Chinese culture

By: Maria Licona, Michele Vasquez, Glenda Sanchez, Jeannette Villanueva, Krista Mak

China is reputed as the oldest continuous civilization in the world. Many aspects of Chinese culture can be traced back many centuries ago. Chinese culture is so diverse and unique, yet harmoniously blended, and presents itself an invaluable asset to the world.

By definition from Wikipedia a culture is a set of shared attitudes, values, goals, and practices that characterizes an institution, organization or group. The Chinese culture is a culture because it fits this exact definition. The Chinese culture is a group that has a set of shared attitudes, values, goals practices which they share.

Demographics

Population: 1,338,612,968 (July 2009 est.)

Location: Eastern Asia

Capital: Beijing

Climate: extremely diverse; tropical in south to subarctic in north.

Ethnic groups: Han Chinese 91.5%, Zhuang, Manchu, Hui, Miao, Uyghur, Tujia, Yi, Mongol, Tibetan, Buyi, Dong, Yao, Korean, and other nationalities 8.5% (2000 census)

Religion: Daoist (Taoist), Buddhist, Christian 3%-4%, Muslim 1%-2%

Year Population Rank PercentChange Date of Information
2003 1,286,975,468 1 July 2003 est.
2004 1,306,313,812 1 1.50 % July 2005 est.
2005 1,306,313,812 1 0.00 % July 2005 est.
2006 1,313,973,713 1 0.59 % July 2006 est.
2007 1,321,851,888 1 0.60 % July 2007 est.
2008 1,330,044,544 1 0.62 % July 2008 est.
2009 1,338,612,968 1 0.64 % July 2009 est.
2010 1,338,612,968 1 0.00 % July 2009 est.

Major infections diseases

degree of risk: intermediate
food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever
vectorborne diseases: Japanese encephalitis and dengue fever
soil contact disease: hantaviral hemorrhagic fever with renal syndrome (HFRS)
animal contact disease: rabies
note: highly pathogenic H5N1 avian influenza has been identified in this country; it poses a negligible risk with extremely rare cases possible among US citizens who have close contact with birds (2009)

http://www.indexmundi.com/china/demographics_profile.html

Values, Beliefs, and Attitudes

Predominant religions:

Confucianism– An ethical belief system based on the aspects of responsibility and obligation in relationships.  Confucianists believe that society will be just and harmonious as long as long as everyone observes the responsibilities and obligations in relationships between all people and organizations-including government.  Confucianism stresses duty, sincerity, loyalty, honor, filial piety, respect for age and seniority. Through maintaing harmonious relations as individuals, society itself becomes stable. Primary role: achieve harmony

http://www.kwintessential.co.uk/resources/global-etiquette/china-country-profile.html

  • Taoism (Daoism)– The believer seeks to promote inner peace of individuals and harmony with their surroundings.   “In a nutshell, Taoism is the consolidation of a number of concepts and practices that make up the “Path”, or “Way”, of living. The consolidation of ideas and concepts include basic principles or “theories” regarding the body, diet, breathing and physical exercises, uses of herbs, philosophical inquiry and, of course, meditation. All of which the Taoist feels brings a human being into closer alignment with the “natural order” of life and living – a pathway that humankind appears to have gotten derailed from.” – Madelyn Hamilton

http://users.ntplx.net/~bbarrett/intro-tao.html

  • BuddhismBuddhism starts with the idea of impermanence.  Nothing is forever.  Desires are seen as a source of pain, and if you overcome desires, you overcome pain.  Meditation is a key aspect to Buddhism along with the eight-fold path to enlightenment, which is similar to the idea of the Christian “ten commandments”. 

Buddhists believe in no-self, ethics, karma, rebirth, enlightenment and Nirvana.  They believe that the goal in life is to do good and attempt to attain a heightened sense of enlightenment and peace.

http://www.mahidol.ac.th/budsir/buddhism.htm

  • Christianitya religion stemming from the teachings of Jesus.  It is based on the holy book of the Bible and the Ten Commandments.  They believe that Jesus is the son of God who died to save all of the people in the world who believe in him, accept him into their hearts and live to honor and serve him.

http://www.answers.com/topic/christianity

Chinese Thought:

It is critical you avoid losing face or causing the loss of face at all times

Face- The concept of ‘face’ roughly translates as ‘honor’, ‘good reputation’ or ‘respect’.
There are four types of ‘face’:
1) Diu-mian-zi: this is when one’s actions or deeds have been exposed to people.
2) Gei-mian-zi: involves the giving of face to others through showing respect.
3) Liu-mian-zi: this is developed by avoiding mistakes and showing wisdom in action.
4) Jiang-mian-zi: this is when face is increased through others, i.e. someone complementing you to an associate.

