The people of Japanese origin have quite independent healthcare perceptions that caregivers must understand to deliver quality treatment options and care procedures. This implies that healthcare professionals must consider autonomy and accountability to avoid possible malpractices during care delivery. Therefore, this will facilitate early diagnosis of illnesses, especially in cultures that rely on tolerance to self-indulgence. On a global perspective, doctors should develop competency through effective communication and sensitize patients on dietary practices to help distinct cultures receive topnotch care. This will improve sensitivity to drugs and boost fertility rates in Japan, whose population is current dwindling. Furthermore, international citizens should design their name cards bilingually, especially when attending conferences in China. This helps in creating positive acculturation and communication patterns involving cycles and interrelationships that favor everyone. Notably, the Chinese have a unique culture involving stoicism despite mental complications that cause emotional and nervous disorders. Generally, although the Japanese and Chinese cultures have various differences regarding diets and fertility rates, they hold a common view regarding death.
A. Japanese Case Study #1
1.
Cross-cultural misunderstanding will arise when Mother Shimizu is placed in a church-related life-care community in the US. The different perceptions, values, and beliefs in the new cultural context of care will contradict the expectations, preferences, and attitudes of the patient (Purnell & Paulanka, 2008). Therefore, the caregiver’s failure to recognize both the Japanese interdependent healthcare perceptions and US’s egalitarian contexts of care will compromise the understanding of Shimizu’s illness, treatment, and care procedures; and eventually conflict.
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2.
The international family has cultural, religious, and medical resources. For example, the family has Japanese employees in North American healthcare institutions that will adhere to the legal and professional obligations regarding patient autonomy and accountability when reporting, solving, and documenting problems. This will reduce medical malpractices. Additionally, the Confucian belief in education is a spiritual resource that will improve interpersonal relationships and loyalty among Japanese employed abroad.
3.
The Japanese health-seeking behaviors and beliefs may account for the late diagnosis of glaucoma. For example, the underlying behaviors that highly recognize tolerance to self-indulgence may curtail early diagnosis of the diseases. Additionally, their beliefs do not permit verbal expression of their feelings, which is a way of caring for the other family members nonverbally. Therefore, such beliefs may worsen Ken’s condition, resulting in late diagnosis of the disease.
4.
Mother Shimizu will be forced to carry her Japanese health insurance since she works for neither American institutions nor companies. Consequently, Marianne may be burdened by increased Medicaid spending related to the provision of long-term care services. Additionally, Shimizu may require local community assistance while seeking care in America due to her poor verbal English skills that may impede clear communication and her needs may not be known.
5.
Marianne is inclined to some American dietary practices that involve the consumption of foods with higher fat and carbohydrate contents. In addition to poor Japanese diets, which rarely include milk products due to lactose intolerance, Marianne usually took unbalanced diets during her stay in Japan. Such foods perpetuate obesity and heart disease due to increased sodium intake, excessive alcohol consumption, and overuse use of food additives and soy sauce.
6.
Ken is countercultural because he is already married and still stays with his mother, a cultural issue that promotes mother-son incest in Japanese society (Purnell & Paulanka, 2008). Although Mother Shimizu is supportive of the couple, staying with together is a deviation from the mainstream cultural norms. Again, the mother should run the home and demonstrate responsibility for their children, but staying with them after age 18 is prohibited.
7.
Marianne faces the pressure related to the task of cooking meals for Ken while at the same time has to care for her three children who have established their careers abroad. Therefore, her frequent visits to America to check on the children and for medical checkups do not allow her to satisfy her husband, Ken, back in Japan. Consequently, the vicious cycle of motherhood mounts significant social pressures on her.
8.
When Marianne starts residing with Mother Shimizu and her three children in America, Ken will feel that he has failed as a husband in taking responsibility to raise a family. Marianne will have become more individualistic and egalitarian, taking care of the children and Ken’s mother. Again, Ken will experience hikkikomori , mostly due to his glaucoma conditions that compel him to stay indoors; hence, preventing him from meeting the needs of both the mother and his wife.
9.
