Cultural Diversity of Vietnamese People

Vietnam is located on the eastern edge of the Indochinese Peninsula. Vietnam boarders the Gulf of Thailand, Gulf of Tonkin, and the Pacific Ocean to its east. To the west is Cambodia, Thailand and Laos, with china to the north. While Vietnamese is the only official language of Vietnam, there are many different languages in the country. Vietnamese is the most common first or second language but some tribes in mountain areas speak a language of their own. Vietnamese is in the top 20 most spoken languages of the world with about 80 million people speaking Vietnamese worldwide.

Most health beliefs have three factors. Spiritual (evil spirits) Balance, (hot/cold, yin/yang) or a western version (germ theory). Vietnamese practitioners use methods from all three to heal their patients. Common practices include: “Medical Rituals” with chanting, potions, amulets, “Bua” an amulet of cloth with a Buddhist verse tied to a string, prayer and incense, coining, cupping, pinching, steaming, balms, acupuncture, acupressure or massage, and herbs. Home or Folk remedies are often tried first, especially whit children. Some of the practices listed above could leave petechia marks or bruises. This should not be considered abuse. It is their way of trying to help their children before bringing them in to an office setting.

In Vietnamese culture, mental illness does not exist. It is a symptom of an imbalance in the body. Medical care is often to relieve symptoms. If medicine is not prescribed, Vietnamese patients may look to another provider to relieve symptoms. If the symptoms go away, so has the illness, so they will discontinue medications. Vietnamese patients may nod, smile, and say “yes” to acknowledge that they heard you, rather than that they understand or approve. They may be reluctant to say “no” to a doctor or health care provider because it may be considered disrespectful or cause disharmony.

Only the wealthy can afford to see a MD. Others see a traditional medicine practitioner called an Occidental Doctor. Occidental doctors have no formal training and are trained from one generation to the next. Only men are allowed to train as occidental doctors. Physicians are considered experts. Patients expect a diagnosis and treatment at the first appointment without testing and may not trust a physician who cannot provide this.

It can be considered a challenge if eye contact is made with someone of a higher status. If the person is of the opposite sex, eye contact could be an expression of deep passion. The proper respectful behavior is to avoid eye contact when talking with someone who is not your equal or of the same sex.

A handshake is an appropriate greeting but should not occur between opposite sexes unless initiated by the Vietnamese person. Friends often hold hands or place an arm over their friend’s shoulder. Do not touch someone's head or pass anything over someone’s head. When passing items, use both hands. Pointing is disrespectful because that is considered a way for people to call to animals.

In an attempt to maintain self-control, a patient may appear stoic. Be aware that they may not show pain or ask for pain medications.

Vietnamese people have the expression 'gio*` da^y thun' which literally means rubber band time to show the elasticity of Vietnamese time. If the appointment is made for 8:00, people would show up at 8:45 or even 9:00. As for the Vietnamese language, there are two different levels of “now”; “Ba^y gio*`” which means now, but not immediately, and 'Ngay ba^y gio*`' Now.

The Vietnamese diet is heavily based on rice and vegetables with small amounts of meat and fish. Their cooking methods are similar to Chinese cooking but with little or no fat or oil. Native born Vietnamese often lack the enzymes to digest lactose making them intolerant to dairy products. Bananas, mangos, papayas, oranges, coconuts, pineapples are popular snacks. A traditional Vietnamese diet is not balanced the way western culture thinks of a balance diet. This could create Nutritional deficits and so a multivitamin is often recommended.

Vietnamese families teach children to be respectful and obedient in the home. Three generations in one home is standard. Frequently, there most senior male is the patriarch. Several of the siblings with their spouses and children will share the home. Cousins, aunts, and uncles will live in the same house in the same way we consider children, mom, and dad. Family and loyalty are major points of Vietnamese culture. Vietnamese elderly do not go to retirement or nursing homes. The oldest son and his family will take care of their senior family members. According to the Vietnamese Cultural Profile by Diversicare: The Vietnamese value system is based on four basic tenets: allegiance to the family, yearning for a good name, love of learning, and respect for other people.

It is important to be respectful of Vietnamese practices, while trying to build a bridge to western treatments. Incorporate beneficial and neutral remedies into the treatment plan and recommendations. Explain to them the importance of being prompt to their appointments. It may not be something they think about unless you explain it to them. Sometimes, a family member will make decisions for the patient to keep the patient from worrying. Ask the patient who should be included in the decision-making process.

Be thorough in your explanations of everything. Ask open ended questions instead of yes or no questions because the patient may not want to say “no” if they believe it could cause conflict. Verify that they understand, and approve, not that they just heard you. Encourage them to ask questions. Let them know it is expected and appreciated. When doing an exam, explain what you will be doing and why. Also, start with the top of the head to honor the highest and most important part of their body first.