Discussing Depression with Vietnamese American Patients

Abstract

Background Asian patients preferentially seek mental health care from their primary care providers but are unlikely to receive it. Primary care providers need culturally-informed strategies for addressing stigmatizing illnesses. Methods 11 Vietnamese American community members participated in semi-structured interviews. Interviews were audio-taped and transcribed. The grounded theory approach was used for qualitative coding and thematic analysis. Results Vietnamese community members describe experiences with depression under four themes: (1) Stigma and face; (2) Social functioning and the role of the family; (3) Traditional healing and beliefs about medications; and (4) Language and culture. Based on this data, we offer suggestions for improving culturally-informed care for Vietnamese Americans. Disucssion Our study adds to the research aimed at improving communication and health care relationships between physicians and Vietnamese American patients. Physicians should learn to tailor their interviewing style to the increasingly diverse patient population.

On Invoking Third Parties in Vietnamese Medical Communication

“…First and foremost, the practice of invoking an RM in this cultural context empowers the patient to behave more assertively in a variety of medical scenarios than they might otherwise do (Fancher et al, 2010; G. T. Nguyen et al, 2007; K. Tran, 2009). One patient manages to circumvent a troublesome administrative requirement (Extract 5), while another invokes an RM in order to obtain a preferred form of treatment (Extract 6).…”

“…In studies on the patient's perspective, the main finding has been that these participants tend to adopt an inhibited, compliant attitude towards those who are charged with treating them. Fancher et al (2010) found that the patients in their study rarely expressed their concerns directly unless asked. In G. Nguyen et al (2007), even though most of the patients reported being 1 This author's name consists of a middle name plus first name only (i.e., there is no surname).…”

“…For consistency, we use the same symbol for this purpose in the interlinear morpheme gloss as well. 9 In morphosyntactic terms (including the use of ellipsis), Vietnamese and English diverge considerably (H. D. Nguyen, 2009). Our priority in the translations is to strike a balance between the naturalness of the English on one hand and faithfulness to the original on th e original.…”

Treatment Recommendation in Vietnamese Medical Consultations

“…And indeed this expectation is borne out in the extant literature. In studies on the patient's perspective, the salient finding has been that these participants adopt an inhibited, compliant attitude towards those who are charged with treating them (Fancher et al, 2010;Nguyen et al, 2007;Tran, 2009).…”

Primary Care Utilization and Mental Health Diagnoses Among Adult Patients Requiring Interpreters: a Retrospective Cohort Study

“…Culturally-adapted mental health screening instruments have been lacking, and increased research to develop and validate these instruments may better assist providers in making mental health diagnoses. 13 Additionally, replacing stigmatizing terms, [26][27][28] and augmenting the use of interpreters with community advisors, mediators or "culture brokers" may facilitate discussion, diagnosis, and treatment of mental health issues. The findings of this study are limited by the inclusion of patient visits over a 1-year period at a single institution, which limits generalizability.…”