By sharing stories of suffering, confusion, and success, Healing by Heart couples an accessible method of learning about the Hmong people, with concrete recommendations about how to enhance cross-cultural health care relationships."
List of Illustrations ix
Preface and Acknowledgments xi
Introduction 1
PART I Health-Related Cultural Beliefs, Practices, and Values
1 Hmong Culture: Tradition and Change
Kathleen A. Culhane-Pera, M.D., M.A., and Phua Xiong, M.D. 11
PART II Women's Health: Case Stories and Commentaries
2 Controlling Fertility: A Case Story 71
Hmong Preferences for Natural Family Planning
Marline A. Spring, Ph.D., and Mayly Lyfoung Lochungvu 73
Social, Cultural, and Ethical Aspects of Controlling Fertilityin the Hmong Community
Peter Kunstadter, Ph.D. 80
3 Woman with Pregnancy Complications: A Case Story 88
The Cultural Complexity of Obstetrical Care
Helen B. Bruce, R.G.N., S.C.M., M.T.D., C.N.M., and Chue Xiong, R.N. 92
Conflicting Cultural Practicesin Deciding about a Cesarean-Section
Carol A. Tauer, Ph.D. 98
4 Woman with Vaginal Bleeding: A Case Story 104
Culturally Responsive Care for a Hmong Woman with Vaginal Bleeding
Deu Yang, L.P.N., and Deborah Mielke, M.D. 106
Influence of Conversion to Christianity on a Hmong Woman'sDecision about Hysterectomy: A Pastor's Perspective
Lu Vang with Phua Xiong, M.D. 111
PART III Children's Health: Case Stories and Commentaries
5 Children with High Fevers: Case Stories 117
Hmong Health Beliefs and Practices Concerning Childhood Fevers
Kathleen A. Culhane-Pera, M.D., M.A., and Va Thao, L.P.N. 120
State-Ordered Medical Care for Our Son: Parents' Perspective
Parents (Anonymous) 129
Family-Centered Cultural Collaboration in Pediatric Care
Donald Brunnquell, Ph.D., and Stephen Kurachek, M.D. 133
6 Bottle-Fed Toddler with Anemia: A Case Story 141
Iron-Deficiency Anemia in Bottle-fed Toddlers
Cher Vang, M.P.A., and Christopher L. Moertel, M.D. 144
A Culturally Informed Public Health Responseto Pediatric Anemia in the Hmong Community
Elanah Dalyah Naftali, Dr.P.H., R.D., and Mao Heu Thao, L.P.N., B.A. 149
7 Infant with Down Syndrome and a Heart Defect: A Case Story 156
Defining Best Interest for a Hmong Infant: A Physician's Challenge
Gregory A. Plotnikoff, M.D., M.T.S. 159
"Why Do They Want to Hurt My Child?": The Mother's Perspective
Phua Xiong, M.D 165
PART IV Chronic Disease: Case Stories and Commentaries
8 Man with Diabetes and Hypertension: A Case Story 173
Type 2 Diabetes Mellitus in the Hmong Community
Kevin A. Peterson, M.D., M.P.H., May Lee Vang, A.A.,
and Yer Moua Xiong, M.P.H.176
"I Tell You This Story of Healing": A Shaman's Perspective
Yer Moua Xiong, M.P.H., as told by Nkaj Zeb Yaj 183
9 Young Woman with Kidney Failure and Transplant: A Case Story 186
Endstage
Mai Neng Moua 190
Painful Cultural Differences in a Hmong Family:The Mother's Perspective
Phua Xiong, M.D. 198
PART V Mental Illness: Case Stories and Commentaries
10 War Veteran with Depressionand Posttraumatic Stress Disorder:
A Case Story 207
Social and Spiritual Explanations of Depression and Nightmares
Bruce T. Bliatout, Ph.D., M.P.H., M.S.Hyg., Dr.Ac. 209
Depression and Posttraumatic Stress Disorder:Prevailing Causes and Therapeutic Strategies with Hmong Clients
Vang Leng Mouanoutoua, Ph.D. 216
11 Domestic Violence: A Case Story 222
Traditional Hmong Concepts of Wife Beating
Mymee Her, Ph.D., and Chue Pao Heu 224
Changing Gender Roles and Domestic Violencein the Hmong Community:
A Feminist Perspective
Pacyinz Lyfoung, J.D. 234
12 Woman with Psychosis: A Case Story 239
Cultural Interpretations of Psychosis
Joseph Westermeyer, M.D., Ph.D. 241
Integrating Hmong and Western Approaches to Spiritual Illnesses
Thomas Vang, M.S. 251
PART VI End-of-Life Care: Case Stories and Commentaries
13 Hospice Patient with Gallbladder Cancer: A Case Story 255
Cultural Complications in End-of-Life Carefor a Hmong Woman with Gallbladder Cancer
Kathleen A. Culhane-Pera, M.D., M.A. 258
The Husband's Plea for Provider Honesty
Phua Xiong, M.D. 265
14 Pregnant Woman with a Brain Hemorrhage: A Case Story 269
Strategies for Health Care Providers and Institutions
to Deliver Culturally Competent Care
Elizabeth C. Walker Anderson, B.A.,
and Patricia F. Walker, M.D., D.T.M.&H. 273
Accommodation of Cultural Differences in End-of-Life Care
Karen G. Gervais, Ph.D. 280
15 A Widowed Mother's Search for a Good Place to Die: A Case Story 284
Providing a Spiritually Appropriate Place
for My Mother's Care and Death
Mrs. Chang's Daughter (Anonymous) 287
"Please Help Me": A Physician Respondsto a Hmong Woman's End-of-Life Struggles
Kathleen A. Culhane-Pera, M.D., M.A. 289
PART VII Culturally Responsive Health Care
16 A Model for Culturally Responsive Health Care 297
Recommendations for Health Care Practitioners 305
Recommendations for Health Care Administrators and Educators 343
Recommendations for Public Policy Makers 347
Dorothy E. Vawter, Ph.D., Kathleen A. Culhane-Pera, M.D., M.A.,
Barbara Babbitt, B.S.N., R.N., M.A., Phua Xiong, M.D.,
and Mary M. Solberg, Ph.D.
Editors and Contributors 357
Index 363