. In general, most Chinese people are very group oriented.  They are closely tied to family, school, work, and country.  They value the best interest of the group over the individual.
. To maintain harmony, they are sure not do anything to cause someone else public embarrassment.
. They are willing to suppress or subdue their own feelings for the good of the group.
. Chinese people are not confrontational.  If someone disagrees with what another person says, rather than disagree publicly, the person will remain quiet. This gives face to the other person, while speaking up would make both parties lose face.

The difference between Chinese and American Culture can make communication in health care a challenge…

1. Respect/Protection of Elders/Filial Piety. This value may lead to not informing family members of illness to “protect” them.   Because of this value, Chinese people may hesitate to place their family members in long-term care, or hesitate to talk with family members about Advance Directives.

2. Karma. Many Chinese believe that it is bad luck to talk about illness or death, as it may cause it to happen.

3. Psychosomatic Integration. Somatization(conversion of a mental state such as depression or anxiety into physical symptoms) in traditional Chinese culture is an acceptable way to express emotional distress and obtain attention; patient may be perceived as a “hypochondriac”.

4. Formalistic Conformity/Deference to Authority. Patients may not verbalize anxiety or doubts regarding their medical care in front of medical personnel, but then not follow through with treatments. This can be misinterpreted as patient noncompliance or insincerity.

5. Decision Makers. Traditionally expected to be husband or oldest son.

6. “Saving Face”. May make it harder for patients to admit to having problems, especially mental health problems. Their tends to be a stigma associated with mental illness in the Chinese culture.  It is seen as shameful.  They may not want to question or disagree with physician to their face, so they will not come back, “doctor shop”, or not take medication as prescribed.

7. Concepts of Yin/Yang and “chi” or “qi” (vital energy). Many Chinese believe in traditional Chinese medicine which involves a vital energy force and meridians of energy in the body that affect health and illness, which are also influenced by food and each individual’s association with body organs.

http://www.kwintessential.co.uk/resources/global-etiquette/china-country-profile.html

Chinese Medicine


Chinese medicine is an ancient form of healing still used today all over the world.

  • Acupuncture: meridians are pathways of energy, or “chi”, which lead to various organs.
  • Cupping: using heated bamboo cups to reduce stress, congestion, colds.
  • Herbology: use of plant or animal parts in the treatment of illness and deficiencies and to stimulate the body’s “chi”.
  • Yin/Yang concept: elders may avoid the cold, and may avoid certain foods considered to be “cold” foods.
  • Meditation/Exercise: often used to help alleviate stress.

Dress and Style

An outstanding characteristic of traditional Chinese clothing is not only an external expression of elegance, but also an internal symbolism. Each and every piece of traditional clothing communicates a vitality of its own. This combination of external form with internal symbolism is clearly exemplified in the pair of fighting pheasant feathers used in headwear.

* Business attire is conservative and unpretentious.
* Men should wear dark coloured, conservative business suits.
* Women should wear conservative business suits or dresses with a high neckline.
* Women should wear flat shoes or shoes with very low heels.
* Bright colours should be avoided.

http://www.chinatownconnection.com/art_of_chinese_dress.htm

Communication

Chinese people speak mandarin (Putong Hua, Hanyu, Huayu, Guoyu, standard Chinese) which is based on Beijing Dialect. The Chinese culture is closely related but mutually unintelligible languages and dialects. Chinese is a language, or a group of languages, spoken by 1.3 billion people worldwide. It has 56 ethnic groups, over 80 languages, and about 30 kinds of character. http://www.chinatownconnection.com/learning_chinese

