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PubMed2002

Emotional expression and physiology in European Americans and Hmong Americans.

Ethnographic and clinical observations suggest that Asians are less expressive than European Americans. To examine whether this difference emerged in online emotional responding, 50 Hmong Americans (HAs) and 48 European Americans (EAs) were asked to relive past episodes of intense happiness, pride, love, anger, disgust, and sadness. Facial behavior and physiological reactivity were measured. For most emotions, more cultural similarities than differences were found. There were some exceptions: During happiness, fewer HAs than EAs showed non-Duchenne smiles (i.e., "social" smiles), despite similarities in reported emotional experience and physiological reactivity. Within-group differences between "less Hmong" and "more Hmong" HAs were also found. Implications of these findings for our understanding of culture-emotion relations are discussed.

Acculturation↗

PubMedDate not supplied

Beliefs of mothers in Asian countries and among Hmong in the United States about the causes, treatments, and outcomes of acute illnesses: an integrated review of the literature.

An understanding of mothers' beliefs regarding the causes of illness, treatment, and outcome is an important component of culturally competent care. However, little is known about the beliefs of Asian parents related to acute illnesses. The purpose of our article is to synthesize what is known about the beliefs of mothers regarding the causes, treatment, and outcome of acute illnesses in Asian countries and Hmong in the United States. The literature review covers the period from 1990-2000. The electronic bibliographic databases explored included Pub Med, MEDLINE, HealthSTAR, CINAHL, and PsycINFO. Keywords used were beliefs, health beliefs, mothers or parents, cause of illness or etiology, treatment, diarrhea, acute respiratory infection, measles, Asia, and Hmong. A total of 15 articles were retrieved and examined. Using the matrix method, each article was evaluated according to five frames of reference: journal, purpose, sample, method, and findings. Content analysis was used to generate themes. Expressions of belief related to the causes of illnesses among mothers from Asian countries and Hmong who have emigrated from Laos to the United States of America were found to be quite similar. Beliefs about practices were primarily related to feeding and home care. The majority of mothers first provided treatment for their children using traditional practices. When the child did not recover, the mother sought medical advice.

Acute Disease↗

PubMed2002

Infant feeding practices: the case of Hmong women in Australia.

I discuss infant feeding beliefs and practices among Hmong women in Melbourne, focusing particularly on changed patterns that have occurred since their settlement in Australia. Traditionally, Hmong women breastfeed their newborn infants. Most women can breastfeed successfully in their homeland. However, since their settlement in a new country, some women have changed to bottlefeeding. Reasons given include the need to study English and seek employment, the availability of infant formula, insufficient milk, and their concern about the health and well-being of the infants. Hmong women either choose breast- or bottlefeeding based on what they think is best for their babies; their clear intention is to have children who will be healthy and thrive. Understanding of women's beliefs and practices relating to feeding is essential in creating a breastfeeding campaign. More importantly, the information will assist health professionals to support mothers in their choice of a feeding method, whether it be breast or bottle.

Adult↗

PubMed2006

Discordance between N-acetyltransferase 2 phenotype and genotype in a population of Hmong subjects.

Polymorphisms of N-acetyltransferase 2 (NAT2) acetylation may influence drug toxicities and efficacy and are associated with a differential susceptibility to select cancers. Acetylation phenotype may have clinical implications. The purposes of this study were to determine the genetic basis of an apparent predominance of slow acetylation phenotype and to assess concordance with genotype in a population of Hmong residing in Minnesota. Urine and DNA obtained from unrelated Hmong 18 to 65 years of age were used to determine phenotype from caffeine metabolites, whereas direct nucleotide sequencing of the NAT2 coding region, followed by cloning, identified all known allelic variants. From 61 subjects (27 men, 30 +/- 11 years), analysis of 50 urine-DNA pairs identified 46 (92%) slow acetylators and 4 (8%) rapid acetylators by phenotype. Genotypic analysis inferred 5 (10%) slow acetylators and 45 (90%) rapid acetylators. There is 86% discordance between phenotype and genotype. A predominance of NAT2 slow acetylation phenotype in the Hmong is confirmed, and a significant discordance between NAT2 phenotype and genotype is identified. In this population, slow acetylation phenotype determined by a metabolic probe would not have been predicted by genotype alone. Environmental, genetic, or phenotypic anomalies that may contribute to this discordance should be considered and evaluated in future studies within this unique population.

