Assignment: culture table

General Overview of Chosen Culture

The Hmong cultural group resides in the mountainous regions of Vietnam, Laos, Thailand, and China. According to Stuart, Cherry, and Stuart (2011), “there are approximately four to five million Hmong, with about three million living in China” (p. 89). While geographically located on the continent of Asia, this culture is very unique and different from other Asian cultures. The Hmong language is very expressive and comprised of two main dialects: Green Hmong and the more common, White Hmong (Owens, 2007). About 60% of the estimated 300,000 Hmong population living in the United States speak fluent English (Stuart et al., 2011, p. 90).

Stuart et al. (2011) describe Hmong families as large, with the oldest male considered to be the head of the household and decision-maker for the entire family unit. Stuart et al. also reported that marriages are often arranged, divorce is generally not accepted, and the elderly remain living with family members their entire lives. Owens (2007) reports that Hmong males are considered to have higher status than females, and it is common for wealthier men to have several wives. According to Owens, the people of this culture identify themselves according to a social structure involving clans, and typically marry outside of their own clan.

The diet of this culture is predominantly rice, noodles, vegetables and cooked or boiled meat (Stuart et al., 2011). Animal sacrifice is a common ritual practiced by the Hmong, and provides meat for spiritual meals and rituals for healing (Stuart et al., 2011).

The spirituality and religious practices of the Hmong culture seem to vary among the family lineages and are passed from one generation to another through oral tradition (Owens, 2007). Traditionally, Hmong people are polytheistic and practice animism, a belief that spirits inhabit inanimate objects (Owens, 2007). They believe that Shamans communicate with spirits that are able to give guidance on health and healing (Owens, 2007; Stuart et al., 2011). Stuart et al. (2011) report that most believe in reincarnation and that ancestral spirits return through births of new family members.“Almost all aspects of traditional Hmong life are affected by contact with supernatural beings” (Owens, 2007, Religious Life Section, para. 4). Owens (2007) reports that people of this culture perform many rituals for the purpose of accomplishing the will of the ancestors and natural spirits. If the ancestors are pleased, protection of the believer’s descendants from illness and natural disasters will result (Owens 2007).

The Hmong people prefer to communicate with others of the same gender, avoid direct eye contact (considered rude), and do not tend to trust translators or interpreters (Stuart et al., 2011). It is common for older people within this culture to not be able to read or write any language, including their own (Stuart et al., 2011). Owens (2007) states that Hmong patients may respond with “yes” even when they disagree with what is being said to them.

Common physical conditions associated with this culture are asthma, respiratory disease, diabetes, kidney disease, and obesity (Stuart et al., 2011). Owens (2007) reports the frequent use of herbal remedies and healing rituals performed by Shamans to address physical and mental symptoms

Values and Beliefs that Impact Health Care

· It is common not to express pain.

· Modesty is important and same-sex caregivers are preferred.

· Placentas are often buried so that a person’s spirit can locate it later.

· They do not discuss death and dying. Terminally ill are referred to as “tired.”

· Buttons, zippers, jewelry, or any metal on clothing cannot be on the body after death as this inhibits the soul from traveling.

· Organ donation is not accepted.

· Pregnant women may ask a Shaman to tie an amulet around the abdomen to protect her from evil.

(Stuart et al., 2011)

· Illness may be perceived as a result of an evil spirit or unhappy ancestor.

· Invasive procedures may cause a soul “loss.”

· They want to dress the dying in nice clothes for proper entrance into the next world.

· People that are sick prefer only warm or hot foods. This includes new mothers who typically eat only warm foods for 30 days.

· Surgery is to be avoided.

· Traditional Hmong elders do not want anyone to touch their heads.

· They prefer that the top of the head of a child not be touched.

· Praising a newborn may cause harm from evil spirits.

(Owens, 2007)

Nursing Approaches and Considerations

· It may be important for family to take a dying patient home in order for the soul to reincarnate properly at the time of death. Allow family to clothe the body in attire that this culture requires at the time of death.

· Refrain from complimenting or staring at small Hmong children out of respect for their belief that harm might come to the child. Direct questions and discussions to parents of a pediatric patient. Allow children to keep amulets or protection strings (worn around the neck) out of respect for cultural practice.

· Consider that individuals will suppress exhibits of pain and will most likely not request pain medication. Be mindful of pain medication schedules and offer prescribed doses in a timely manner to provide comfort and relief.

· Communicate any dietary requests and needs. Make warm foods and liquids available for patients (especially post-partum).

· Honor the emphasis the Hmong patients have for modesty and encourage same-gender caregivers when possible.

Spiritual Care

Establishing trust between the caregiver and Hmong patient is the first step in providing compassionate and supportive care that is respectful of the individual’s values and beliefs.The nurse must be respectful of rituals and spiritual practices that the patient and family members choose for comfort and strength. When patients and families are open to prayer, this must be explored and initiated by either the nurse or someone that the family members are comfortable with.

The patient of this culture may perceive that his or her condition or illness is a result of disapproval or anger from the spiritual world (Owens, 2007). As a result of this perception, symptoms of guilt, fear, or depression may be observed in the Hmong patient. These feelings may need to be addressed with good listening skills and non-judgmental approaches by healthcare providers. Alternative reasons or factors for illness and disease would need to be emphasized with the patient and family.

Nurses may have the opportunity to offer hope and a sense of peace to Hmong patients that face uncertainty at the end of life, and yet are not comfortable talking about death with family members within this culture. Even though the biblical worldview does not support the idea of reincarnation, the Christian nurse must be prepared and ready to share the anticipation for one’s soul to experience eternal life made possible through belief in a Savior, Jesus.

General Overview of Chosen Culture

Use this space for a 4-paragraphnarrative describing the characteristics of your chosen culture. This may include geographical and demographic information, predominant worldview,religion and spirituality, language, family roles and social structures, and traditions or customs.

Values and Beliefs that Impact Health Care

· Bullet values and beliefs associated with health, including end-of-life considerations (i.e. illness, suffering, death and dying, nutrition, childbirth, pain, mental illness, sexuality,etc….).

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· One citation may be used at the bottom of each bulleted list in each cell. Additional lines may separate lists if more than two sources are cited.

Nursing Approaches and Considerations

· Briefly describe a minimum of fivehealthcare approaches and/or considerations that are unique to this chosen culture.

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Alignment to Christian Worldview

Use this spacefor a 3-paragraph narrative discussing an effective approach for providing spiritual support and care from the Christian worldview.