Relationships

previous research indicates that attitudes toward commitment in a relationship differ slighly in the Chinese society from the American society Hsu came to the conclusion that, for the Chinese, the term “romantic relationship” or “dating relationship” contains the elements of necessary seriousness and long-term commitment, therefore a romantic relationship is often perceived as one step before marriage On the other hand, Cohen and Dion contended that a committed relationship in the US culture is formed on the basis of strong emotional experiences.  From these observations, we can see that commitment has a more pragmatic function in the Chinese culture, which often reflects the obligation or responsibility of a person that is involved in a relationship, whereas Americans are more likely to focus on the emotional apects of a relationship.

http://sitemaker.umich.edu/psy457_lamyiu/commitment

Role of Confucianism. Confucianism has played an important role in forming Chinese character and behavior. Its primary purpose is to achieve harmony, the most important social value. This is achieved by everyone having well defined roles and acting towards others in a proper way. It is interesting that there is no Chinese equivalent for the word “self”.

There are five cardinal relations (“wu lun”): sovereign-subject, father-son, elder-younger brother, husband-wife, friend-friend. The family is the center and comes before the individual. The father is the undisputed head of the family. With regard to filial piety (“xiao”), sons, especially the oldest son, have specific obligations toward the family and are expected to respect and care for parents (McLaughlin & Braun, 1998). In pre-modern China, the act of suicide was not necessarily deviant behavior if it was associated with duty or loyalty to the family.

“Li”, the “proper way” or “propriety”, includes a set of rules for interaction with others and the role system. Control of emotions, restraint, obedience to authority, conforming and “face” are highly valued and important.
(Additional references for the section: Lassiter, 1995; Tseng & Wu, 1985)

http://www.stanford.edu/group/ethnoger/chinese.html

Non-Verbal Communication

* The Chinese’ Non-verbal communication speaks volumes.
* Since the Chinese strive for harmony and are group dependent, they rely on facial expression, tone of voice and posture to tell  them what someone feels.
* Frowning while someone is speaking is interpreted as a sign of disagreement, so they keep an impassive expression when speaking.
* It is considered disrespectful to stare into another person’s eyes. The Chinese avoid eye contact in crowded places to give themselves privacy. http://www.chinatownconnection.com/learning_chinese.htm

Traditions

There are many traditions of the Chinese culture, a select few are below with a little explanation of what exactly each one is.

* Ancient Healing Techniques-The Chinese practice healing techniques that have been passed down for generations. The Chinese believe there are a couple of ways to help you keep focus and regulate the temperature of your body. One secret is done by placing your palm on your stomach. When you do this for even less than a minute, you will feel the warmth of your hand radiating throughout your body to help keep you warm.

Chinese Color of Happiness-The Chinese symbol for happiness is the red envelope.

It has been a belief that red envelopes bring happiness, good luck and prosperity.

Chinese Foot Binding-Chinese Foot Binding has been done for thousands of years to young Chinese females who want to look beautiful. Foot binding first emerged in the 10th century and was done in girls aged 6 or younger. It first occurred in the wealthiest parts of China but later became so popular that only the poorest or those who worked in the fields could not do it. The early Chinese thought that tiny feet were beautiful and bound feet were considered sexy. It was also seen as mysterious and attractive and a symbol of wealth and power since women with bound feet couldn’t work. The term they often used was, “lotus hooks”.

*Chinese Marriage Traditions-The procedures of an ancient Chinese marriage came from the phase, “Three Letters and Six Etiquettes”. The three letters are the engagement letter, the delivery of gifts letter and the taking of the bride letter. In ancient times, if a man is interested in a woman, he will ask a middle-women to explore the possibility and if appropriate speak with the woman’s family about it. If the woman’s family found him acceptable, they would notify him so that he could make the official proposal by delivering the formal letter of engagement. If the proposal is accepted the next step is to deliver wedding gifts to the woman’s family. Along with the gifts is a Delivery of Gift letter which is essentially a list of items and quantity much like a delivery order. By signing the letter and taking the gifts, it signifies the woman’s family acceptance of the marriage. And finally the third letter is known as the “Taking the Bride” letter as it is the letter that the groom has when he arrives at the bride’s home on the wedding day. When the bride accepts the letter she is then considered a part of the groom’s family. The six Etiquettes refers to the six main procedures in an ancient Chinese marriage. It includes the official proposal, the checking of Ba Zi (compatibility using a system of Chinese Astrology), selection of auspicious date for the wedding, deliver of gifts, confirmation of wedding dates and finally the wedding itself. Here is the order in more detail.