Acetylation↗

PubMedDate not supplied

Coming to the cultural "in-between": nursing insights from a Hmong birth case study.

This article discusses the historical background and traditional beliefs of the Hmong. Cultural conflict occurs when traditional Hmong beliefs and Western health care ideologies are misunderstood. A specific case study focuses on care of a Hmong woman and her husband after a precipitous birth, hemorrhage, and surgical intervention. Nursing insights are identified from "in-between" the cultures. Establishing cultural awareness is an essential first step toward cultural competence.

Acculturation↗

PubMed1995

Hmong cultural practices and beliefs: the postpartum period.

The purpose of this study was to explore the cultural practices and beliefs of the Hmong in the postpartum period. Using the qualitative research method of in-depth interviewing, data were collected through semistructured interviews. A convenience sample of 52 childbearing Hmong women was interviewed with the help of Hmong interpreters. The interviews were audiotaped and transcribed for analysis. Data analysis revealed cultural practices and beliefs categories related to diet, rest period, appropriate clothing, breast feeding, and sex practices in the postpartum period. Implications for nursing include both cultural sensitivity and an understanding of such traditional practices, before suggesting or implementing any health-promotion activities.

Adolescent↗

PubMed1995

Sociocultural factors in the use of prenatal care by Hmong women, Minneapolis.

Understanding the sociocultural context of prenatal care underuse by an immigrant population can suggest programmatic changes that result in more effective health care delivery. Ethnographic survey interviews of female Hmong clinic patients conducted in 1987/88 revealed that they objected to biomedical procedures and to being attended by several doctors; the women also reported poor communication with staff as a problem. Clinic reforms implemented in 1989/90 included hiring a nurse-midwife, reducing the number of pelvic examinations, expanding hours of operation, creating a direct telephone line to Hmong interpreters, and producing a Hmong-language prenatal health care education videotape. Women interviewed in 1993 reported a more positive clinic experience.

Adult↗

PubMed2004

Culturally responsive care for Hmong patients. Collaboration is a key treatment component.

Since the end of the Vietnam War, tens of thousands of Hmong refugees have resettled in the United States. This ever-increasing population presents specific challenges to the US healthcare system as Hmong seek to preserve their cultural identity while acclimating to American society. Primary care physicians can enhance their interactions with these patients by seeking to understand various elements of Hmong culture, particularly its approach to medicine and healing. By extension, such knowledge and skills will aid physicians in all encounters with patients who belong to minority cultural groups.

Asian↗

PubMed2001

Hmong and prenatal care.

Providing prenatal care to the Hmong can be a challenge for the Advanced Practice Nurse. Although some Hmong have become acclimated to Western medicine, others may not understand Western preventative medicine, health promotion or prenatal care. Traditional cultural beliefs and socioeconomic status may contribute to the barriers a practitioner faces when providing prenatal care to a Hmong client. Practitioners must assess each client and identify barriers. Integrating cultural beliefs and Western medicine practices can then foster prenatal care.

Asian↗

PubMed2005

Multidrug-resistant tuberculosis in Hmong refugees resettling from Thailand into the United States, 2004-2005.

In December 2003, the U.S. Department of State initiated a resettlement program for 15,707 Hmong refugees who had been displaced from Laos and were living on the grounds of Wat Tham Krabok, a Buddhist temple in Thailand. In January 2005, reports of tuberculosis (TB) cases among refugees still in Thailand and refugees who had arrived in the United States, including some cases caused by multidrug-resistant (MDR) strains, prompted a 1-month travel suspension. After enhanced screening in Thailand and intensified TB-control measures in the United States, resettlement resumed on February 16. A majority of the Hmong refugees in Thailand and the United States with TB diagnosed were started on treatment and monitored. As of July 15, no additional TB cases had been diagnosed among newly resettled Hmong refugees. U.S. health departments should continue to ensure careful monitoring for TB among this refugee group.

