Japanese: Cultural Interview and Nursing Assessment
Presentation of client and scenario
This interview was conducted with a Ms. X, a Japanese national visiting friends in another country. She was, over the course of the interview, asked about a number of personal and culturally sensitive factors about her native culture that might affect a nursing intervention.
It is important for a nursing practitioner to keep this in mind as, in the 2000 census, 796,700 residents of the U.S. identified their "race" as Japanese,
Thus it is useful for all nursing practitioners, particularly those residing on the West Coast to keep abreast of Japanese cultural traditions. (Tanabo, 2001) Also, even when residing in Japan, Japanese first-generation immigrants have traditionally seemed less eager than other immigrant groups to assimilate into the hegemonic culture. One measure of this is that compared to other Americans of Asian background, a lower percentage of Japanese elders speak English. "In 1990, only 36% said they did not speak English very well." (Tanabo, 2001)
This difficulty in English communication is one of the first and perhaps most obvious factors to consider techniques and subjects in nursing interventions with members of this population
Socioeconomic factors in cultural assessment guidelines and culturally sensitive interventions
The subject of this interview still resided most of the time in Japan. Although Ms. X was from a relatively affluent Japanese home, and was twenty-three, she was still living with her parents, and intended to do so until she married. This is quite common in Japanese culture, she assured the interviewer, and not seen as evidence of immaturity, but respect, regardless of her own personal state of affluence. She said parents bridled at any attempts upon Ms. X to perhaps share an apartment with a friend, even though Ms. X's friends were 'nice girls,' according to the admittance of her parents. Most of Ms. X's income was thus disposable, and used for her own pleasure.
Increased income and job security was thus not connected, for this unmarried woman, to greater familial independence, as it might be in America. It has been noted that "the Japanese concept of filial piety," which stems from Confucianism and was brought to Japan in the seventh century and has been passed down through the ages still holds strong culturally. Japan is often described, as a society where the 'tall peg' or the nonconformist is nailed down to keep harmony with the whole, and family and social order, filial piety was felt to extremely important. Children are expected to obey and respect their parents, bring honor to their parents by succeeding in work, and support and care for parents in their old age. (Tanabo, 2001)
Thus, an individual, particularly a female individual should not be immediately construed as immature during an intervention, despite a more dependant lifestyle dynamic not dependant upon economics from this culture.
Lifestyle in cultural assessment guidelines and culturally sensitive interventions
Ms. X was dependant upon her family for shelter and emotional sustenance, although she had an active adult social life. At times, this caused conflict with her parents. One potential source of intervention if this was unduly conflict-ridden might be an exchange of Ms. X taking on more financial responsibility in exchange for more freedom -- but culturally, this seems to be incompatible with the family's accepted way of life.
Additionally, for many Japanese "kodomo no tame ni" or "for the sake of the children" is the motto -- in exchange for familial control over many spheres of life that American children might bridle at, given the value of independence in American culture, Japanese children both male and female are seldom required to do chores around the house -- Ms. X's mother, she said, performed most household tasks, despite the presence of the elderly Mr. X's grandmother in the home.
Mrs. X's difficulties with her mother-in-law, while not directly related to her daughter's issues, might be another potential source of intervention, as it seemed to cause conflict in the family dynamic, despite the stress upon taking care of one's elders in the culture.
Family Values in cultural assessment guidelines and culturally sensitive interventions
When discussing family decision-making and how physicians conducted themselves in working with families, Ms. X noted that according to the traditional hierarchy is maintained, the father of the house would preside, then the oldest adult son, although Ms. X's elder brother was no longer living with the family,…