Proposing: when a boy’s parents intended to make a match, they would invite a matchmaker to propose with them at the girl’s home. It was the custom that the first time matchmaker went as a guest they could not be served tea in order not to ‘lighten the marriage’. If the proposal was successful, however, the matchmaker (usually a woman) would be rewarded with profuse gifts and feasts to show the two families’ gratitude. Many unmarried young people could not see and were unfamiliar with each other till their wedding day.

Birthday Matching: after knowing the girl’s full name and birthday, they would ask a fortune teller to predict whether that could match their son’s and whether there would be a happy marriage. The Chinese zodiac would be surely taken into consideration.

Presenting Betrothal Gifts: if the match was predicted to be auspicious, the matchmaker would take gifts to the girl’s parents and tell them that the process could continue.

Presenting Wedding Gifts: This was the grandest etiquette of the whole process of engagement. Prolific gifts were presented again to the girl’s family, symbolizing respect and kindness towards the girl’s family as well as the capability of providing a good life for the girl.

Selecting the Wedding Date: the boy’s family asked the fortune-teller to choose a date according to the astrological book when it would be proper and propitious to hold the wedding ceremony.

Wedding Ceremony: the wedding ceremony began with the groom and his party meeting the bride in her home. Before this day the bride’s dowry would have been sent to the boy’s house. The dowry represented her social status and wealth, and would be displayed at the boy’s house. The most common dowries included scissors like two butterflies never separating, rulers indicating acres of fields, and vases for peace and wealth.

http://www.travelchinaguide.com/intro/social_customs/marriage/

* Chinese Masks and Culture-Chinese masks are used for two main elements of Chinese culture. The Chinese New Year masks which are worn by Chinese people to welcome the New Year throughout the world. And the Opera masks which are painted and drawn on the faces of the actors and singers and are used to depict the traits and characteristics of the role each actor is playing. Chinese New Years masks are not seen at any other time of the year. The Chinese masks in their rich and vivid colors are worn and displayed to show the nature of the festivity.  Chinese masks are made up of numerous materials like stones and metals, leather and cloth, paper and grass. They are then painted in different color themes and designs. Some masks represent animals or humans like the lion or the dragon. Red is a popular color to use as said once before it is thought to bring prosperity. The Chinese opera masks are either painted on or worn as thin cloth masks. Common colors used in facial make up is yellow which represents cruelty, Silver and Gold which are typically used to represent gods and demons and for spirits and ghosts, blue which is vigor and valor and green which depicts justice and chivalry.

Chinese Superstitions-Shooting off firecrackers on Chinese New Year’s Eve is the Chinese way of sending out the old year and welcoming in the new. On the stroke of midnight, every door and window in the house has to be opened to allow the old year to go out. Many people also do not eat meat on the first day of the Chinese New Year because it is believed that this will ensure a long and happy life. Some may eat a whole fish, that represents togetherness and abundance, or a chicken with its head and feet intact, which symbolizes prosperity. Still another superstition is that any noodles in your bowl should be left uncut, as a sign of long life. A home is thought to be lucky if a plant blooms on the New Year’s Day, as this is a sign of a prosperous life.

Social Organizations

Major social organizations in China are as follows:

All-China Federation of Trade Unions: This mass organization is the supreme leading body of all the local trade union organizations and national industrial union organizations in China. Founded in May 1925, it currently has 103.996 million members. The current Executive Committee chairman is Wang Zhaoguo.

All-China Youth Federation: Founded in May 1949, this federation comprises all the youth organizations in China, including the Communist Youth League, All-China Students’ Federation, All-China Young Men’s Christian Association, All-China Young Women’s Christian Association, Chinese Association of Young Entrepreneurs, and Chinese Association of Young Township Entrepreneurs, Chinese Association of Young Scientists and Technicians, Beijing Association of Young Editors and Reporters, Chinese Youth Volunteers Association, Chinese Youth Association for Industrial Promotion and Development, Chinese Youth Research Society, Youth Federation of Organizations Directly Under the Central Authorities, Youth Federation of the Central State Organizations, National Civil Aviation Youth Federation, along with the youth federations of the individual provinces, autonomous regions, and centrally administered municipalities. All-China Federation of Industry and Commerce: Founded in October 1953, this people’s association organized by people in industry and commerce functions as a non-governmental chamber of commerce for promoting business people’s domestic and overseas ties. Its current Executive Committee chairman is Huang Mengfu.