Humans↗

PubMed1997

Critical thinking, health policy, and the Hmong culture group, Part I.

The author discusses the historical connection between the Hmong and the U.S. military operations in South Eastern Asia; gives an overview of Hmong culture health traditions, such as efficacious, neutral and harmful; socioeconomic data; immigration and the local community; and health problems specific to the Hmong.

Death, Sudden↗

PubMedDate not supplied

Hepatitis B status of Hmong patients.

BACKGROUND: This study was conducted to determine the hepatitis B status, by age, of Hmong patients attending a St. Paul family practice residency clinic. METHODS: The clinic records of 1585 Hmong patients 4 years of age and older were reviewed for information about hepatitis B status. Those without evidence of previous serologic testing or vaccination were invited to participate in the study by being tested for three hepatitis B virus (HBV) markers-hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and hepatitis B core antibody (anti-HBc); those whose results were positive for HBsAg and anti-HBc were also tested for hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT). Patients whose results were positive for only anti-HBc had their serologic tests repeated after 3 or more months, and those patients whose results remained positive for only anti-HBc were offered the vaccine and further follow-up serologic tests. RESULTS: Of the 434 total participants, 77 (18 percent) had acute or chronic infection (HBsAg present). The rate of infection was highest-28 percent-in the group of patients 15 to 19 years old. Of 66 patients with positive test results only for anti-HBc, 33 of 36 (92 percent) who had follow-up serologic tests after 3 or more months had the same result again in the absence of intervention. Six of 8 (75 percent) patients with results positive only for anti-HBc who received hepatitis B vaccine subsequently converted to an immune status (anti-HBs positive). For all age groups, the cost of pretesting patients with an unknown HBV status and vaccinating susceptible patients was less than the cost of vaccinating without pretesting. CONCLUSIONS: This study, which confirmed previous findings of a high occurrence of hepatitis B virus infection in Hmong refugee communities, found the highest rate of infection to be among adolescents. Prevaccination testing appeared to be a cost-saving procedure for patients whose hepatitis status was unknown.

Acute Disease↗

PubMed2006

The cultural education of academic evaluators: lessons from a university-Hmong community partnership.

This article explores some of the lessons a university-based evaluation team learned while attempting to hire, retain, and work with staff members from a local Hmong community. These staff members were hired to assist a federally-funded community collaborative with implementing and evaluating a family strengthening program for Hmong families with adolescents. Over the course of two years, a succession of individuals were hired and resigned from a key staff position. These resignations occurred at critical points in the project, undermining a critical component of the program's evaluation. Through interviews, observations, self-reflection, and feedback from colleagues and reviewers, a better understanding of the reasons for these difficulties began to emerge. The challenges examined in this article help to illustrate some of the complexities faced by academics when conducting a community-based project with an underserved racial ethnic population. The article concludes by discussing some of the lessons learned and what they might suggest for others doing similar types of work.

Adolescent↗

PubMed1996

Potential cost savings for Medi-Cal, AFDC, food stamps, and WIC programs associated with increasing breast-feeding among low-income Hmong women in California.

