Running head: CHINESE CULTURAL INTERVIEW

Chinese Cultural Interview

Tuyet Nguyen
California State University, Stanislaus

CHINESE CULTURAL INTERVIEW

Chinese Cultural Interview

In nursing profession, the ability to effectively interview patients from different cultures
offers a good opportunity to learn more about each others cultures. This paper represents an
interview conducted with Jessica Chen on Saturday, October 12, 2013 and all information
presented is a result of this personal communication (Jessica Chen, personal communication,
October 12, 2013). The interview took place in her private home. She got married to a Chinese
engineer 20 years ago. Currently, she is an accountant and has two teenage daughters. Jessica
took several lower general education classes with me two years ago. The paper is a summary
about her Chinese culture, how her culture affects her life and beliefs based on 12 cultural
domains of Purnells model, and appropriate nursing interventions (Purnell, 2008).
Overview
Jessica Chen came to the United States 16 years ago from Beijing, China. Beijing,
capital of China, is located in the warm temperature zone with a semi-humid climate and has
four distinctive seasons, with short springs and autumns and long summers and winters (China
National Convention Center, n.d.). In Beijing, she had a Bachelor of Art degree, major in
business and worked as an accountant. In 1993, Jessica and her husband got married in Beijing.
She came to the United States to reunite with her husband four years after marriage.
Communications
In Beijing, Jessica speaks Mandarin which is also a dominant language in this city. There
are many different dialects in China, but she only knows about Mandarin or Putonghua which is
mainly based on the Beijing dialect. When she is talking to her family members or best friends,
her tone and volume of speech can be fast and a little bit loud. But, if she is talking to people
from different cultures, especially whom she first meets, she often speaks in a soft tone and low

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volume. She does not feel comfortable sharing thoughts and feelings with others except her
husband and her mother. In her culture, touch often means invading to someones comfortable
zone. Unless touch occurs between husbands and wives and same-sex family members, people
in her culture feel uncomfortable to be touched even with a good intention. Touch between
same-sex friends is acceptable. In general, handshake and head nodding are acceptable ways of
greeting outsiders. She prefers to be greeted by her last name. In English, the first name goes
ahead of the last name, but the last name is in front of the first name in Chinese.
Jessicas personal distance when communicating on a one-to-one basis is at least an arm
length with strangers and arm-length with friends. When communicating to a stranger and an
older adult, she often avoids direct and consistent eye contact because it means angry and
disrespectful in her culture. However, when communicating to her husband, children, and
friends, intermittent soft eye contacts might present. Eye contact does change among
socioeconomic groups in Beijing. In addition to eye contact, soft facial expressions with smiling
and head nodding are often present when communicating to others.
For temporal relationships, she was present-oriented when she was in Beijing. However,
she becomes future-oriented when she moved to the United States to reunite with her husband.
A better future for her daughters is the priority. She and her husband strongly believe that
education is the main key to open the door to that future; therefore, they make sure that their
daughters understand the importance of education and commit to do well in class. In terms of
time, she is always on time for her appointments as well as social engagements.
Family Roles and Organization
A strict gender hierarchy in the traditional Chinese family has implicated that, the status
and function of women were downgraded and relegated to the roles of reproduction and

