Cultural competent care
Lee and Weise (2009)
When East Meets West: Intensive Care Unit Experiences Among First-Generation Chinese American Parents
The Journal of Nsg Scholarship 41 (3), 268-275.

This was a qualitative and phenomenological study with a convenience sample of 25 first-generation Chinese American families, with infants hospitalized in the ICU's of three San Francisco area teaching hospitals.

There were many stressors noted for both fathers and mothers of these hospitalized infants. The seven themes were identified to be unique in this sample: perceived incompetence, self blame, blame from others, filial piety, lack of support in US, communication issues and cultural differences.

This study was designed to help health care workers to provide culturally competent care and to understand Chinese American parents' perceptions while their infants are hospitalized in the ICU. I believe many of these themes can be carried over to the care of adult Chinese American patients and their families.

Almost all of the parents demonstrated perceived incompetence: they lacked confidence in taking care of their sick children and considered themselves "stupid" or not as intelligent as the nurses taking care of their infants. They felt helpless and frustrated.

Many mothers and fathers demonstrated self-blame, they felt that they caused the preterm labor or medical condition that plagued their infant. One mother felt that she consumed too many cold foods during her pregnancy, Asians often follow a strict diet during their pregnancy consisting of hot foods only. The one father blamed himself because of his career choice as a chemist: that the toxins he exposed himself to harmed his infant.

Blame from others came from extended family members and spouses. Mother-in-laws would blame their daughters-in-law for not following a traditional diet during her pregnancy, thus causing the infants illness. One husband blamed his spouses hypothyroidism and hypertension for their child's illness. One infant had a skin tag on his ear, the father blamed the mother for the defect: she ate too many pig ears during her pregnancy.

Many first generation Chinese Americans do not have any support in the US. Their families are all over seas. Even if they do have close family in the US, the to not utilize it because of filial piety. It is taboo to cause their elders stress or worry. Communication barriers with lack of fluency in the English language is another issue. This can lead to miscommunication of a medical diagnosis and treatment.

Cultural differences were another obstacle. In the postpartum period the mothers are not supposed to cold air and need to consume hot foods only. One father reported elevated stress levels because he was expected continue performing his duties at work, at home, and to his spouse who spent much of her time in the NICU visiting their infant. He had to drive across town everyday to obtain a live chicken from Chinatown, bring it home to his mother-in-law to prepare, they bring it across town again to the hospital for his postpartum wife to consume.

This is an abbreviated summary of a very interesting piece of research. I recommend that you read this article in it's entirety if you get the chance.