Asian Cultural V alues & Health Beliefs & the Impact They ...

1 ANA Asian Forum, 201524 November 2015 Sorrento in the Park, One Tree Hill Domain, AucklandPresenter: Sue Lim, Operations Manager Asian Health ServicesAsian Cultural Values & Health Beliefs &the Impact They Have on DecisionsAround Nutrition and Physical Activity: A Local Example of A Culturally Appropriate ApproachScope & LimitationsScope of presentation Cultural values, Beliefs and practices relating to nutrition and physical activity in East Asian and South-East AsianLimitations Culture is dynamic and transitional and is not limited to ethnic or racial make-up Information provided in this presentation is generalised and for informational purposesOverviewIntroduction Asian population DiversityCultural ValuesHealth Beliefs and PracticesOverseas literature reviews: Cultural appropriate approaches for Health promotionLocal example.

2 Culturally appropriate Health promotion interventionSummaryDemographics: Asian Population (Census2013) NZ: 2/3rd of the Asian population lived in the Auckland Region Asian ethnic group is 3rd largest ethnic group in NZ European 74%, Maori , Asian , Pacific Peoples Asian ethnic group almost doubled in size since 2001 ( ) Top 6 Asian Ethnic Groups: chinese , Indian, Filipino, Korean, Other South East Asian , JapaneseAuckland Region: (298,554) of the population was AsianAsian ethnic group is 2nd largest ethnic group in AucklandTo p 6 Asian spoken languages: chinese , Korean, Hindi, Gujarati, Japanese and of Asian not English speakers ( chinese 19%, Korean 12% and Indian4 %)DiversityLevel 2 Asian CategoriesOther Asian (Code 44)Indian(Code 43) chinese (Code 42)South East Asian (Code 41) Asian NFD*(Code 40)

3 JapaneseKoreanAfghaniSri Lankan NFD*Sri Lankan TamilSri Lankan NEC*SinhaleseBangladeshiNepalesePakistan iTibetanEurasianAsian NEC*Indian NFD*BengaliFijian IndianGujaratiTamilPunjabiSikhAnglo IndianIndian NEC* chinese NFD*Hong Kong ChineseCambodian ChineseMalaysian ChineseSingaporean ChineseVietnamese ChineseTaiwaneseChinese NEC*Southeast Asian NFD*FilipinoCambodianVietnameseBurmeseIn donesianLaotianMalayThaiSoutheast Asian NECO ther SE AsianAsian NFD*Exploring Cultural ValuesIndividualism v CollectivismIndividuals are concerned about consequences of action for themselves, not othersCollectivists primarily view themselves as members of a groupCollectiveAsianPacific IsMaoriSthAfricaNew ZealandGreat BritainIndividualistGeert Hofstede'sDimensions of Culture(Adapted primarily from ~ ~donclark/ ) Power DistanceThe extent to which members of a culture expect and accept that power is unequally distributedHigh PDAsianPacific IsMaoriIndianSth AfricaNew ZealandGreat BritainLow PDGeert Hofstede'sDimensions of Culture(Adapted primarily from ~ ~donclark/ )

4 Uncertainty AvoidanceThe degree to which members of a culture feel threatened by unpredictable, uncertain or unknown situationsHigh UncertaintyAsianPacific IsMaoriSth AfricaNew ZealandLow uncertaintyGreat BritainGeert Hofstede'sDimensions of Culture(Adapted primarily from ~ ~donclark/ ) Masculinity vs FemininityFeminine = Quality of life Masculine = Quantity of lifeGender roles within a societyMasculineAsianPacific IsMaoriSthAfricaNew ZealandGreat BritainFeminineNorwaySwedenJapanGeert Hofstede'sDimensions of Culture(Adapted primarily from ~ ~donclark/ ) AcculturationAdapted from Berry Psychology of Acculturation.

5 Neuliep(2003).SeparationIntegrationMargi nalisationAssimilationDegree of contact with host culture and micro Cultural groupsDegree to which native Cultural identity is maintainedX AxisY AxisWestern and Eastern Health Beliefs and Practicesin relation to Nutrition and Physical ActivityExplanatory modelsof Health and wellness and illness The only cure you believe in, cures. Tamil ProverbDifferent cultures have different ways of understandinghealth and wellness and illness. How Health , wellness and illness are explained is strongly influenced by Cultural values. "The explanatory model of a particular illness consists of signs and symptoms by which the illness is recognised; presumed cause of the illness and prognosis is established.