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household work; therefore, gender roles are clearly and sharply differentiated for husbands and
wives in traditional Chinese families (Kim, Laroche, & Tomiuk, 2004, p. 11). Similar to
traditional Chinese families, Jessicas husband, Mike Chen, is the head of the household.
Compared to other Chinese men living in China, her husband is more willing to listen to her
suggestions. However, he is the one who makes final decisions even if the decisions go against
others wills. Unlike traditional Chinese families, Jessica enters the workforce to share financial
burden with her husband. Her daughters are expected to help her with chores and cooking so
that they will sense what their roles look like in the future when they get married.
For her daughters, showing disrespect and talking back to parents are taboo behaviors.
All decisions about future, including education, occupation, and marriage, must be discussed
with parents. According to Wang (1998), children obtain gender role concepts very early,
internalize certain gender role messages transmitted by their parents, and form gender
role stereotypes. Based on the studys result, it is understandable how Chinese culture affects
Jessica and her husband on their decision making over their daughters lives instead of letting
them exploring their own choices.
Jessicas parenting style is authoritative, in which she and her husband place reasonable
limitations, consequences, and expectations on their daughters behaviors and allow them to
express opinions (Hockenberry & Wilson, 2009). Also, Jessica and her husband incorporate the
use of reward as a positive reinforcement and use fair discipline (Hockenberry & Wilson, 2009).
Although physical punishment is common and is often not considered as child abuse in China,
Jessica and her husband are very against it.
Jessicas family is an extended family, including her, her husband, her two daughters, and
her mother-in-law who is 79 years old (Hockenberry & Wilson, 2009). Her mother-in-law

CHINESE CULTURAL INTERVIEW

helped her take care of her daughters when they were young and supported her family during
financial crisis. Since gender-related roles of men and women in the Chinese family system are
defined clearly, alternative lifestyles and nontraditional families, such as single parents, blended
families, and same-sex families, are viewed as dysfunctional families (Hu & Wang, 2013).
Jessica worries that the nontraditional families will have negative effects on future generations.
According to Hu and Wang (2013), perceived parental attitudes toward marriage can be
understood from the central role of familism in Chinese culture, in which the emphasis on
continuing the family by bearing male offspring through heterosexual marriage. Therefore, it is
easy to understand why Jessica has the negative attitude toward those nontraditional families.
Workforce Issues
According to Jessica, there are different religions in China, such as Taoism, Buddhism,
and Christianity. However, the main religions are Taoism and Buddhism. The religion of
Jessicas family is Buddhism. When she worked as an accountant in Beijing, she neither
encountered nor witnessed any workforce issues regarding different religions. Jessica thinks that
Chinese culture promotes unity as a community, family, or nation more than as an individual.
Therefore, Chinese develops assimilation, in which the individuals need to adapt themselves to
fit in the main stream in favor of unity (Williams , 2001). About gender inequality in workplace,
Jessica says that it was terrible during her generation and she thinks it still exists in China.
Biocultural Ecology
Chinese is classified as Asians which have yellow skin, straight and black hair, small eye
with dark color, low nose bridge, and short (Facts and Details, 2011). Skin problems due to sun
exposure are not common. According to Jessica, the diseases or health conditions that are
common with Chinese are diabetes, lactose intolerance, and osteoporosis. Majority of her female

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family members, including herself, suffers from lactose intolerance and osteoporosis. Also, there
are many people in her family having Type 2 diabetes. In fact, it is estimated that about 180
million people in the world suffer from diabetes today, in which there are 21 million people with
diabetes in China (World Health Organization, n.d.). Besides, almost 70 million Chinese over
the age of 50 suffer from osteoporosis and about 687,000 hip fractures in China each year
(International Osteoporosis Foundation, n.d.). Jessica informs that antibiotic resistance was
common because there was no prescription required to buy antibiotics when she was in China.
High Risk Behaviors
According to Jessica, alcohol and tobacco abuse and domestic violence among Chinese
men are common. In fact, an international survey on domestic violence of more than 2,000
Chinese found that half of male participants have physically or sexually abused their wives or
girlfriends (China.org.cn, 2013). During Jessicas childhood, she and children at her ages were
living in a poor condition partly because there was no birth control. Male circumcision is not
common in China. Because of expensive health care cost both in China and the United States,
she prefers to try traditional practices and over-the-counter medications first and only seeks help
from Western medicine if the traditional treatments fail.
Jessica identifies her family as sedentary lifestyle. Even though she understands the
importance of increased physical activity, sometimes everyone is too busy and feels exhausted
after hard working and studying days. Every other weekend, Jessica, her husband, and her
daughters sometimes walk or ride bicycles several miles around the nearby park. Safety
measures, such as seat belts and helmets, are applied strictly in her family.
Nutrition
According to Jessica, there is no specific meaning of food. Food is used as a treat during

