People of Korean Heritage.People of Mexican Heritage.Read chapter 20 and 21 of the class textbook and review the attached PowerPoint presentation. Once done answer the following questions;1. Describe the heritage of the Korean and Mexican people and discuss if there is any similarity in their roots.2. Describe some healthcare beliefs of the Korean and Mexican heritage and how they influence the delivery of evidence-based health care.3. Mention some customs practice by the Korean and Mexican to cure diseases.You must use at least two evidence-based references (excluding) the class textbook. A minimum of 700 words is required.
ch20.ppt
ch21.ppt
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean American Culture
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Overview/Heritage
▪ This presentation focuses on the
commonalities among Koreans from the
Republic of South Korea, although some
information may be congruent with North
Koreans..
▪ The first major immigration from Korea
occurred between 1903 and 1905, when
more than 7,000 men arrived in Hawaii.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Overview/Heritage
▪ South Koreans immigrate to America to
increase socioeconomic opportunities and
improve educational opportunities.
▪ They place a high value on education.
▪ Their reputation for hard work,
independence, and self-motivation has
earned them the label of the “model
minority.”
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Communication
▪ The dominant Korean language, han’gul, was the
first phonetic alphabet in East Asia.
▪ Most Koreans in America can speak, read, write,
and understand English to some extent.
▪ Some Americans may have difficulty
understanding their English, especially those who
learned English from Koreans who spoke with
their native intonations and pronunciations.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ A high value is placed on harmony and the
maintenance of a peaceful environment.
▪ Most are comfortable with silence.
▪ Small talk may appear senseless and
insincere.
▪ Most stand close when conversing.
▪ Touch in the realm of health care is readily
accepted.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ Touching among friends and social equals is
common and does not carry a sexual
connotation, as it might in Western societies.
▪ Hugging and kissing are uncommon among
parents and children as well as among
children and older aunts or uncles.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ Age, gender, and social status determine the
use of eye contact.
▪ Respect for those in senior positions is
shown by not looking them directly in the
eye.
▪ Feelings are infrequently communicated in
facial expressions.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ More traditional Koreans are past-oriented. Much
attention is paid to the ancestry of a family.
▪ Yearly, during the Harvest Moon in Korea, chusok
(respect) is paid to ancestors by bringing fresh fruits
from the autumn harvest, dry fish, and rice wine to
gravesites.
▪ The younger and more educated generation is more
futuristic and achievement-oriented.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ Punctuality is the norm for keeping
important appointments, making
transportation connections, and reporting
to work.
▪ The number of surnames in Korea is limited:
the most common ones are Kim, Lee, Park,
Rhee or Yi, Choi or Choe, and Chung or Jung.
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Korean Communication
▪ Korean names contain two Chinese
characters, one of which describes the
generation and the other the person’s given
name.
▪ The surname comes first.
▪ However, because this may be confusing to
many Americans, some Koreans in the
United States follow the Western tradition of
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles and Organization
▪ Men are the primary financial providers.
▪ Women are expected to stay home and care for
the children and domestic affairs unless they are
professionals.
▪ Women have long been degraded in Korean
society and seen as appendages of male family
members.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles and
Organization
▪ In earlier times, a woman’s identity was
determined by her role as someone’s daughter,
wife, or mother. While many still practice these
gender relationships, more educated women
and men no longer adhere to these Confucian
values.
▪ Parenting in Korea is authoritative, although
class differences play a more influential role in
determining parenting styles and family roles.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles & Organization
▪ Children are expected to be well behaved
because the whole family is disgraced if a child
behaves in an embarrassing manner.
▪ Discussing domestic violence violates Korean
cultural norms.
▪ Dating is uncommon among high school
students, although it is gaining in the US.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles & Organization
▪ Once young adults have entered a university,
they receive their freedom and are permitted to
make their own decisions about personal and
study time.
▪ With rapid acculturation, children often take on
the values of the dominant society or culture
and challenge parents who support traditional
values and ideals.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles & Organization
▪ Parents expect their children to care for them in
old age.
▪ Hyo (filial piety) is the obligation to respect and
obey parents, care for them in old age, give
them a good funeral, and worship them after
death.
▪ The obligation to care for one’s parents is
written into civil code in Korea.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles & Organization
▪ Older people are frequently consulted on
important family matters as a sign of respect
for their life experiences.
▪ Old age begins when one reaches the age of
60 years.
▪ Women who divorce may suffer social stigma.
▪ Living together before marriage is not
customary in Korea.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Family Roles & Organization
▪ If pregnancy occurs outside marriage, it may
be taken care of quietly and without family and
friends being aware of the situation.
▪ Lesbian and gay relationships are frowned
upon.
