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Patient case study. Part I: I would like to start by saying that AIDS is a short form for Acquired Immune Deficiency Syndrome. It is a disease that damages the body's immune system (the system that helps fight off illnesses). When a person's immune system is damaged, he or she is more likely to become sick from illnesses that might not hurt a person who has a healthy immune system. The person's body with AIDS cannot defend itself, and it isn't able to fight off infections and some kinds of tumors. We need to remember that although AIDS is contagious, it is much harder to get than a cold or the flu.
In fact, it's very important to know how people don't get AIDS: you can't get it from hugging, kissing, or holding hands. One can't get it from sitting next to someone who has AIDS or by being in school with someone who has AIDS. AIDS is not spread by coughing or sneezing, and it's not carried by mosquitoes or other bugs. AIDS, I should note here, is transmitted when the Human Immunodeficiency Virus (HIV) is spread from the inside of an infected person's body into the inside of another person's body. The germ can do this in three main ways: Sex with AIDS infected person. HIV is in an infected person's blood, a man's semen, and secretions from the vagina of a woman.
Some doctors and researchers think that HIV can get into the bloodstream through cuts or sores on the vagina, penis, rectum (anus), and possibly even the mouth. Some of these cuts can be so small that a person might not even know they were there. Sharing needles, toothbrushes, syringes with AiDS infected persons. People who inject drugs are at risk of infecting themselves with HIV - this includes intravenous drugs (drugs that are injected into a vein) as well as injected steroids. Many people who use needles to take drugs share the needles with other drug users. When a person infected with HIV does this, the virus can be spread to another person through tiny amounts of blood attached to the needle.
From mother to a child. A newborn baby can get HIV from his mother if she has the virus in her body. This can happen before the baby is born or while the baby is being delivered. In rare cases, mothers can pass HIV on through breastfeeding. Sometimes, the mother doesn't know that she has HIV until she is already pregnant. Luckily, scientists have found that pregnant women with HIV who receive treatment for HIV are much less likely to spread the virus to their babies when they are born.
Babies who are born to HIV-infected mothers are also given medicine to prevent HIV infection. The family that I interviewed was the family of Li Mau, who moved to the USA about 5 years ago to live with their distant relatives who were born in the USA. The family consists of: Husband, Ma-no, is 40 years old. Ma-no works as an electric engineer for a small company. Wife, Sue-min is 35 years old. Sue-Min works as a bookkeeper, as well as manages to create and sell cakes for a profit.
Child, Susan is 4 years old (born in the USA). Susan is supervised by an au pair nanny. What is the historical background of the cultural group of the person you interviewed? The cultural group of the Li Mau family belongs to the asian ethnic origin. The wife, Sue-Min is a traditional Chinese and she remembers all of her relatives to be of Chinese descent. Ma-no is of mixed asian descent, namely of Chinese and Korean.
His father moved to China sometime after the WWII and this is where he met his wife to give birth to Ma-no. Susan is an American of Chinese-korean descent. Under what conditions did they come to the US? The Li Mau family had a distant relative living in the USA as a resident.
After asking them about the ways of how they entered the USA, the Li Mau family told me that it took them a long time and much money for the lawyers to create a case that the Li Mau family was discriminated and persecuted in China and thus had to flee to the USA to the relative to remain safe. As far as I understood, they found some legal loophole to get their permanent residence in the USA. How might this background affect the individual / family perception of HIV/AIDS? Historically, the Chinese have very low rates of HIV/AIDS compared to other minority groups currently present in the USA. From the interview with the Li Mau family I understood that they love each other and remain faithful to each other.
They are aware of the high AIDS rates in the USA and certainly are still shocked by the immoral behavior of the US teens and adults as they see in daily encounters and on TV. Both Sue-min and Ma-no appear to be shy and certainly hesitant to pursue promiscuous activity that might increase their chances of getting AIDS. B. Ethnic populations respond best to interventions that are consistent with their values and beliefs. What is the cultures dominant view of the nature of humankind? The Li Mau family calls themselves Christians, despite the atheistic propaganda in China.
