (Office...
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...Description Causes Tuberculosis is caused by the bacteria tubercle bacillus or mycobacterium tuberculosis. The bacteria was discovered by a microbiologist Robert Koch in 1882. Transmission When a person who is infected with TB exhale, sneezes, cough, speaks or sings tiny droplets of fluid containing tubercle bacilli are released into the air. The mist, or aerosol is inhaled through the nasal passage. The bacteria can stay in the air for several hours. A fetus can be infected with tuberculosis by inhaling or swallowing the amniotic fluid of an infected mother. Once inhaled tubercle bacilli reach the alveoli and are spread by the lymph vessels to nearby lymph nodes. The bacilli moves through the blood vessels to distant organs. They may become inactive or latent or they may cause the active disease. The tissue damage is caused by the reaction of the person’s tissue to its presence. After several weeks the host develops an immune response to the bacilli, cells attack the bacilli and permit the initial damage to heal and prevent future disease permanently. Being infected with the bacteria does not mean that the person is contagious or ill. They might have symptoms of the disease. The chest x-ray will remain negative. However they can become ill after many years. Symptoms The symptoms of Tuberculosis disease are weight loss, fever, night sweats, coughing, chest...
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...Epidemiology, Tuberculosis, and the Homeless Population Rebecca J Buck NUR 408 July 29, 2013 Felita Patterson Epidemiology, Tuberculosis, and the Homeless Population Among many misconceptions, tuberculosis is not a disease of the past. Tuberculosis remains a public health issue. It is estimated that one-third of the total world population is infected by tuberculosis (TB). The American lung association (2013) states, in 2011 alone there were nearly 9,000,000 new diagnosed cases of tuberculosis around the world and an estimated 1.4 million deaths because of this disease. In the United States, TB is not as common (but still a problem). In 2011, only 10,500 people reported having TB (Trends in Tuberculosis Morbidity and Mortality). Research shows that there are many preceding factors that predispose a person and increase the risk of contracting TB. Epidemiologists have studied and determined that many of these preceding factors are evident in vulnerable populations around the world, particularly the homeless population. The science Daily (2013) reports that “one in five homeless people with tuberculosis die within a year of their diagnosis” (Death Rate from Tuberculosis in Homeless Alarmingly High). In addition to the high death rate for TB among homeless people, public health officials also recognize a growing threat of drug resistant strains within these vulnerable populations. Theses drug resistant strains of tuberculosis require longer, more consistent treatments...
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...Tuberculosis Connie Todd Grand Canyon University – NRS 427 November 28, 2015 Tuberculosis How can we control the spread of tuberculosis, throughout our world? “As one-third of our world’s population is thought to have been infected with tuberculosis (TB), new infections are reported in at least 1% of the population each year” (Wikipedia, 2015, p. 1). In 2013, an estimated 1.5 million deaths associated with TB have occurred. Most of which are from under developed countries across the globe (World Health Organization, 2015). As this number has been decreasing, too many have been infected. The largest concentration is seen in the Asian and African countries, at 80%. While in the United States, 5-10% of the population test positive. With tuberculosis following second behind HIV/AIDS in most common deaths from infectious disease, it has become a worldwide discussion. Understanding the history, recognizing the signs and symptoms, various treatment options, and prevention, will help bring this epidemic to a level of control. Since the start of time, tuberculosis has been present. Earliest unambiguous evidence of the disease have been dated around 17,000 years ago, in remains of a bison in Wyoming. Prehistoric skeletal human remains have been detected as far back as 4000 BC. With tubercular decay in an Egyptian mummies dating 3000-2400 BC and the Americas in about 100 AD. “As first established as a pathology by Dr. Richard...