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parties, weddings, and funerals. Chinese foods are so various, but they typically serve with
steam rice or rice noodle. When people are sick, foods cooked with herbals for several hours are
preferred. When Jessica lived in Beijing, Chinese people loved to eat salty and fat foods.
However, due to an increased knowledge about healthy foods recently, Chinese people,
including herself, limit their salt and fat intakes. The significant vitamin and mineral
deficiencies experienced by Chinese probably are vitamin D and calcium due to lactose
intolerance and lack of sun exposure.
Pregnancy and Child Bearing Practices
During Jessicas generation, she states that fertility practice was not common. Majority
of people during that generation could not afford to pay or was afraid of having abnormal babies.
Jessica supports the fertility practice because it brings hope and happiness for many couples who
are unable to have biological children. Since she thinks raising a child is a full-time job, birth
control is necessary to space out between children so that her children will receive the best care.
She prefers to use condoms as birth control.
In terms of Jessicas cultural beliefs toward pregnancy, Jessica thinks that pregnancy is a
natural process, so medical interventions should be minimal. During the first and last trimesters,
she usually tries to avoid having sex to minimize the harmful effects on baby. During
pregnancy, women in her culture are advised to be more active so that they can have easy
deliveries. About pregnancy taboo practices, Jessica shares that consumption of dark-colored
foods is believed to cause darker skin on baby. Also, pregnant women are not allowed to eat
snake and rabbit meat which are believed to cause skin problems and cleft lip on baby. During
labor, Jessica only wants her own mother and her husband to attend. Silence labor is common in
her culture because loud and crying labor is embarrassed. Jessica strongly believes in theory of

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hot and cold, in which women should avoid taking a bath for a month, keeping the body warm,
avoiding cool air go into the body, and eating only hot foods after delivery.
Death Rituals
In Jessicas culture, both birth and death are considered as natural processes. White is the
color of death and mourning. Burial of the dead is always the first choice, needs to be well
prepared, and follows certain rules. Cremation is traditionally uncommon. The deceased people
will be worshipped by the family at home using an ancestral tablet. Mourning continues for
another 100 days. Chinese do believe in afterlife, in which the soul of the deceased family
members might return.
Spirituality
Jessica states that she usually goes to Buddhist pagodas twice a week to meditate and
hear the chanting. By doing those, her soul feels much calmer. Jessica identifies two great
sources of strength which are her family and her religion. These two sources of strength go hand
in hand and balance her life. She strongly supports the idea of collaborate spirituality and health
practices because it will help achieve the goal of delivering the best cares during hospital stays.
Health Care Practices
Jessica identifies four normal processes in life which are birth, aging, illness, death.
Since illness is one of four normal processes, she only seeks medical help if life-and-death
situations occur. Language barrier is still a problem for people from her culture to seek medical
care. Saving face is an important aspect for Chinese, so misunderstanding between health care
providers and Chinese patients often occurs. The main reason is that head nodding in Chinese
patients does not necessarily mean they actually understand the information. They try to save
faces for both sides.