They fully agree with the concept of divine creation and with the fact that all diseases are either sent on earth by God to punish or test people or by Satan to do his dirty job on earth. They believe also that the diseases like AIDS, and cancer are present on the earth to signify that we live in the last time and should expect the end of the world as described in the Revelation. What are the dominant religious / spiritual beliefs? The family's dominant belief is Christianity (protestant).
How might these views or beliefs influence the cognition's associated with HIV disease. The Li Mau family told me that they personally do not know of anyone who has AIDS and thus cannot answer this question correctly. At the same time they noted the following: A person who has AIDS is no different from any other person on earth and thus should be respected. AIDS is like a Russian roulette and one can never be 100 % certain that she / he is safe.
They told me of some news they heard when one man got AIDS in the barbers shop, when shaving. They said that the Gods ways are unforeseeable and it is rather possible that God is trying to convey some message to humanity by sending all different sicknesses and diseases on them. At the same time they are confident that those who obey god and who in general lead the healthy life style and adhere to the principles of morality as a rule are less likely to get the AIDS. They also noted here that they were a family and thus technically did not need any external contacts except for the job. C. For women to protect themselves from HIV infection, they must rely not only on their own skills, attitudes, and behaviors, but also on their ability to convince a partner that protection is necessary.
The Li Mau family does not use condoms during sexual intercourse, yet consider it to be a safe sex as long as none of the partners has any sexual contact with people outside the family. How is the family unit defined? The Li Mau family considers itself to be a traditional as a biological, procreative and child-rearing structure and emphasize the biological relationship among family members. They also believe that the church has been especially vocal and rigid in its definition of family and they support it, too.
For example, the Church often refuses to recognize a coupling as a family if the couple is not married in Church, if one of the partners in the coupling had been in a previous coupling, or if one of the partners in the coupling does not adhere to the teachings and practices of the Church. Through its power to define family, the Church meets its own needs to insure member loyalty and continued submission to the teachings and practices of the Church. One the other hand, after living for 5 years in the USA they start to believe that the economic system markets goods and services produced by the economy to the family consumption unit and defines family with as few members as possible to discourage the sharing of goods and services within an extended family. The economic system also establishes a system of financial accountability so debts owed by one family member become an obligation on other family members. How do men and women communicate? Family Communication provides a framework for analyzing the family as a communication system.
It examines the ways in which members of family systems interact to develop, sustain and manage their relationships in an era when family issues are at the forefront of national concerns, particularly in governmental, educational and religious arenas. Historically, research in family interaction was conducted on families with members in treatment for physical or psychological difficulties. However, recent years have seen an explosion of research and writing about family interaction in functional families. This tele course calls on this research to provide a descriptive introduction to family communication in everyday life across a wide range of family types. Old and young?
The Li Mau family believes that the elderly should have more power and privileges than the adults or children should have. They find it necessary to have their parents live with their children till their death rather than to put them in the sanatorium or the house for the elderly. What is expected of women, men, the young and the old? Men are expected to be strong, masculine, food-providers and hunters who are able to provide well for the family and for the retirement.
Women are supposed to be feminine, cute and beautiful. They should bear and rear children with the help of the husbands and do what they want. Children are supposed to be extremely obedient to their parents and should have their own initiative only after graduating from college. The parents are supposed to make 90 % of the decisions for the children and oblige them to finish a university. How is conflict resolved inside the family unit and conflict resolved with those outside the family? The Li Mau family said that they do not have conflicts (yeah right! ).
After asking them loaded questions I understood that the conflicts are usually resolved quickly in favor the man. In other words, the wife usually gives up her interests in his favor and in favor of their child. The husband also bases all the outcome to benefit the child. What are accepted child-rearing practices? The children are supposed to be obedient to the parents who have the ultimate authority. Therefore, the children must do the first half of their lives whatever they are told.