▪ Personal disclosure to friends and family
jeopardizes the family name and may lead to
ostracism.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Workforce Issues
▪ The skills and work experiences Koreans bring
from their home country are often not accepted in
the American workforce, forcing them to take
jobs in which they may be over skilled.
▪ A supervisor is treated with much respect in work
and in social settings.
▪ Informalities and small talk may be difficult for
Korean immigrants.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
ClickerCheck
An older adult Korean American man does not
maintain eye contact with the nurse who is
teaching him insulin injection. The nurse
recognizes that lack of eye contact means he
a. Does not understand the instructions.
b. Does not care about the instructions.
c. Is demonstrating respect.
d. Is hard of hearing.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Correct Answer
Correct answer: C
Many traditional Koreans do not maintain eye
contact with people in authoritative positions as a
means of demonstrating respect.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Workforce Issues
▪ For an employee to refuse a request of an
employer is unacceptable, even if the
employee does not want or feel qualified to
complete the request.
▪ American slang and colloquial language is
difficult for Koreans to understand.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Biocultural Ecology
▪ Common physical characteristics include dark
hair and dark eyes, with variations in skin color
and hair darkness.
▪ Skin color ranges from fair to light brown, with
those residing in the southern part of South
Korea being darker.
▪ Epicanthal skin folds create the distinctive
appearance of Asian eyes.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Biocultural Ecology
▪ Common health conditions occurring with
Koreans include the following:
schistosomiasis, renal failure, asbestosis,
hypertension, tuberculosis, hepatitis, stomach
cancer, lactase deficiency, osteoporosis,
peptic ulcer disease, and insulin autoimmune
deficiency disease.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean High-Risk Health Behaviors
▪ Korea continues to manufacture and use
asbestos-containing products
▪ Smoking by women in public is taboo, but some
women smoke at home.
▪ Men have a high incidence of alcohol
consumption.
▪ Seat belts are worn infrequently in South Korea.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Nutrition
▪ The traditional Korean diet includes steamed
rice; hot soup; kimchee; and side dishes of fish,
meat, or vegetables served in some variation for
breakfast, lunch, and dinner.
▪ Breakfast is traditionally considered the most
important meal.
▪ Rice is served with 5 to 20 small side dishes of
mostly vegetables and some fish and meats.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Nutrition
▪ Food is flavorful and spicy. Cooking includes a
variety of seasonings: red and black pepper,
garlic, green onion, ginger, soy sauce, and
sesame seed oil.
▪ Most Korean Americans are at high risk for
calcium deficiencies due to lactose
intolerance.
▪ A cultural treatment for the common cold is
soup made from bean sprouts, anchovies,
garlic, and other hot spices
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Pregnancy & Childbearing
Practices
▪ Pregnancy is a highly protected time for women.
▪ Both pregnancy and the postpartum period are
ritualized.
▪ Once a woman is pregnant, she starts practicing
Tae-Kyo, which literally means “fetus education.”
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Pregnancy & Childbearing
Practices
▪ The objective of Tae-Kyo is to promote the health
and well-being of the fetus and mother by having
the mother focus on art and beautiful objects.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Death Rituals
▪ Death and dying are fairly well accepted in the
Korean culture.
▪ Prolonging life may not be highly regarded in the
face of modern technology.
▪ Families are expected to stay with family
members and assist in feeding and personal care
around the clock.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Death Rituals
▪ Many believe that patients should not be told
they have a terminal illness.
▪ Crying and open displays of grief are common
and signify the utmost respect for the dead.
▪ Relatives and friends pay respect by viewing
photographs of the deceased instead of viewing
the body.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Death Rituals
▪ An ancestral burial ceremony follows death,
with the body being placed in the ground facing
south or north.
▪ Rice wine is sprinkled around the gravesite.
▪ The eldest son or male family member sits by
the deceased, sometimes holds a cane, and
makes a moaning noise to display his grief.
▪ The cane is a symbol of needing support.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Spirituality
▪ Organized religions include Christianity,
Buddhism, and Chondokyo.
▪ The church is a powerful social support group for
Korean immigrants.
▪ Christians believe the spirit goes to heaven;
Buddhists believe the spirit starts a new life as a
person or an animal.
▪ Family and education are central themes that
give meaning to life.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Health-care Practices
▪ Herbal medicine may be used in conjunction with
Western biomedicine.
▪ Herbal remedies include ginseng, seaweed soup,
and haigefen (clamshell powder), which has high
levels of lead, causing abdominal colic, muscle
pain, and fatigue.
▪ Acupuncture, acumassage, acupressure, and
moxibustion therapy are commonly used.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Health-care Practices
▪ Some Korean Americans are stoic and are slow
to express emotional distress from pain.
▪ Others are expressive and discuss their
smallest discomforts.
