The majority of Japanese immigrants began arriving in the United States toward the middle part of the 19th Century. These first Japanese immigrants passed down many characteristics of historic Japanese culture to subsequent generations, and these characteristics still abide in the Japanese American psyche (Easton & Ellington, 2010). Today, Japanese culture is prevalent in many areas of the Western U.S., most notably in the cities of Los Angeles, San Francisco, Portland, and Seattle. It is important for providers to understand that features of the historic Japanese culture remain within the mindset of Japanese Americans, and that these cultural characteristics influence the values, the communication practices, and the health care perspectives of Japanese Americans.
In order to deliver culturally congruent care, providers should be aware that certain cultures possess differing values systems, and these values can have an effect on how a particular client within the culture communicates with health care providers. For example, if a person highly values respect, it would be wise for a provider to show the utmost respect for his or her client, perhaps by simply calling the client “Mr. or “Mrs.,” lest the therapeutic relationship suffer. Providers should also be aware that culture has an effect on how a client perceives his or her own health, how a client views the causes of illness and disease, and how a client responds to particular health interventions (Potter & Perry, 2009). Some Japanese Americans possess deep-rooted patterns of communicating that they use when interacting with other people. Providers should be familiar with these communication patterns, as well as the attitudes that some Japanese Americans may have toward alternative and complimentary therapies and death and dying issues. Only when providers understand these particular issues pertaining to Japanese Americans can they be able to deliver the culturally competent care needed to ensure desirable outcomes for their clients. Japanese Values
Many health care providers are familiar with the core values associated with Japanese culture such as politeness, harmony, group orientation, and the desire for success. The Japanese also have three distinct words to characterize three traditional values that, although dismissed by some as archaic remnants of the past, still permeate the culture (Wood, 2006). The first value, on, illustrates indebtedness. When Japanese Americans perceive that they are receiving high quality care, they may show their indebtedness by profusely thanking the caregiver. The concept of giri translates into an obligation to the community. Providers caring for a Japanese American may perceive that the client is very demanding when it comes to the care they receive, as he or she may believe that it is the obligation of the caregiver to operate in a precise and professional manner. The last traditional Japanese value is ninjo. Ninjo refers to the desire to follow a path that one thinks feels the most natural, despite social obligations (Wood, 2006). A provider who does not deliver excellent care to a Japanese American may find that the client wishes to be cared for by another healthcare professional. Communication
All cultures can be categorized into two broad communication paradigms: low context and high context. People who operate in a low context culture tend to communicate in a direct manner, and they rely on the dissemination of explicit thoughts and ideas in order to give and obtain information. Conversely, people who function in a high context culture, like many people of Japanese decent, tend to be less likely to explicitly express their views, preferring instead to communicate in a less direct manner (Thill & Bovee, 2008). The fact that many Japanese Americans operate in a high context cultural environment has tremendous healthcare implications. If a provider is...