The Chinese People’s Association for Friendship with Foreign Countries: Founded in May 1954, the Association aims to promote friendship and mutual understanding between the Chinese people and those in other countries. On behalf of the Chinese people, it contacts friendly organizations and individuals in other countries and develops mutual exchanges, providing a bond of friendship linking the Chinese people with people throughout the rest of the world.

All-China Women’s Federation: Founded in April 1949, this mass organization was founded to get women from all ethnic groups and all walks of life united to fight for women’s further emancipation. The All-China Women’s Federation works hard for the protection of women’s rights and interests, including political rights, labor employment rights, property rights, cultural and educational rights, and personal rights, as well as marriage and family rights, and special rights related to their physiological characteristics. The Fifth Session of the Seventh National People’s Congress passed the Law on the Protection of Women’s Rights and Interests in April 1992, signaling that China’s work on safeguarding women’s rights and interests had entered a new stage defined by law

The All-China Federation of Trade Unions (ACFTU) is a mass organization of the Chinese working class led by the Communist Party of China and formed by the workers and staff members on a voluntary basis. It is a bridge and bond linking the Party and the masses of the workers and staff members, an important social pillar of the state power of the country, and the representative of the interests of the trade union members and workers and staff members.

http://www.chinaculture.org/library/2008-02/14/content_22259_2.htm

Work ethics

Protestant Work Ethic: With the Asian Diaspora reaching American shores around the 17th century, the Confucian model easily took hold in US institutions and became the embodiment of the ideal worker in a present day society dominated by neo-liberalist work values. It awakened among Asians the long dormant freedoms that were historically deprived of them but enjoyed by the northern Europeans during the early branching of working civilizations. Hard work, respect for authority and a cooperative spirit appeared to be the branding characteristics that have, over time, positioned the Asian worker as a valued asset of an enterprise in America.

Confucion Influence: Fundamental to the admirable traits exhibited by working Asian workers and professionals are frugality, hard work, cohesive family units, value for education, trading skills, respect for authority and reverence for duty. These qualities are readily traced to the Asian world influenced by a Confucian model characterized by patriarchal concerns and a continuous quest for cooperative harmony-typical Asian traits.

Historical Perspective: The presence of Chinese, Filipinos, and Asian Indians in the New World can be traced as far back as the 17th century. The Asian Indians once reigned as an economic power in the medieval ages trading spices, gold, and tea, portrayed underlying traits that are quite visible among their descendants today.

Todays Outlook: This brings us full circle to the question of whether the Asian work ethic is indeed a fact or a fallacy. Thus it is not difficult to deduce how the Asian work ethic finds expression in a society where capitalism thrives. It is as if the Asian worker has been freed from the self-imposed suppression influenced by generations of religious practices. It is as if at last the Asian worker has been liberated from the control of what one may describe as spiritual and magical beliefs.

http://www.apmforum.com/columns/eaststrategy1.htm

Other Interesting superstitions

*Clipping toenails or fingernails at night is bad luck, the person will be visited by a ghost.

*If a dog howls continuously at night, this means death.

*Hearing a crow cawing at 3 and 7 am means the hearer will receive gifts; hearing a crow caw between 7 and 11am means rain and wind; and between 11am and 1pm means quarrels.

*Beating a person with a broom will rain bad luck upon that person for years.

*Wearing a mustache is considered bad luck.

*Never point at the moon or your ears might get chopped off.

*Don’t sweep the floor on New Year’s Day lest you sweep away the good fortune.

*Don’t keep a pet turtle or it will slow down your business.