The fertility rate in Japan is only 1.4 births per woman annually. However, the country’s crude mortality rate is 10.3 per 1000 individuals while the average life expectancy at birth is 83.6 for both sexes (United Nations, 2017). Similarly, the US has a fertility rate of 1.8, which is nearly the same as that of Japan. Conversely, the US has a lower death rate of only 8.3 per 1000 people as compared to Japan (United Nations, 2017).
10.
Native Japanese do avoid eye contact with strangers. This is so because they believe that maintaining sustained eye contact with novelty individuals is a sign of rudeness. They usually look at the stranger’s eye and then away or even down before looking again. However, Americans maintain eye contact with both strangers and friends as a sign of friendliness and trust.
11.
The Japanese people are more sensitive to beta-blockers, psychotropic drugs, and alcohol than many white populations (Purnell & Paulanka, 2008). This may be due to their poor abilities to metabolize mephenytoin and other associated medications. Additionally, they have greater sensitivity to benzodiazepines like diazepam and neuroleptics (Purnell & Paulanka, 2008). Therefore, the prescription of such drugs should involve lower doses in regards to the patient’s body mass since they can only metabolize acetylate substances like tranquilizers and caffeine.
12.
Most Japanese obtain calcium in foods like dairy products that include milk, cream, cheese, butter, and yogurt. However, they mostly prefer reduced-lactose milk and low-fat milk due to the aforesaid lactose intolerance among a greater percentage of the population. They also obtain abundant quantities of calcium from foods like soybean curd ( tofu ) and some unboned fish (Purnell & Paulanka, 2008). However, calcium is strictly lacking in water supplies because fluoridation is prohibited.
B. Chinese Case Study #1
1.
It is imperative to design your name card bilingually even if you were to attend a business meeting of English-speaking professionals. This implies that the card should be dual-sided with English print on one side and Chinese on the other. However, the Chinese side should contain simplified characters that are characteristic of mainland China, Singapore, Malaysia, and Indonesia (Purnell & Paulanka, 2008). Notably, the family name should appear first then followed by the given name; although it is also important to include titles when referring to Chinese.
2.
Chinese healthcare providers tend to keep time for scheduled meetings due to their faster adaptation strategies to workplace culture and norms. Their ability to acculturate as fast as possible makes them fit the new cultures and you can expect them to be on time for proposed meetings. Again, their adherence to Guanxi promotes trust and uprightness that help in timing meetings and establishing strong relationships and building networks (Purnell & Paulanka, 2008).
3.
Some healthcare meetings involve serving traditional Chinese meals like peanuts and soybeans. Also, grains are common in those diets since maize, wheat, sorghum, and rice steamed with vegetables and meats are rarely absent. However, noodles and fried eggs may as well be served with a variety of meat choices like pork, fish, and chicken, which are significant sources of proteins (Purnell & Paulanka, 2008). Before-dinner toasts may as well be presented to business colleagues, interspersed with speeches; and are usually accompanied by chopsticks, holders, small plates, and glasses in addition to finger towels for messy foods like Beijing duck. Personally, if the Chinese serve raw fruits and vegetables, I would not eat it. This is because such raw foods are potential sources of contamination due to unsanitary conditions in the country.
4.
According to Chinese, life is a series of cycles and interrelationships that get their meanings from your perceptions on how you live it. They view life depending on past experiences with themselves, what happened to others, and the interrelationships between those past events (Purnell & Paulanka, 2008). Therefore, adversity is a source of strength because they regard either current or past antagonistic phenomena as important in foretelling what the future holds. Similarly, the Western meaning of life focuses on the interrelationships between family’s resources, financial, emotional, and physical resources that dictate goal setting and performance appraisal (Purnell & Paulanka, 2008). However, it Chinese ways of thinking differ from the Western ways in that; the latter is based on mental capabilities to solve client problems.
5.
Chinese male lifestyle involving smoking is a serious health risk responsible for the development of chronic obstructive pulmonary disease (COPD). This is because continued exposure to irritating cigarette gases from the smoke result in breathing difficulties, coughing, and wheezing, which eventually cause lung inflammation and airflow obstruction (Kant & Gupta, 2008).
6.
