Transcultural Health Care

A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean American Culture

Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Overview/Heritage

  • This presentation focuses on the commonalities among Koreans from the Republic of South Korea, although some information may be congruent with North Koreans..
  • The first major immigration from Korea occurred between 1903 and 1905, when more than 7,000 men arrived in Hawaii.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Overview/Heritage

  • South Koreans immigrate to America to increase socioeconomic opportunities and improve educational opportunities.
  • They place a high value on education.
  • Their reputation for hard work, independence, and self-motivation has earned them the label of the “model minority.”

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Communication

  • The dominant Korean language, han’gul, was the first phonetic alphabet in East Asia.
  • Most Koreans in America can speak, read, write, and understand English to some extent.
  • Some Americans may have difficulty understanding their English, especially those who learned English from Koreans who spoke with their native intonations and pronunciations.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • A high value is placed on harmony and the maintenance of a peaceful environment.
  • Most are comfortable with silence.
  • Small talk may appear senseless and insincere.
  • Most stand close when conversing.
  • Touch in the realm of health care is readily accepted.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • Touching among friends and social equals is common and does not carry a sexual connotation, as it might in Western societies.
  • Hugging and kissing are uncommon among parents and children as well as among children and older aunts or uncles.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • Age, gender, and social status determine the use of eye contact.
  • Respect for those in senior positions is shown by not looking them directly in the eye.
  • Feelings are infrequently communicated in facial expressions.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • More traditional Koreans are past-oriented. Much attention is paid to the ancestry of a family.
  • Yearly, during the Harvest Moon in Korea, chusok (respect) is paid to ancestors by bringing fresh fruits from the autumn harvest, dry fish, and rice wine to gravesites.
  • The younger and more educated generation is more futuristic and achievement-oriented.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • Punctuality is the norm for keeping important appointments, making transportation connections, and reporting to work.
  • The number of surnames in Korea is limited: the most common ones are Kim, Lee, Park, Rhee or Yi, Choi or Choe, and Chung or Jung.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Korean Communication

  • Korean names contain two Chinese characters, one of which describes the generation and the other the person’s given name.
  • The surname comes first.
  • However, because this may be confusing to many Americans, some Koreans in the United States follow the Western tradition of using the given name first, followed by the surname.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles and Organization

  • Men are the primary financial providers.
  • Women are expected to stay home and care for the children and domestic affairs unless they are professionals.
  • Women have long been degraded in Korean society and seen as appendages of male family members.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles and Organization

  • In earlier times, a woman’s identity was determined by her role as someone’s daughter, wife, or mother. While many still practice these gender relationships, more educated women and men no longer adhere to these Confucian values.
  • Parenting in Korea is authoritative, although class differences play a more influential role in determining parenting styles and family roles.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles & Organization

  • Children are expected to be well behaved because the whole family is disgraced if a child behaves in an embarrassing manner.
  • Discussing domestic violence violates Korean cultural norms.
  • Dating is uncommon among high school students, although it is gaining in the US.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles & Organization

  • Once young adults have entered a university, they receive their freedom and are permitted to make their own decisions about personal and study time.
  • With rapid acculturation, children often take on the values of the dominant society or culture and challenge parents who support traditional values and ideals.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles & Organization

  • Parents expect their children to care for them in old age.
  • Hyo (filial piety) is the obligation to respect and obey parents, care for them in old age, give them a good funeral, and worship them after death.
  • The obligation to care for one’s parents is written into civil code in Korea.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles & Organization

  • Older people are frequently consulted on important family matters as a sign of respect for their life experiences.
  • Old age begins when one reaches the age of 60 years.
  • Women who divorce may suffer social stigma.
  • Living together before marriage is not customary in Korea.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Family Roles & Organization

  • If pregnancy occurs outside marriage, it may be taken care of quietly and without family and friends being aware of the situation.
  • Lesbian and gay relationships are frowned upon.
  • Personal disclosure to friends and family jeopardizes the family name and may lead to ostracism.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Workforce Issues

  • The skills and work experiences Koreans bring from their home country are often not accepted in the American workforce, forcing them to take jobs in which they may be over skilled.
  • A supervisor is treated with much respect in work and in social settings.
  • Informalities and small talk may be difficult for Korean immigrants.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

ClickerCheck

An older adult Korean American man does not maintain eye contact with the nurse who is teaching him insulin injection. The nurse recognizes that lack of eye contact means he

Does not understand the instructions.

Does not care about the instructions.

Is demonstrating respect.