*Festival-Dragon Boat Festival and Dragon boat racing traditionally coincides with the 5th day of the 5th Chinese lunar month (varying from late May to June). Both the sun and dragon are considered to be male. The sun and the dragon are at their most potent during this time of the year, so cause for observing this through ritual celebrations such as dragon boat racing. The use of dragon boats for racing and dragons are believed by modern scholars, sinologists and anthropologists to have originated in southern central China more than 2,500 years ago, along the banks of Chang Jiang.

http://www.chinatownconnection.com/chinese-society-traditions.htm

Sense of Self/Space

The Chinese view themselves as rosy and not humble. It seems that when Chinese income increases, traditional humbleness disappears. Eight points were determined after research, 1. Chinese have big country’s proudness, 2. Chinese are smart and flexible, 3. The Chinese are natural born opportunity seekers, 4. Chinese are proud of their traditional culture, 5. Chinese are hardworking and willing to learn, 6. Chinese believe in power of Guanxi (describes the basic dynamic in personalized networks of influence, and is a central idea in Chinese society), and 7. Chinese life is content.

http://beijingman.blogspot.com/2009/01/chinese-themselves.html

Food and Feeding Habits

For the Chinese eating takes a high priority in their daily life and one of their greetings they use is “ni chi fan ma?” which means “have you eaten yet?”  Chinese are known to buy their foods fresh and many of the animals in the market are alive.  Chinese food is different from region to region and in some places they use more rice than noodles and in other places they use more noodles than rice.  The Chinese use rice like here in the USA the bread and they can eat it during breakfast, lunch and dinner.  A typical meal for a Chinese person is rice or noodles, soup, vegetables and dumplings (a typical food in china made with ground pork or with chicken).  Chinese do not drink anything with their meals because the soup is like the drink but they drink tea before and after their meals.  Some popular snacks sold in the food stalls are crayfish, roast duck, bowls of snails noodle soups and pineapple on stick.

http://factsanddetails.com/china.php?itemid=149&catid=11 a &subcatid=73

For the Chinese is very important to socializing during their meals and Chinese are known to stop doing what they are doing when is time to eat no matter how important is what they are doing.  In the Chinese culture when they are going to eat no one can start eating until the eldest person picks  up his chopsticks and begins to eat and no one should live the table before the eldest is finish eating.  Chinese people think that it is rude to eat in front of someone who is not eating or eating when you are walking on the streets.  Also when you are eating it is rude to add salt to the food because it is an insult to the cook.

http://factsanddetails.com/china.php?itemid=112&catid=4&subcatid=19

Time Consciousness

Chinese are very aware of time and when they have an appointment they need to arrive on time or a few minutes early.  If the Chinese arrive late to an appointment especially a business appointment they see this as an insult and they think that you are not very interested in doing business with them.  If you are invited to a dinner you need to arrive on time but never arrive before the time of the dinner.

http://ilint.illinois.edu/travel/China.pdf

Health risks/High risk behaviors

The Chinese are at high risk for developing lung problems that can lead to dead because of pollution being so high.  Chinese are also at risk for heavy metal toxicity because there are many heavy metals like lead and mercury in the lands and the water that contaminate the crops and the fish.  There is a high incidence of cholera and hepatitis and an increase in digestive cancers do to the contamination of the drinking water.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799473/?tool=pmcentrez

Among all the countries China is the one that has the most consumers of tobacco and this has a great impact in Chinese health. There are three disease related to smoking in china cancer, being the one with the highest death, cardiovascular disease being in second place and respiratory disease in third place.        http://content.nejm.org/cgi/content/full/360/2/150

Taboos or important things to take note of

There are many taboos in the Chinese culture like in all other cultures and here are some of the taboos you might want to be aware of.  When the Chinese receive gifts they only receive the gifts that come in even numbers and they avoid the ones that come in odd numbers as a taboo.  They also avoid the number four although it is an even number but they avoid it because “four” sound like “death”.  Also never give anything white or black to a Chinese because they have different meanings for them then for the American culture.  The color white for them means poverty and the color black is the color of calamity and grief.

http://www.chinatravel.com/facts/traditions-and-custom/traditional-etiquette-and-taboos.htm

Chinese have to use their chopsticks to eat everything and it is a sign of bad luck if you drop your chopsticks in the table because it is a sign of bad luck.  Also never stick them in a bowl of rice so they are stand up because this means death.

