As discussed earlier Japanese perception of pain is quite different in expression of pain compare to for example, Mexicans. Japanese believe “that the expression of pain or anger must be restrained because in doing so it allows one to be in control of one’s self” (Alvardo, 2008, p.26). Hence the client will not discuss the pain, because client may feel like burdening the healthcare provider. In comparison, the Mexican men show stoicism because it is associated with what they call “machoismo seen as strong and courageous” despite this behavior clients will vocalize their pain. (Alvardo, 2008, p.19).
Nurse’s own culture, personal bias, values and beliefs may alter the ?interpretation of patient’s pain experience
An effective client care comes from the versatility and diversity of healthcare team. This not only enhances the knowledge about different culture but also builds tolerance and openness to other cultures. However, if the interdisciplinary team lacks respect for one another’s and the patients ‘culture, it can lead to inadequate delivery of care and may result in long lasting negative effects. Therefore, it is important for a nurse to identify her own beliefs, values and biases, which could otherwise, hinder in the provision of quality of care. The skills highlighted by Alvaredo (2008), are; understanding the culture through having the cultural awareness, by keeping an open mind about other cultures different than that of one’s own. Additionally, the appropriate knowledge about that culture, equipping oneself with required skill through self-learning, creating encounters through engaging with clients, and having the desires/motivation to be culturally competent. A nurse “…must be able to understand clients’ cultural beliefs, values, and practices in order to work with them to determine their needs and the interventions most likely to improve their health.” (Potter et al.,2014).
According to Potter et al., (2014), a health care provider cannot judge client’s beliefs and values about health according to his/her culture. In an effective, safe and culturally competent delivery of care, heath care providers should carry out practices that are imperative to understanding client’s perception of pain. Consequently, being “aware of cultural and ethnic determinants of health, differing beliefs about health and medicine among ethnic communities, and barriers to accessing care that affect members of minority or marginalized populations. (Perry et al., 2014, p 47).
Assessments in relation to Culture being studied
It has been suggested by Linton (2014), to assess for pain monitor patient’s temperature, pulse, respiration and blood pressure. In addition, “…pain is private, and to know whether a person is experiencing pain, it must be public through verbal or nonverbal signals or behaviors” (Alvarado, 2008, p. 12). Some tools that nurses can use to measure pain in Japanese clients are; Numeric Pain Intensity Scale, having patient rate pain between 0-10. Another Scale that may be helpful in identifying pain is the Face pain Scale. This scale has smiling face indicating no pain and crying face illustrating intense pain, this helps private clients like Japanese verbalize their pain.
Nursing interventions be in management of pain when caring for Japanese patients may be Pharmaceutical, Traditional, Alternative and Inter- professional
In addition to western medications, Japanese also use alternative therapies for pain management. These include “dietary supplements are is the most important, followed by aromatherapy, traditional Chinese medicine (Kampo), Ayurveda and electromagnetic fields. In addition to these domains, hot spring bathing, lifestyle drugs, anti-aging medicine and environmental medicine.” (Alvarado, 2008, p.27). Therefore, incorporating modalities of medicine into the plan of care may be useful in treating the illness when possible. Another behavior that the healthcare provider must be aware of is stoicism (no emotions) in Japanese clients. Thus, it is healthcare provider’s duty to “educated on the necessity of treating pain. It may be appropriate to have pain medications scheduled for those that hold this belief.” (Arvada, 2008, p.31).
All in all, we have discussed throughout the paper how essential it is for the healthcare provider is to educate oneself with the client’s culture in order to provide the right treatment. This is achieved by understanding the concepts about pain in regard to the client’s culture. As mentioned previously pain is subjective therefore, treatment plan should be individualized from client to client. For instance, A study by Yamada (2006) found alternative therapies such as Kampo which “is holistic medicine wherein mind and body are regarded as unified, and the aim of kampo is harmonization of the disordered whole individual. Moreover, Kampo is philosophi- cal, empirical, synthetic, humanistic, per-diagnosis, tailored and subjective medicine.” (Yamada, 2006, p.799)., have shown to improve physical as well psychological quality of life in Japanese participants. This can be achieved though actively engaging in the learning by asking a client about their culture and self-learning. Nursing is not about pushing medication, because that anyone can do if trained. It is about having compassion, kind approach, and empathy for our clients.