6 These are interpreted by individuals and or significant others and on labelling the problem proceed to address it appropriately through recommended therapies" (Olenja, 2003).The success of Health promotion intervention and compliance will depend to a significant degree on the formation of a collaborative model that is acceptable to scientific and western biomedical modelis based on disease causation and believes that medicine is the art and science of healing. Examples Surgery Therapy Rehabilitation Evidence-based practice Psychology Diagnostic servicesTon & Lim (2006)ScientificWestern Biomedical ModelSupernaturalSupernatural Model (ancestors, stars, spirits, environment (fengshui), karma) Supernatural Beliefs relate to the influence of a power or powers considered beyond nature.

7 Treatment examples Restitution to another person Rituals and prayers for forgiveness Ceremonies to appease spirits, deities or GodTon & Lim (2006)Supernatural ModelReligiousSpiritual / ReligiousModel - ill deeds, karma, fate, neglect in practiceGood Health occurs when one is fulfilling the requirements of one s faith, while poor Health means one has not been true to their faith. Treatment ExamplesReading religious texts, praying ExorcismAttending religious eventsTon & Lim (2006)Spiritual / Religious Model Humoral(earth, air, fire, water). Based on the theory that the human body is filled with four basic substances called humours blood, yellow bile, black bile and & Lim (2006)HumorSeasonElementOrganQualitiesAn cientNameModernNameMyers-BriggTypeIndica torAncientCharacteristicsBloodspringairl iverwarm&moistsanguineartisanSPcourageou s,hopeful,amorousYellowbilesummerfiregal lbladderwarm&drycholericidealistNFeasily angered,badtemperedBlackbileautumnearths pleencold&drymelancholicguardianSJdespon dent,sleepless,irritablePhlegmwinterwate rbrain/lungscold&moistphlegmaticrational NTcalm,unemotionalHumoral / Body Balance Model18 Balance Model.

8 Health and Wellness and Healing PracticesTai Chi (Korean is called Taekgyeon) chinese Folk DanceYogaCuppingMoxibustionPinchingSteam ingBalmAcupunctureAcupressure or MassageHerbsPatent medicinesQi Qong (Chi Kung)AyurvedicMedicine19 Cultural Meaning About Food Some believes in food values to maintain the principle of maintaining the balanceof various elements in the body Some believes food as preventive medicine Socialisation food is perceived as a way to interact with family, friends, community and a way of social bonding Food and Religion Islam halal food and no intoxicants in medications or preparations.

9 Fasting monthSikh forbids the eating of beef and porkHindus most practising Hindus are vegetarianBuddhism many Buddhists are vegetarianCross- Cultural resource for Health practitioners working with CALD clients - Family values influencingdecisonsFilial DutyFamily and mutual dependence is valued over independenceFilial DutyFatherand sons are heads of household and decision makersFilial respect &reverence to ancestors is importantNuclear familyPatrilinealand extendedEldest sons inherit family leadership Respect for elders and those in authorityMales and females equally respectedElder Males and females equally respectedHealth Beliefs influencingnutrition and physical activityChiKiorchiYing & yangUm & yangAm & duongHumoral imbalanceWesternconcepts of disease causation SpiritualityBuddhism/ChristianityConfuci anism,Taoism & Shamanism Muslim Cross- Cultural resource for Health practitioners working with CALD clients - Literature Review.

10 Culturally appropriate approaches for Health PromotionsAsian Motivatorsfor Health PromotionCollectivism Cultural characteristic Interdependent Conformity Filial piety, submissionAvoidanceChoiceSelf-regulation Group automonyGroup identityPhysical PleasureSelf-effacementOther oriented self-efficacySocial HarmonyCoburn, C, L., Weismuller, P, C. (2012). Asian Motivators for Health Promotion. Clinical Practice Department. Journal of Transcultural Nursing 23(2) 205 214 Barriers to Lifestyle Change in Migrant South Asian PopulationsWho influence dietary decisionsExpectation of the roles within the family The meaning of physical exerciseThe view on body types Belief of cooking method Disease attribution fatalism Accessible of food Acculturation Patel, M.