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Followers of Buddhism, including Jessica, believe that pain and suffering might be the
consequence from doing bad things in the last life. Keeping that idea in mind, the ability to
tolerate the pain is often high. Some Chinese patients look very calm and quiet, but they might
be suffering from severe pain. Regarding mental illness, if mental illness occurs in elderly, it
might be considered as normal process. However, if it occurs in young people, they might or
might not seek help from Western medicine or Eastern medicine depending on various situations,
such as finance and socioeconomic status. There is no difference between physical and mental
illnesses. Chinese people believe that blood volume is constant and are scared of losing blood.
So, blood transfusion is acceptable. Organ donation is not common because people like to die as
a whole. Transplantation is also acceptable.
Health Care Practitioners
Chinese often considers health care providers are the most superior. They respect and
trust health care providers without questioning. Since Jessica identifies herself as a conservative
person, she only prefers health care providers of the same sex. Especially, same-sex health care
providers are more desired if physical exams and procedures involving the private areas.
However, if there is no choice of health care providers for any reason, she accepts opposite-sex
health care providers.
Nursing Interventions and Standards of Practice for Chinese Patients
According to Wehbe-Alamah (2008), Madeleine Leininger suggests three major
modalities to guide nursing judgments and actions to provide cultural congruent care that is
beneficial, satisfying, and meaningful to people: (a) Culture care preservation or maintenance;
(b) Culture care accommodation or negotiation; and (c) Culture care repatterning or
restructuring. Based on Jessicas points of view influenced by Chinese culture, culture care

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10

preservation or maintenance, which focuses on those assistive, supporting, facilitative, or

enabling professional actions and decisions that help people of a particular culture to retain
and/or preserve relevant care values so that they can maintain their well-being, recover from
illness, or face handicaps and/or death would be the most appropriate mode (Wehbe-Alamah,
2008, p. 93). When taking care of Chinese patients, nurse should explain the cause of illness and
disease because patients may view illness and death as natural processes of life. Chinese patients
will try traditional medicine first and seek Western medicine if the traditional treatments fail.
So, it is very important for nurses to ask patients if they use traditional medicine in a friendly
approach and show patients how eager nurses want to learn more about traditional medicine
instead of criticizing. Nurses should also consult with physicians to incorporate patients
traditional practices, such as herbals and acupuncture, with Western care if they are not
contraindicated to each other. Since Chinese patients are family-oriented, it is important to
integrate family-centered care by engaging the whole family in discussions that involve decisions
and education about care.
Out of 12 standards of practice for culturally competent nursing care, two applicable
standards to Chinese patients are knowledge of cultures and culturally competent practice
(Douglas et al., 2011). Through the knowledge of cultures, nurses should gain a basic
understanding about patients cultures, such as foods, traditional practices, cultural norms, and
taboos, so that effective nursing cares are achieved. For examples, Chinese patients only prefer
to drink hot liquids or eat hot foods when sick or after delivery. If nurses do not know about it,
patients may be offered ice water and get dehydrated because they will not drink it. Besides,
through culturally competent practice, nurses should be aware of nurses own cultures, patients
cultures, and cultural differences when implementing culturally congruent nursing care. For

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11

example, if nurses do not develop cultural competence, nurses may prejudge patients traditional
practices based on nurses own cultures and beliefs.
Cross-Cultural Experience
As interviewing Jessica, I noticed many common things between her culture and my own
Vietnamese culture. Specifically, both cultures avoid direct and consistent eye contact and
prefer hot fluids and foods when sick or after delivery. Normally, when conducting an interview
with interviewees who value direct eye contact, I have to adjust myself and tell the interviewees
in advance that I do not mean to offend them if sometimes I do not give direct eye contact with
them. Because Jessicas culture and my culture have the same meaning about eye contact, I feel
much more comfortable when interviewing her.
Also, I noticed that Jessica was very against nontraditional families, such as blended
families and same-sex families, through her verbal and nonverbal clues, such as pausing for a
while before answering with tense voice. Birth control was a topic which she seemed to hesitate
to answer probably because it was related to her sexual life, a sensitive topic in her culture.
Overall, I had a very good experience when interviewing Jessica.
Through this cultural interview, I gained more knowledge about the interviewees
culture, things I should promote, and things I should avoid when working as a nurse. Before the
interview, I spent time to look up several journals and articles about interviewees culture to get
the basic ideas to appropriately generate my questions. I had to think about the way I approach
my questions without unintentionally offending the interviewee and readjust my own cultural
norm to fit the interviewees cultural norm. Overall, the cultural interview really helps me
improve my interviewing skill and learn about another culture.

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12
References

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