Mr. Li took quite long before entering the hospital due to the existing Chinese cultural communication patterns. For example, even though his condition was worsening and could not communicate effectively, his confidantes had not developed trusting relationships with healthcare providers. This is why both the wife and daughter-in-law did not share information freely until his son developed close ties with caregivers.
7.
Yes. Mr. Li is of Chinese origin, and it is in their best interests not to display emotions even in exasperating situations (Jeffreys, 2016). This might be the probable reason why he was always a quiet patient who never called for help despite the detrimental chest pain whilst in the intensive care unit.
8.
True. This is because the Chinese family goals and priorities focus on Confucian teachings that greatly value relationships among family members. This is important to maintain the filial loyalty to the family, a concept that forces most families to try anything possible to see one of them getting quality healthcare services (Purnell & Paulanka, 2008).
9.
The physician must be careful with the quantities of medications ordered because Chinese have poor metabolism of mephenytoin like diazepam and higher sensitivity to beta-blockers like propranolol (Purnell & Paulanka, 2008). Therefore, being careful will reduce sensitivity to atropine that may increase heart rates among patients.
10.
Mrs. Li acts rudely brief to her daughter-law because she tries to nurture the latter to maintain the family reputation. However, the daughter-in-law finds discomfort with her traditional mother-in-law because of the demanding and strict rules of Chinese society. She fails to adhere to them and Li’s wife is too demanding on her due to her US descent.
11.
The blames were due to the change from the typical Chinese diet that contains little sweets to Western food with excess sugar on his visit to the city, where the young couple lived. Mr. Li meditates about Tai chi, an exercise that would balance his rhythmic breathing in relation to an external body, internal body, and the environment (Purnell & Paulanka, 2008).
12.
Mr. Li’s stoicism during dying is not surprising because Chinese do not display emotions and they do avoid assistance towards emotional and nervous disorders even amidst fatal experiences. The family refuses to discuss his health and death because they believe that something good will happen to Mr. Li after dying.
13.
Handling the remains of a deceased Chinese requires mourners to tie black armbands on their left arms while white cloth strips around the head.
14.
Chinese mourning rituals usually involve ancestor worship as a way of paying respect to the lost souls. Caring for the grave and worshipping the memory of the deceased is a ritual meant to bring peace to the dead spirits. Also, honoring the dead involves surrounding the coffin with money, food, and other related objects to signify the deceased’s spirits (Purnell & Paulanka, 2008).
15.
Bereavement in a Chinese family involves hiding overt emotions from strangers to harmonize the vicissitudes of fortune, pain, and pleasure. Therefore, the bereavement period is ideal for planning for the future.
16.
Almost all Chinese hold a common view that death is a natural cycle of life and that everyone of their descent must pass through it. This belief affirms their stoic impressions about death.
Conclusion
The higher fat and carbohydrates contents in Japanese diets perpetuate obesity; and are the major contributing factor to the country’s declining populations. However, lifestyle involving smoking and alcohol consumption equally results in heart disease and further increases incest among mothers and their sons. Although the Chinese culture and lifestyle also increase COPD, their diets are quite healthy and promote a positive population growth. The Chinese view death as an event that strengthens their faith and the bereavement period is ideal for planning for future accomplishments.
References
Jeffreys, M R. (2016). Teaching Cultural Competence in Nursing and Health Care. Inquiry, Action, and Innovation (3 rd ed.). New York: Springer Publishing Company. http://lghttp.48653.nexcesscdn.net/80223CF/springer-static/media/samplechapters/9780826119964/9780826119964_chapter.pdf
Kant, S. & Gupta, B. (2008). Role of Lifestyle in the Development of Chronic Obstructive Pulmonary Disease: A Review. Lung India , Vol.25, issue 2, pp. 95–101. Indian Chest Society. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822328/
Purnell, L. & Paulanka, B. (2013). Transcultural Health Care: A Culturally Competence (4th ed.): Philadelphia: F.A. Davis.
United Nations. (2017). World Mortality 2017: Economic and Social Affairs. https://www.un.org/en/development/desa/population/publications/pdf/mortality/World-Mortality-2017-Data-Booklet.pdf
