Question

Mr. Wong is a 78-year-old male from mainland China, who has been admitted for rehabilitation following total hip replacement surgery. He has a poor appetite, has experienced weight loss, and has been unable to participate in physical therapy. Thus, he is not meeting his goals for rehabilitation. No evidence exists to suggest an underlying disease process.

Ms. Faye, the nurse assigned to care for Mr. Wong is interested in learning what might be going on with Mr. Wong to better meet his treatment outcomes. Mrs. Faye considers the possibility that that he does not have adequate pain relief, which could affect his appetite and poor participation in physical therapy. She reviews his history to learn more about him. According the health history, Mr. Wong is a widower of 3 years; he has a son and daughter that live in distant cities. Mr. Wong emigrated from China at the age of 38 and only speaks Cantonese. He has lived in an ethic neighborhood with other Chinese American’s and has worked as a short-order cook in a Chinese restaurant since arriving in the United States 40 years ago.

Ms. Faye arranges for Mr. Lee, a Cantonese translator who is also Chinese, to help her ask Mr. Wong a few questions. She first asks Mr. Wong if he is in pain. When he responds no she follows with another question, asking him if he is depressed or anxious. Again, Mr. Wong responds no, that he is fine. During the interaction, Ms. Faye observes that Mr. Wong does not look at her or Mr. Lee, the translator.

After leaving the room, Ms. Faye expresses her frustration to Mr. Lee, mentioning how hard it will be to help him when he won’t communicate. Mr. Lee responds, “Older Chinese people believe that they must be stoic about pain, and there is a stigma about talking about any mental health problems.” This explanation had not occurred to Ms. Faye, who then recognizes her approach was may have been offensive and that she had failed to consider the underlying cultural differences beyond language.

Ms. Faye asks Mr. Lee to share more about traditional Chinese beliefs. She then asks Mr. Lee to help her ask additional questions using a cultural assessment form as a guide. After gathering additional information from Mr. Wong and gaining additional insight from Ms. Lee, Ms. Faye incorporates strategies that include changes to how his food is prepared and served, changes in approaches to pain management, and involving Mr. Wong’s son and daughter in his care.

The pivotal construct of cultural competency is cultural desire, that is, the desire to understand people who differ from oneself. What actions on the part of a nurse would be indicative of cultural desire?

What examples can you identify from the case study that demonstrate that Ms. Faye respects and acknowledges Mr. Wong’s values, needs, and preferences?

Answer 1

The actions like the nurse willingly asking for the patient's cultural beliefs or traditional belief and trying to implement the same in care. This action by the nurse should provide the patient with good pain relief

The work like enhancing cultural communication, changes made in food preparation and serving, involving family members in care, change in pain management strategy demonstrates that Ms. Faye respects and acknowledgesMr.Wong's values, needs and preferences.