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...Tuberculosis Epidemiology and Chain of Infection Communicable diseases occurring throughout worldwide communities raise public health challenges and demand the attention of health agencies on a global scale. Disease control is a complex issue which requires intervention on the environmental and behavioral level by health agencies and caregivers including public health nurses. Providing primary, secondary, and tertiary methods of prevention are necessary in the interruption of the chain of infection and protection of populations from communicable diseases. Tuberculosis is a deadly disease occurring in one third of the world’s population, infecting nine million people in 2013 and leading to over one million deaths (Centers for Disease Control and Prevention [CDC], 2015). Community health nurses play an integral role in the fight against tuberculosis by providing immediate and follow up care to affected individuals, assisting in research and investigations to combat the disease, and educating communities about early detection, treatment, and prevention. Tuberculosis (TB) is a potentially fatal infection commonly caused by a strain of bacteria called Mycobacterium tuberculosis (Maurer & Smith, 2013). In the most familiar presentation, the lungs are affected, but the bacteria can also infect the kidneys, lymphatic system, brain, and spine (Maurer & Smith, 2013). The disease can manifest in latent form in which an individual is not infectious and cannot...
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...Cultural Views on Health HCA/230 November 21, 2010 Introduction The largest subgroup of Asian Americans is Chinese Americans. The United States Census Bureau (2000) reported that 22.6% of all Asian-Americans are of Chinese descent. Another culture’s population that is quickly increasing is natives from India. Approximately, 8.7 million Indian natives live in the United States. Both of these cultures are dominant in the United States and share similar health views. Chinese Americans Often, Chinese Americans access to health care and other services is denied because of discrimination. Even with Chinese Americans having the highest tuberculosis and suicide rates in the United States, access to health care becomes difficult because of language barriers, cultural conflicts, and attitudes toward illness. Because of these barriers, most Chinese Americans rely on traditional Chinese herbal medicine. There are several agencies such as the Richmond Maxi Center, located in the Richmond district of San Francisco and the Asians for Community Involvement in the Silicon Valley of California that were established to meet the needs of Chinese Americans and other Asian Americans. Today, both Chinese and Western medicines are widely used by Chinese Americans, although some use exclusively Chinese medicine while others only Western medicine. Traditional Chinese health beliefs include adopting a holistic view while emphasizing the importance of environmental factors in increasing...
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...Health disparities are believed to be the result of the complex interaction among genetic variations, environmental factors, and specific health behaviors. Compared with other Americans, Indians experience disproportionately high mortality from alcoholism, tuberculosis, diabetes, injuries, suicide, and homicide. Tribal leaders report that diabetes, unintentional injuries, alcoholism, and substance abuse are rising to crisis proportions in American Indian and Alaska Native communities | Asian | Lack of access to regular care. Asians are least likely to report having a personal doctor compared to other racial and ethnic groups in the US. 19.4 % of Asian adults compared to 12.9% of whites report being without a usual source of health care. Cambodians and Vietnamese are three times more likely to forgo visiting a doctordue to cost compared to all Asians or US residents.• Less satisfaction with care. Compared to other racial and ethnic groups, Asians are least likely to be satisfied with the speed of their care, doctor-patient communication, and office staff.• Fewer preventive services. Asians are less likely to have blood pressure monitoring and pap smears. In fact,cervical cancer screening rates are significantly lower among Asian women in California compared to the general population. Only 60.5% of Vietnamese women reported receiving a pap test in the past three years compared to 86.2% of all women in California.• Poorer quality care. Native Hawaiians and other Pacific Islanders...
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...Epidemiology Paper on Tuberculosis Tuberculosis (Mycobacterium tuberculosis), also known as TB, is a disease spread by respiratory inhalation of droplets that contain the bacteria. Tuberculosis is an ancient disease that has been traced back at least 9000 years. In 1882, Dr. Robert Koch was the first physician to describe Mycobacterium tuberculosis as the germ responsible for tuberculosis. However, treatment that was evidenced based was not put into practice until the 20th century. It is estimated that 2 billion people around the world are infected with the TB bacteria. Approximately 5 to 10 percent of these infected people will actual develop active TB and experience the life-threatening symptoms of the disease. Tuberculosis remains a deadly infection around the world claiming 1.7 million lives per year. TB is generally recognized as a respiratory disease but can also attack the brain and spine, circulatory system, gastrointestinal and genitourinary systems as well as the skin, bones and joints. (Furlow, 2010) The groups of people in the United States that are at risk of developing tuberculosis are those infected with HIV, the homeless, prisoners, poor individuals who live in urban areas, minorities such as African American’s, Hispanics and Asians. Healthcare workers are also at risk in the US and around the world. Countries outside of the US hardest hit by TB are in Asia and sub-Saharan Africa. Rates for infection among American born individuals has...
