Cultural Ethnicity and Nursing Education of Asian or Pacific Island
An Overview of Asian/Pacific Islander Culture
People from Asian countries and the Pacific Islands constitute the third major ethnic sub cultural group in the United States. Asian Americans who have come here originated from approximately 52 countries in the Far East, Southeast Asia, and the subcontinent of India.
Although Japanese and Chinese immigrants settled in the United States in the early 1900s, many Southeast Asians came as refugees to the United States after World War II, the Korean War, the fall of South Vietnam, and the chaos in the governments of Laos and Cambodia. To a large extent, they have settled on the West Coast, particularly in the San Francisco Bay area of California and in Washington state (US Census Bureau, 2017; Villanueva & Lipat, 2000; Young. McCormick, & Vitaliano, 2002).
Also, the states of New York, New Jersey, and Texas have experienced a large influx of Asian people, particularly from China, the Philippines, and Japan. As of 2015, 21 million Asian/Pacific Islanders (5.8% of the total US population) live in the country (US Census Bureau, 2017).
Although Asian/Pacific Islander people have been classified as a single ethnic group, Asian Americans are not homogenous. They represent diverse minority populations with over 800 languages and dialects and their beliefs and practices are not the same because a wide variety of cultural and religious backgrounds are represented (Asian American Health Initiative, 2005; Kim & Keefe, 2010). Some similarities exist among members of this group, but there are also many differences (Purnell, 2013).
By understanding the basic beliefs of the Asian/Pacific Islander people, nurses can be better prepared to understand and accept their cultural differences and varied behavior patterns. The supply of registered nurses of Asian/Pacific Islander descent had grown to 5.8% in 2008 (from 3.1% in 2004) and is close in proportion (although not necessarily in geographic distribution) to the population of this ethnic group in the United States.
Common Values and Believes of Asian or Pacific Island Subcultures
The major philosophical orientation of the Asian/Pacific Islander people is a blend of four philosophies Buddhism, Confucianism, Tao-ism, and phi. Four common values are strongly reflected in these philosophies (Purnell, 2013):
1. Male authority and dominance
2. Saving face (behavior resulting from a sense of pride)
3. Strong family ties
4. Respect for parents, elders, teachers, and other authority figures
Review of the Beliefs and Healthcare Practices of the Asian/Pacific Islander People
The following is a brief review of the beliefs and healthcare practices of the Asian/Pacific Islander people (Pang, 2007; Purnell, 2013).
Buddhism
The fundamental belief underlying Buddhism is that all existence is suffering. The continuation of life, and therefore suffering, arises from desires and passions. According to the Buddhist philosophy, humans are not limited to a single existence terminating in death; instead, everyone is reincarnated.
Cambodians, who are particularly strongly influenced by the
Buddhist philosophy, strive to accumulate religious merits or good deeds to
ensure a better life to come. Sharing, donating, being generous, and being kind
are all ways to accumulate merits. They adhere to a deep belief in karma,
whereby things done in this existence will help or hinder them to reach
nirvana, a place free of pain and suffering
Confucianism
Moral values and beliefs are heavily influenced by Confucian
philosophy, which focuses on the moral aspects of one's personality. Two
predominant moral qualities are humaneness (the attitude that is shown toward
others) and a sense of moral duty and obligation (attitudes that persons
display toward themselves). The principles that guide the social behavior of
people who adhere to Confucianism are described as follows.
Patterns of Authority. The following five relationships run from
inferior (No. 1) to superior (No. 5) to form a pattern of obligation and
authority in the family as well as in social and political realms:
1. Son (child) to father
2. Wife to husband
3. Younger brother to older brother
4. Friend to friend
5. Subject to rule
These patterns of authority and obligation influence decision making
and social interactions. For example, a friend is to regard a friend as a
younger or older brother. Women's subservience to men is reflected in a woman's
behavior to always seek the advice of her husband when making decisions. This
authority needs to be respected by nursing staff when, for instance, a woman
refuses to choose a contraceptive method until she asks for her husband's
advice and permission.
Man in Harmony with the Universe. In the Confucian system, people
are considered to exist between heaven and earth, and life has to be in harmony
with the universe. An example of this principle is when Asians respond
passively to new information, accepting it rather than actively seeking to
clarify it. Therefore, it is important for the nurse to ask the patient for an
explanation of the information taught to determine if it was understood.
Ancestor Worship. Concern for the moral order of relationships is reflected in a deep reverence for tradition and rituals. Great emphasis is placed on funerals, the procedures for mourning, and the group sharing of a meal with the dead.
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