http://factsanddetails.com/china.php?itemid=112&catid=4&subcatid=19

Discrimination of Chinese in Health Care

The journal of Clinical Nursing published an article about Chinese oncology nurses attitudes towards disclosing terminal diagnoses to patients.  It was reported that 55.8% of nurses in the study believed that it was not appropriate to tell the patients if their diagnoses was terminal.  This is actually quite common in not only China, but other western societies.  Culture plays a huge role in this issue.  In the United States, we value the patient’s autonomy, but in China, the family as a whole takes priority over the individual.  Therefore, the healthcare team is obligated to answer to the family, and honor the family’s wishes over the individual.  This is important to note as an American nurse, because it is our duty to provide culturally competent care, but we have to be very careful in this regard because it is necessary that we understand the dynamics and inner workings of other cultures to care for them adequately, but there are rules, protocols, and laws that bind us as American nurses.  It would not be ethical or legal to hide a terminal diagnoses from a patient, or honor the family’s wishes, and disregard the patient.  It is also important that we understand how learning about a culture can often create biases, which is the opposite of what we are trying to do.  We need to treat each individual as so, and not rely on blanket stereotypes when providing care.

Li, J., Liu, C., Zou, L., Huang, M., Yu, C., You, G., et al. (2008). To tell or not to tell: attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis. Journal of Clinical Nursing, 17(18), 2463-2470. Retrieved from CINAHL with Full Text database.

Differences Between Cultures

  • Religion– Chinese people are predominantly Confuciust, Buddhist, or Taoist (Daoist).  Americans are approximately 75% Christian, 15% non-affiliated, and a very small percentage is of other religions such as Buddhism.

http://en.wikipedia.org/wiki/Religion_in_the_United_States

  • The general value of the family as a whole taking precedence over the individual is prominent in Chinese culture, where Americans are much more autonomous and independent from their families and social organizations.

http://www.kwintessential.co.uk/resources/global-etiquette/china-country-profile.html

  • The patriarchal characteristics of China make it unique when compared with America.  The father makes all decisions.  Another interesting aspect is that the eldest son is expected to care for his elderly parents.

http://www.absoluteastronomy.com/topics/Patriarchy

  • The value that is placed on respect is different than what many Americans are used to.  Many Chinese people do everything with respect.  The concept of ‘face’ which requires them to never be disrespected or disrespect others is prominent.  If an individual does something shameful, the family looses face.  The family is looked upon poorly, and often people make decisions based on how it would reflect upon their family.
  • Eye contact is another difference.  In America, it is disrespectful to not look in someone’s eyes when they are speaking to you, but the Chinese view the social encounter in the opposite manner.

http://www.kwintessential.co.uk/resources/global-etiquette/china-country-profile.html

5 things a nurse should know about the Chinese Culture

1. As a nurse one should know that the Chinese culture takes medication different than  in the USA.  Chinese stop taking their medications when the symptoms go away and they save the leftovers and give it to someone else with the same symptoms.

http://ezinearticles.com/?How-Traditional-Chinese-Health-Beliefs-and-Chinese-Culture-Influence-Health-and-Illness?&id=903741

2. As a nurse one should know that it is considered disrespectful to stare into another person’s eyes. A nurse should not look at the Chinese person in the eyes when explaining a procedure or giving them instructions.  The Chinese avoid eye conact in crowded places to give themselves privacy.

http://www.chinatownconnection.com/learning_chinese.htm

3.  As a nurse when caring for the Chinese culture it is important to know that the Chinese have a high respect for authority.  This could cause some communication in healthcare, when the nurse is explaining something to the patient, and the patient nods.  The nurse may think that the patient understands, but the Chinese patient may just be trying to be respectful to someone they see as an authority figure.  It is important that the nurse of the patient express that they understand, and get a medically certified translator if needed.

http://www.stanford.edu/group/ethnoger/chinese.html

4. As a nurse one should also know that the Chinese believe in good spirits. They believe and want only positive spirits around them at any point in time and do many different rituals to remove the bad ones. They will pray to good  spirits to heal someone or to make them feel better.

http://www.chinatownconnection.com/chinese-society-traditions.htm

5. Traditional Chinese Medicine (TCM) is used primariy to cure symptoms of illness. In traditional Chinese culture, taking medication is thought to be aversive, hence medications tend to be taken only until symptoms are relieved and then discontinued; if symptoms are not obvious, medications will probably never be taken.  As nurses we need to be aware of these types of situation and need to expalin the absolute importance of the drug regimin given.  If it is a prophylactic medication we need to again explain the importance of the medication in keepin the individual safe from reoccuring episodes of illness.

http://ezinearticles.com/?How-Traditional-Chinese-Health-Beliefs-and-Chinese-Culture-Influence-Health-and-Illness?&id=903741

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