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Chanell Carcallas-Concepcion, PhD, RN Nursing Education Department, Beijing United Family Hospital
593,832 foreigner nationals living in mainland China (2010 Census) 47% from neighboring Asian countries 23% from Western countries 10% (107,445) reside in Beijing
Present the Western patients experiences related to culture and care expectations while being cared for by Chinese nurses in Beijing.
Hermeneutical Phenomenology Van Manen (1990) specific guidelines for studying lived experience as a human science rooted in hermeneutic phenomenology Munhall (2012) Proposed a more operational stepwise approach
Not a citizen of China Experienced being cared for by Chinese nurses (at least 3 days) Face-to-face Interview
1. Immersion 2. Coming to the phenomenological aim of the study 3. Existential inquiry, expressions and processing.* 4. Phenomenological contextual processing* 5. Analysis of interpretive interaction 6. Writing the phenomenological narrative
I. Conducting Thematic Analysis: 1. Holistic or sententious approach 2. Selective or highlighting approach 3. Detailed or line-by-line approach II. Identify common themes III. Choose particularly illuminating phrases from the data to capture the meaning of the themes
Ten participants Counties of origin: USA = 7 Canada = 1 Europe (Ireland, Switzerland) =2 Ages: 33 49 years old Years in China: 2 15 years
Navigating cultural differences Knowing persons through caring Negotiating care expectations Pain management expectations
I realize that I do have to navigate cultural differences. And really decide what I believe about things believe about my healthcare Sometimes it s hard to know what is cultural or what is just (the nurses ) personality. (Participant 3)
Some expect Chinese nurses to possess cultural awareness and cultural sensitivity.
recognize the differences in culture, but build on similarities culturally competent health care is a process of becoming, rather than being.
The nurses think I m doing something wrong but I think I am really okay. After my (bag of ) water had broken, I felt some resistance (from the nurses) in walking around and using the birth ball. I just hate being scolded by the nurses so if I hear the nurse coming, I jump back on bed and act as if I was being really still. (Participant 3)
Communicating in English Understanding their language Concerns about not being understood
I appreciate it when they (nurses) understand English. Mostly because when I m in pain my Chinese is not that good. I have hard time thinking in Chinese. When I m hurting I need them to be able to speak English. (Participant 7)
nurses talk to each other in the room, they are speaking in Chinese that makes it look like they are not sure about something. It makes you wonder what is going on and what they are talking about. (Participant 8)
focus on medical care almost exclusively rather than patient comfort
I would constantly beg for pain medication. No one would offer it to me voluntarily. When I am in China, I always feel my pain is not managed well. (Participant 5)
Pain is something expected and not; something to be avoided.
that really makes you feel like you are being cared for because you re not just a number, you re not just a person going through the system
Navigating through cultural difference Negotiating care expectations, including management of pain. Fears & uncertainties turned to trust & confidence in being cared for by Chinese nurses Celebration of humanness by knowing persons in caring
Nursing Practice at BJU Hospital nursing practice model included culturally sensitive care Training & Education incorporate findings in: New Nurse Orientation New Gradate Training Levels 1 & 2 Training Preceptor Training Other in-service training
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