Among the challenges health care personnel in California's central valley face has been finding ways to help Hmong Americans manage chronic illness. Interviews were conducted with 11 Hmong shamans diagnosed with diabetes or hypertension and were qualitatively analyzed to ascertain respondents' understanding and management of their illnesses. Hmong shamans are influential individuals within their communities and are often the resource persons to whom patients turn for information on health. Understanding the shamans' perspective on chronic illness was seen as a gateway to understanding how the broader Hmong American community perceived these conditions. The concept of chronic illness was not well understood, resulting in sporadic medication and dietary regimens, limited awareness of potential complications, and a persistent impression that these illnesses could be cured rather than managed. Suggestions for patient educators include family and community involvement in care regimens and the use of descriptive terminology to identify the disease.
The data suggest the persistence of the need for the spiritual healing provided by the shamans within this immigrant community. Shamans' rituals affirmed and strengthened connections to family, culture, and community.
OBJECTIVES. The influx of Southeast Asians into the United States allows for the study of this special population and contributes to a broader understanding of reproductive health. METHODS. We used information on birth certificates to identify 1937 Hmong children born 1985 through 1988 in California, and we compared birthweight and reproductive factors as related to these children with the same factors as related to 3776 White, non-Hispanic children born in the same period. RESULTS. Mean birthweight among Hmong children (3311 g) was significantly lower (P less than .05) than among White children (3452 g), but the proportion of births under 1500 g was higher for Whites. Hmong women were of much higher parity and were more likely to deliver at both a young (less than 18 years) and an old (greater than 40 years) maternal age. At every age and every parity, however, Hmong women had cesarean sections at one-half to one-tenth the rate of White women. CONCLUSIONS. Despite a high proportion of births at high parity and advanced maternal age, Hmong women gave birth to very low-birthweight babies at essentially the same rates as White women. Their lower cesarean section rates, however, deserve further attention.
Interviews were conducted with 94 Hmong Americans in California's Central Valley to explore attitudes regarding placental disposition and the cultural values that affect those attitudes. Research indicated a persistence of the traditional belief that placentas should be buried at home. The placenta is perceived to be essential for travel by the soul of the deceased into the spirit world to rejoin ancestors. Older respondents (older than age 35) and those who self-identified as animists were most likely to believe in the importance of home placental burial. Comments by respondents indicated some reluctance on the part of Hmong patients to ask health care providers for permission to take placentas home. Incorporating non-Western patients' traditional health care practices into Western health care delivery may be facilitated by an awareness of the reluctance of some patients to verbalize their wishes.
Nurses' awareness that the availability of biomedicine does not preclude the continuing or recurring utilization of traditional healers can facilitate understanding of culturally defined health care needs.
Hmong Americans have typically been unwilling to use biomedical palliative care for end-of-life needs. This has resulted in confusion and frustration for Hmong patients, families, and nurses. Hmongs' end-of-life care choices for family members usually involve in-home caregiving provided by the family using a combination of biomedicine and traditional healing methods. Health care decisions are made for the patient by the family and community in this familistic culture. A qualitative approach was used to explore the beliefs that ultimately determine end-of-life care goals and strategies for Hmong patients. Semistructured interviews were conducted with 15 family caregivers of terminally ill patients and 5 shamans and Hmong funeral officiants. Several themes affecting care choices were identified, including cultural legacies of the responsibility of end-of-life caregiving by the family, the desire for family privacy in caregiving, and the role of community in the care for the dying, as well as completion of the rituals that ensure the soul of the deceased reaches the afterlife. Suggestions for improving communication between Hmongs and biomedical providers include providing information about end-of-life care beliefs and strategies to biomedical care providers and providing information to Hmong patients and families about hospice and palliative care options and services to support family care.
Based on the results of a self-administered questionnaire completed by 107 wives of physicians in a rural central California county, this exploratory study examines dimensions of the physician's work and family life associated with excessive use of alcohol. Avoiding the bias of the use of a treatment population, the study seeks to analyze the factors that are predictive of alcohol impairment in physicians' living and practicing in rural areas where role strain is increased. The stress theory's role in explaining alcohol abuse is explored. Several variables associated with increased probability of impairment are identified, including poor relationships with in-laws, extramarital affairs, the intrusion of business into family life, and excessive drinking by one's spouse. Further studies with larger samples are needed to elaborate on and confirm these initial findings.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.