OBJECTIVE: To determine the potential cost savings for four social service programs if breast-feeding rates increased among Hmong women in California. DESIGN: Cost-savings analysis. SUBJECTS/SETTING: Hmong women in California. In this population, breast-feeding is currently uncommon, and use of contraceptives is minimal. MAIN OUTCOME MEASURES: Savings were based on estimates of the resulting decrease in infant morbidity, maternal fertility, and formula purchases (Special Supplemental Nutrition Program for Women, Infants, and Children) if women breast-fed each child for at least 6 months. Costs were projected over a 7.5-year period and future values were discounted with annual interest rates of 2% or 4%. RESULTS: Substantial savings estimates were associated with breast-feeding for all four programs. The total projected savings over the 7.5-year period ranges from $3,442 to $4,944 (4% discount) to $4,475 to $6,0960 (0% discount) per family enrolled in all four programs. This translates into an estimated yearly savings of between $459 and $659 (4% discount) and $597 and $808 (0% discount) per family. APPLICATIONS: Although health care providers generally accept that breast-feeding is the preferred method for feeding infants, many still view the choice as a neutral one; that is, they consider low breast-feeding rates in the United States a cultural choice with no cost to society. This analysis provides evidence that breast-feeding is economically advantageous for individuals and society.

Aid to Families with Dependent Children↗

PubMed2001

Hais cuaj txub kaum txub--to speak of all things: a Hmong cross-cultural case study.

Cross-cultural medicine is a field that describes how disparate value and belief systems concerning health and disease affect the delivery of health care. This report describes the conflict between a Hmong immigrant family and the Western medical establishment over the care of their child with end stage renal disease [ESRD]. The health care providers, social service agencies and medical center failed to adequately respond to the needs of the family. The medical staff [nephrologist, nurse coordinator, dietician, social worker, and CPS worker] worked with a transcultural nurse, Hmong community health worker and the family, to design and negotiate a treatment plan that would be acceptable to the family and the health care team. Trust was reestablished between the family and the healthcare providers and the medical outcome for the child improved.

Journal Article↗

PubMedDate not supplied

Hmong women and postpartum depression.

Evidence of postpartum depression in Western culture has been widely documented in the literature. The conclusion reached by many researchers is that women are vulnerable to depression following childbirth to some extent. It has been suggested that postpartum depression is a culture-bound syndrome that develops because of lack of supportive rites and rituals surrounding childbirth. The present study was undertaken to explore postpartum depression in Hmong women living in the U.S. and the influence of cultural practices on postpartum depression. The results indicate that cultural beliefs and practices help the Hmong women adjust to the postpartum period. Whatever symptoms of depression they reported were related to living in a different culture and different environment, and using a language to which they were not accustomed.

Acculturation↗

PubMed2001

Breast cancer screening among Hmong women in California.

BACKGROUND: Breast cancer is the leading cause of cancer incidence and mortality among Asian American and Pacific Islander (AAPI) women in the United States. Hmong women are among those at the highest risk for health problems, due to high rates of poverty, language isolation, and cultural barriers. METHOD: One-on-one survey interviews were completed with 201 Hmong women aged 20 years and older in Fresno, Long Beach, Orange County, and San Diego to determine their breast cancer screening behaviors--breast self-examination (BSE), clinical breast examination (CBE), and mammography. RESULTS: Overall, 51% of all respondents had ever performed BSE. Among respondents aged 40 or older, 52% had ever had a CBE and only 30% had ever had mammography. DISCUSSION: Significant correlates of CBE and mammography screening are presented, and implications of findings for research and education are discussed.

Adult↗

PubMed1989

Psychosocial adjustment of Hmong refugees during their first decade in the United States. A longitudinal study.

Over their first decade in the United States, 100 Hmong refugees were studied on three occasions. Data included demographic characteristics, acculturation skills, traditional affiliations and pastimes, material acquisitions, psychosocial problems, and self-rating scales. In addition to a description of the data changes, a multiple regression analysis was performed. Changes demonstrated considerable evidence of acculturation, psychiatric care seeking, and greatly reduced symptom levels for several symptom complexes. However, a large minority of subjects remain illiterate, unable to speak English, generally involved with other Hmong but not with the majority society, and/or have high symptom levels on self-rating scales. Regarding symptom changes, depression, somatization, phobia, and self-esteem symptoms improved the most with time and acculturation. On the contrary, anxiety, hostility, and paranoid symptoms changed little. Multiple regression analyses indicated that strong traditional ties (e.g., large household size, being an herbal healer), older age, marital problems, and medical complaints were most associated with high symptom levels.

Acculturation↗