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...Health of Asian Americans Professional health care in the United States is faced with many challenges when working with people of different cultures. One of the challenges is developing and practicing standards for different minority groups that are culturally sensitive, competent and can adhere to the appropriate nursing care around the globe. The basis of the existence of any state is to maintain the health of everyone. The criteria for human health among minority groups are different, but all share the happiness and joy of life, which is the beginning of health and longevity. The Asian Americans represent one of the minority groups in the United States that has its own cultural, biological, socioeconomic, education and sociopolitical barriers to health. According to Centers for Disease Control and Prevention (CDC) (2013), the population of Asians, including those of more than one race in 2011 was estimated at 18.2 million in the United States population. The three largest Asian groups in the United States in 2011 were Chinese with the estimate of 4 million people, Filipinos - 3.4 million people, and Asian Indians - 3.2 million people (CDC, 2013). The Census Bureau projects that by the year 2050, there will be more than 40.6 million Asians living in the United States, which will represent more than nine percent of the total U.S. population (CDC, 2013). Based on these numbers it is important for health care providers who are facing rapidly growing racially and ethnically...
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...Asian Indian Culture and Tradition NURS236: Transcultural Nursing March 29, 2016 According to the U.S. census, there are over 1.6 million people of Asian Indian origin in the United States. Asian Indians began immigrating to the U.S. as early as the turn of the 20th century. Most found work in agriculture working on farms. Between 1980 and 1990, the population of Asian Indians in the U.S. increased by 125%. Due to family reunification laws, the number of Asian Indian elders who followed their offspring to this country has also risen (India, 2015). There are now two major groups of Asian Indians, those who came to U.S. in the late 1960’s and early 70’s, and the group who came much later. According to the 1990 Census data, there were approximately 23,000 Asian Indian elders over the age of 65; 83% are foreign born and 51% do not speak English very well. Only 12%, however are classified as linguistically isolated (without an adult who speaks English in the household) – the smallest of any Asian ethnic group (India, 2015). Older Asian Indian immigrants are often financially dependent on their children. They face the challenges of a culturally different society, such as a language barrier, culture mismatch, new lifestyle factors, and role reversal. In traditional Indian society, extended family members usually live together as a single-family unit. Often, the husband's parents will join the family after they have retired or when help is needed. The grandparents' role in raising...
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...a.|Race| b.|Culture| c.|Ethnicity| d.|Social group| ANS: B Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of mankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups. PTS: 1 DIF: Cognitive Level: Remember REF: 44 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Psychosocial Integrity 2. Which term best describes the emotional attitude that one’s own ethnic group is superior to others? a.|Culture| b.|Ethnicity| c.|Superiority| d.|Ethnocentrism| ANS: D Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed...
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...Health Promotion Among Asian Americans Robert Ramirez Grand Canyon University: NRS-429V Family-Centered Health Promotion February 22, 2015 Health Promotion Among Asian Americans The U.S. Public Health Service defines health promotion as “the process of advocating health in order to enhance the probability that personal, private, and public support of positive health practices will become a societal norm” (Edelman, Mandle, & Kudzma, 2014). Health is a basic human right; optimal health is a well-balanced structure of emotional, physical, spiritual, psychological, intellectual, and social well-being. The purpose of health promotion in nursing is to increase health knowledge that will in turn positively influence health behaviors of individuals and communities (Foster, 2012). Roughly 36% of the U.S. population is made up of various ethnic or racial minorities. Of that 36%, 4.8% were Asian Americans. According to the Office of Management and Budget, “Asians” consist of people that originate from the Far East, Southeast Asia, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan Thailand, Vietnam, or the Philippine Islands (CDC, 2014). These 14.7 million people are dispersed throughout the country, with Hawaii having the largest concentration (57%) of the total Asian population (CDC, 2014). The CDC (2014) states that minority groups “experience a disproportionate burden of preventable disease, death, and disability compared with non-minorities.” This paper will concentrate...
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