The Family Members :
Foua Yang, Nao Kao Lee, Lia Lee, Yer Lee
Care Providers :
Merced Community Medical center, Catholic Private Hospital
Actors :
Doctors, nurses, veterinary medicine practitioners, obstetricians, interpreters, Hmong patients, and social workers
Settings/environments :
Lia Lee seizure illness and treatment happened in Merced city in the state of California. Lia Lee, the 15 th child of Lee’s born at a hospital, at the age of three months she began to experiences Seizure and parents took her to Merced Community Medical center. She got misdiagnosed a couple of times due to communication barrier since Lees didn’t understand English until in 1983 when Dan Murphy a family practice doctor who was interested and knowledgeable on issue relating Hmong people, he diagnosed Lia Lee with symptoms aspiration Pneumonia. Lia was put on ampicillin medication twice a day to clear up aspiration Pneumonia and also twenty milligrams of Dilantin elixir medicine twice a day to suppress any future grand mal seizures.
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Child and family stress :
Disruption of family routine, the Lees were worried if in future Lia will heal, developing a feeling of confusion when seeking treatment in western hospitals and pain.
Stressors:
Lia’s Seizures complication
Issues and concerns :
The Lee’s blamed their daughter Yer Lee for slamming the door. They doubted the efficacy of Western Medical techniques and communication barrier,
Strengths :
The presence of doctors like Dan Murphy interested in Issues related to Hmong peop
Possible interventions :
Proper diagnosis of patient illness, prescription of correct medicine along with healthy cooperation between Hmong patients and doctors to provide better treatment
Case Discussion
Note: As you begin, share some examples and your reactions to the family and the doctors/care providers.
Lia’s Seizure treatment in Merced Community Medical center
I appreciate how the Lees were consistent on taking their daughter for treatment in MCMC from when she experienced seizure symptoms. The Hmong culture recognizes people who experience seizures to hold special power and these people end up becoming Shamans who have the ability to see things which normal people can’t see. The Lee family was much worried about their daughter’s health and did not allow tradition or lack of trust in western treatment hold them back from seeking treatment for their daughter. I feel overwhelmed by how the MCMC caregivers were willing to provide better health care services to Hmong people despite the language barrier and cultural difference an example is Dan Murphy a family practice doctor who was interested and knowledgeable on issues relating to the Hmong people, and he successfully managed to treat Lia Lee case.
How did the family understand and view Lia's diagnosis and condition? What were their perceptions of this as a "family stressor”?
The Lees viewed Lia to be kind of an anointed one, like members of a royal family. They believed Lia was an exceptional person in Hmong culture because she had a special spirit in herself and she could grow up to become a shaman. Sometimes their thinking was that this was not much of a disease but a blessing. However they were worried and concerned about their daughter’s health and well-being.
What did the doctors/providers want and expect from the family? Who helped build bridges to address cultural barriers?
The doctors expected the Hmong families to collaborate with them when seeking treatment and follow-up medical treatment together with giving patients the right prescription.
What is needed for effective communication around the care and treatment of children such as Lia with a chronic medical condition, mainly when cultural and language differences or barriers may exist? Family role? Medical caregivers’ roles? The roles of others involved in the family’s life?
Effective communication would require the hiring of a talented interpreter who holds excellent communication skills both in English and Hmong language. Furthermore he or she should be knowledgeable about Hmong culture. A skilled interpreter would significantly help to break the barrier of communication between the two parties, and the doctor would gain insight on issues relating to the child’s health such as treatment history, symptoms and type of medication previously prescribed before the doctor progress of administering treatment.
What were some of the related factors that impact caring for Lia while also considering her developmental needs, family strengths, and overall family functions?
Among the Hmong culture, a child is the most important possession a family can have and hence the child is always with her mother, sleeping in her arms during the night and riding her back during the day and protecting them from abuse. The Lees were more responsive to fusing and crying of Lia since they were naturally worried to think that anything might compromise Lia’s health and happiness.
What are the worrying considerations for care providers who work with diverse cultures?
Cultural respect by medical care providers is essential to help reduce treatment disparities and support access to high-quality medical services which are responsive to patient’s needs. Cultural awareness-nurses should at least possess an insight relating to a patient cultural health value and beliefs.
When doctors/medical providers and parents are brought together, each will have their own experiences and understandings. How can the two worlds meet and then collaborate?
The medical center should create a feedback treatment program where parents and doctor can raise their concerns relating to the treatment experience encountered by patients and how doctors and parents behave. Insights from this program will assist the medical care center in implementing programs which will promote effective collaboration between the two parties and promote treatment service delivery.
Given the publication date of the book: Do these barriers still exist for families with a range of linguistic and cultural backgrounds and spiritual beliefs?
Yes these barriers are still present in our society, for example consider a family that migrate to the United States from non-speaking English country, at first they will experience difficulty not in seeking better health services but also other essential services and navigating around the town until they learn how to speak English or get help from an interpreter.
Do you have examples from your own family experiences?
Last year during summer we toured Bali an island in Indonesia, and it was so difficult to navigate around the town alone, buy anything from a shop or seek treatment from local dispensary due to the language barrier, but with the help of a translator, everything seemed normal.