Namely: Finish the high school well. Graduate from the university. Get a good-paid job After they have the job the parents allow them to do whatever they want, yet still expect the children to stay in touch and let them in their house and families when the parents get old. The parents also are the vital decision makers for children with respect to their marriage and job selection. How may the above influence the HIV of the client in the case study? The children of Li Mau family according to Ma-no are going to be taught about the AIDS at a somewhat exaggerated manner so that they are scared of the disease and of different temptations present in college and high school.
The Li Mau believes that it is better for children to be prejudiced about AIDS than careless about it. D. Living in a new environment and culture is inherently challenging. What is known about the acculturation process for this group? The Li Mau family believes that they are getting Americanized in their views of the medicine and the world. They both speak decent English and believe that the US political system is healthier than that of China.
They plan to take several courses in college to get more practical skills and thus better jobs. They believe that consumerism is a right thing and one should work good for a good living. How might this process influence the clients HIV? Just like the majority of Americans the Li Mau family has phobias of AIDS and despite the knowledge of how AIDS spreads, they said that they would quit their jobs if the AiDS infected person worked in the cubicle next to them. Part II. Health, Illness, and, Treatment What are the explanations for states of health and illness?
The believe that the main business of the US medicine is business. In china they say, the main business is to make the person healthy and sound regardless of the costs. As a result of this they say the medicine is state-controlled and is non-profitable at all. Here in the US they find it very formal and unfriendly, when a doctor is not willing to talk with you past the time dedicated to you. How is HIV/AIDS viewed? HIV and AIDS is viewed as a non-curable diseases, yet just like the majority of Americans they think AIDS does not relate to me because we have sex only with one stable partner.
What is the nature of traditional treatments and healers? In china the traditional healers and medicine is very much developed and they actually prefer the traditional medicine to the modern hi-tech diagnosis and treatment. They try to constantly buy different food additive and truly consider ginger to be a panacea. How is the US health care system regarded? The US health care system is regarded as one of the most sophisticated and effective in the world yet as the one available only for the rich. How could health care providers most effectively approach / interact with the family?
Certainly, they believe that the health care providers should have been more attentive to the non-white minorities, because the family said they feel some sort of indifference to them from the medical personal. The also noted that this can possibly be because of the cultural differences between the USA and China, where the doctor besides doing his job would engage in a social conversation with the patient, speak about the recent news and rumors and just act as a friend. Part III. The Nurses Cultural Influences. My cultural background is certainly different from the cultural backgrounds of the Li Mau family who spent most of their lives in china rather than in the USA.
I view a family more as a liberal union of two people who want to enjoy their time together and give birth to the children. The children in my personal opinion need to be taught how to make choices for themselves and the parents should rather serve as advisors and not as commanders. Some of the bad choices of children if they are not harmful should be allowed by the parents. In other words, if a child wants to spend his / her weekly allowance on buying a book or going to the movies that would cost him / her an opportunity to buy some other cool things they desire they should be allowed to do so. As for the universities, I believe that they should still be encouraged to go, yet not forced to go there. Women and men should be equal in their right and should both be able to earn a living because a reliance on the husband may prove disastrous should the husband die.
I agree with the family about the fact that doctors should be more as friends rather than as specialists who just want to get the most from the hour of time they dedicate to you. Speaking about the challenges I might encounter when dealing with the family by providing cross-cultural nursing care I see the following: The family might need a more close communication rather than a cold and distant as they get from the other doctors. The family values their children more than themselves. Thus, whenever I would need to recommend something I should certainly make it clear that the child will benefit from that (to have healthier parents, etc. ) The family is absolutely certain that they are not going to get AIDS because of their lifestyles.
I will need to explain them that AIDS might be around them, thus they should take care. The family appreciates the healthy medicine, i. e. chiropractics, herbal medicine etc.
thus, I will need to make sure that they are aware of the natural means of curing anything prior to prescribing the medicine that the traditional Americans use.
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