▪ Organ donation and organ transplantation are
rare, reflecting traditional attitudes toward
integrity and purity.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Health-care Practices
▪ Mental illness may be stigmatized. Hwa-Byung,
a traditional Korean illness, occurs from the
suppression of anger or other emotions.
▪ These emotions are expressed as physical
complaints, ranging from headaches and poor
appetite to insomnia and lack of energy.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Korean Health-care Practitioners
▪ More traditional individuals frequently prefer
health-care providers who speak Korean and are
older.
▪ Because of modesty, women prefer women
health care providers to perform Pap smears,
mammography, and breast examinations.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
ClickerCheck
Mrs. Kim brings her 15 year old daughter to the parish nurse
because she is having abdominal cramps and fatigue that
have worsened since she began giving her haigefen. The
nurse should request a blood test for
a. Iron levels.
b. Lead levels.
c. Calcium levels
d. Potassium levels.
Transcultural Health Care: A Culturally Competent Approach, 3rd Edition
Correct Answer
Correct answer: B
Haigefen is an herbal compound that is made with
clamshells which has a high lead content.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Mexican Americans
Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
▪ Mexican, Mexican American, Latino(a), Chicano(a), la
gente de la raza, Hispanic, etc. are commonly used
terms.
▪ Second largest Spanish speaking group in the world
▪ 500+ different dialects and ethnic groups in Mexico
▪ Mexico City is one of the largest cities in the world
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
▪ 60% of the population is mestizo—a blend of
Spanish white and Indigenous Indian
▪ The majority of the Hispanic population in the
United States
▪ Hispanic is the largest “minority” group in the
United States surpassing African Americans in
1999
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
▪ Original inhabitants, along with Native American
Indians, of southwest United States
▪ Majority of newer immigrants come to the United
States for economic opportunities and are poorer
than previous immigrants
▪ Low educational rates in the United States
▪ Ninth-grade educational level required in Mexico
—mean is 5 years
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications
▪ Dialect varies by region of Mexico, including
Mayan
▪ Rapid speech pattern with apocopation (e.g.,
como esta usted = com-esta-sted)
▪ Idiomatic and slang expressions are common—
like English
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
▪ Concepts of personalismo is important.
▪ Touch between the men and between women is
acceptable.
▪ Men and women greet with a hug and kiss to the
cheek.
▪ Eye contact with staring is expected for peers.
▪ Many avoid direct eye contact with superiors as a
sign of respect.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
▪ Intense eye contact can cause the “evil eye,” a
folk illness common in all Hispanic and
Mediterranean cultures.
▪ Children are more susceptible to the evil eye
than are women who are more susceptible than
men.
▪ Healthcare provider should greet men with a firm
handshake.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
▪ Temporality varies via socioeconomic level
▪ Clock time is not categorically imperative; events
begin when they begin and not until then
▪ Name format: First name, middle name, father’s
surname followed by mother’s maiden name.
▪ A woman takes her husband’s last name which is
place before her maiden name..
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles
▪ Traditional families are patriarchal but vary
greatly.
▪ Current research is dispelling the myth of
machismo and patriarchal decision-making.
▪ Children are closely protected and are not
expected to work or do many chores in middleclass families—children are supposed to be
allowed to be children.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued
▪ Children are taught to respect parents, elders,
and teachers, etc.
▪ Multigenerational families in Mexico, less so in
the United States.
▪ Children have comadres, compadres
(godparents).
▪ Single parenting somewhat stigmatized, severely
so in some groups.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued
▪ Significant number of Unido until at which time
the family has the money for a religious wedding
ceremony.
▪ Academic and professional degrees are highly
respected.
▪ A good education also means having good
manners.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued
▪ If family and close friends are aware of
gay/lesbian relationships, they are not talked
about.
▪ Stigma continues to be a significant problem with
many.
▪ Dignity, Hola, and Ellas are support groups and
they all have 800 numbers and are located in
Washington, DC.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
▪ Intestinal parasites and diarrhea are major health
problem among immigrants; also tuberculosis,
STIs, and HIV/AIDS.
▪ Hypertension, cardiovascular disease, diabetes,
malaria, cholera, typhoid, dengue fever, and high
suicide rates. Incidence varies from point of
migration and living conditions.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology Continued
▪ Alcohol metabolism is slowed, especially among
those with an Indigenous Indian ancestry.
▪ Require lower doses of antidepressants and are
poor metabolizers of debrisoquinine.
▪ Greater toxicity from tuberculosis drugs.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
▪ Large percentage of women are overweight—
seen as positive and is a sign of health,
fertility, wealth, and beauty.
▪ Anytime is a time to celebrate with food.
▪ Food choices vary by area of immigration—
mountains, metropolitan areas, seaports, etc.
▪ Staples include tacos and rice and plantains.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Nutr …
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