Is hard of hearing.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Correct Answer

Correct answer: C

Many traditional Koreans do not maintain eye contact with people in authoritative positions as a means of demonstrating respect.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Workforce Issues

  • For an employee to refuse a request of an employer is unacceptable, even if the employee does not want or feel qualified to complete the request.
  • American slang and colloquial language is difficult for Koreans to understand.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Biocultural Ecology

  • Common physical characteristics include dark hair and dark eyes, with variations in skin color and hair darkness.
  • Skin color ranges from fair to light brown, with those residing in the southern part of South Korea being darker.
  • Epicanthal skin folds create the distinctive appearance of Asian eyes.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Biocultural Ecology

  • Common health conditions occurring with Koreans include the following: schistosomiasis, renal failure, asbestosis, hypertension, tuberculosis, hepatitis, stomach cancer, lactase deficiency, osteoporosis, peptic ulcer disease, and insulin autoimmune deficiency disease.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean High-Risk Health Behaviors

  • Korea continues to manufacture and use asbestos-containing products
  • Smoking by women in public is taboo, but some women smoke at home.
  • Men have a high incidence of alcohol consumption.
  • Seat belts are worn infrequently in South Korea.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Nutrition

  • The traditional Korean diet includes steamed rice; hot soup; kimchee; and side dishes of fish, meat, or vegetables served in some variation for breakfast, lunch, and dinner.
  • Breakfast is traditionally considered the most important meal.
  • Rice is served with 5 to 20 small side dishes of mostly vegetables and some fish and meats.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Nutrition

  • Food is flavorful and spicy. Cooking includes a variety of seasonings: red and black pepper, garlic, green onion, ginger, soy sauce, and sesame seed oil.
  • Most Korean Americans are at high risk for calcium deficiencies due to lactose intolerance.
  • A cultural treatment for the common cold is soup made from bean sprouts, anchovies, garlic, and other hot spices

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Pregnancy & Childbearing Practices

  • Pregnancy is a highly protected time for women.
  • Both pregnancy and the postpartum period are ritualized.
  • Once a woman is pregnant, she starts practicing Tae-Kyo, which literally means “fetus education.”

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Pregnancy & Childbearing Practices

  • The objective of Tae-Kyo is to promote the health and well-being of the fetus and mother by having the mother focus on art and beautiful objects.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Death Rituals

  • Death and dying are fairly well accepted in the Korean culture.
  • Prolonging life may not be highly regarded in the face of modern technology.
  • Families are expected to stay with family members and assist in feeding and personal care around the clock.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Death Rituals

  • Many believe that patients should not be told they have a terminal illness.
  • Crying and open displays of grief are common and signify the utmost respect for the dead.
  • Relatives and friends pay respect by viewing photographs of the deceased instead of viewing the body.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Death Rituals

  • An ancestral burial ceremony follows death, with the body being placed in the ground facing south or north.
  • Rice wine is sprinkled around the gravesite.
  • The eldest son or male family member sits by the deceased, sometimes holds a cane, and makes a moaning noise to display his grief.
  • The cane is a symbol of needing support.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Spirituality

  • Organized religions include Christianity, Buddhism, and Chondokyo.
  • The church is a powerful social support group for Korean immigrants.
  • Christians believe the spirit goes to heaven; Buddhists believe the spirit starts a new life as a person or an animal.
  • Family and education are central themes that give meaning to life.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Health-care Practices

  • Herbal medicine may be used in conjunction with Western biomedicine.
  • Herbal remedies include ginseng, seaweed soup, and haigefen (clamshell powder), which has high levels of lead, causing abdominal colic, muscle pain, and fatigue.
  • Acupuncture, acumassage, acupressure, and moxibustion therapy are commonly used.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Health-care Practices

  • Some Korean Americans are stoic and are slow to express emotional distress from pain.
  • Others are expressive and discuss their smallest discomforts.
  • Organ donation and organ transplantation are rare, reflecting traditional attitudes toward integrity and purity.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Health-care Practices

  • Mental illness may be stigmatized. Hwa-Byung, a traditional Korean illness, occurs from the suppression of anger or other emotions.
  • These emotions are expressed as physical complaints, ranging from headaches and poor appetite to insomnia and lack of energy.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Korean Health-care Practitioners

  • More traditional individuals frequently prefer health-care providers who speak Korean and are older.
  • Because of modesty, women prefer women health care providers to perform Pap smears, mammography, and breast examinations.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

ClickerCheck

Mrs. Kim brings her 15 year old daughter to the parish nurse because she is having abdominal cramps and fatigue that have worsened since she began giving her haigefen. The nurse should request a blood test for

Iron levels.

Lead levels.

Calcium levels

Potassium levels.

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Transcultural Health Care: A Culturally Competent Approach, 3rd Edition

Correct Answer

Correct answer: B

Haigefen is an herbal compound that is made with clamshells which has a high lead content.