Uploaded by Christian John Gellor


University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
Group 2
-Shintoism is Japan's indigenous spirituality. It is believed that every living thing in nature
(e.g. trees, rocks, flowers, animals - even sounds) contains kami.
 Kami are not God or gods. They are spirits that are concerned with human beings - they
appreciate our interest in them and want us to be happy - and if they are treated properly
they will intervene in our lives to bring benefits like health, business success, and good
exam results.
-Shinto is an optimistic faith, as humans are thought to be fundamentally good, and evil is
believed to be caused by evil spirits. Consequently, the purpose of most Shinto rituals is to
keep away evil spirits by purification, prayers and offerings to the kami.
 Shinto is not a way of explaining the world. What matters are rituals that enable human
beings to communicate with kami.
Value Orientations
- Time is VALUED
 Time is considered valuable and must be used wisely. The basic idea of punctuality in
Japan is that you should be ready to go with whatever is planned at the starting time. This
means, for example, if your work shift starts at 9:00 you should be in the office, at your
desk with your computer on at 9:00. Hard work in the present is seen as important for
future successes. Polychronic time is associated with doing many things at once and is
concerned with relationship rather than task completion. They suggest that the Japanese
tend to use monochronic time when dealing with outsiders but polychronic time in their
interpersonal relations.
Communication Practices
- Japanese: Use much non-verbal language; may understand written communication better
than conversational language. Emotions are often hidden. Silence is often used.
 The Japanese culture is a relatively non–eye contact culture, and this is quite noticeable in
public speaking and in the communication process. Most Asian Americans consider it
disrespectful to look someone directly in the eyes, especially if that person is in a superior
 For some Japanese Americans, emotional expression of anger is unusual, and a stoic
reaction is often manifested as a response to pain. Gaman is a Japanese concept that stems
University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
from the verb gamansuru, which translates as “to bear, to endure, to tolerate” and which
has to do with self-control and endurance. Japanese elders found that gaman had
importance in help-seeking behaviors among nisei who tended to value enduring pain and
discomfort with perseverance and dignity. Gaman is also considered a valuable social skill
to be learned in childhood and used later in life when facing hardships, such as when in
Estimates that, for Japanese, communication of feelings and attitudes is 5% verbal, 38% vocal,
and 55% facial expression. Thus, facial expression plays a crucial role in communicating
emotions and attitudes. It is essential to remember that the traditional behavior of some
Japanese is to control emotions, especially in formal and public situations. This value is
believed to have originated in heijo-shin (“ordinary state of mind”) in Zen Buddhism, which
advocates controlling emotions and maintaining a neutral presence. An inappropriate smile
may sometimes be seen as an unconscious and reflective attempt to avoid troubling others by
showing one’s true feelings.
Japanese culture is viewed as a non-touch culture. A hug is rarely offered and hugging is not
common practice. There is close contact with infants but less touch or physical contact among
adults. found that Japanese touch family members less frequently than people in other
cultures do. Physical contact may be perceived negatively and introduce tension into
Communication Practices Implication to Nursing Care
 Because it is impolite to think of personal needs, some Japanese Americans, when asked if
they want something to eat or drink, may respond negatively. In such instances, if the
nurse does not try to persuade the client to eat or drink, the nurse may be perceived as
insensitive. The nurse should offer at least two to three times, even after receiving a
negative reply the first time.
 The nurse can learn to anticipate needs and accurately assess discomforts by relying on
astute interpretation of the meaning of nonverbal expressions and behaviors. It is essential
to remember that subtle facial expressions and gestures are expected to be understood.
Japanese clients may wait silently rather than ask questions because they believe health
care providers know best and will meet their needs without being asked. This relates to a
high regard for “anticipatory care” and the concept of omakase. Omakase refers to a
coping style that allows the patient to place his or her trust in the physician or nurse;
University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
therefore, the health care provider carries the burden for the patient. For the Japanese,
health professionals are authority figures and are to be trusted.
Family System
-Strong intergenerational family structure is practiced.
 Intergenerational relations are close among most Japanese. There continues to be a flow of
goods, money, and services among the generations. The general pattern of the Japanese
family is the vertical family structure, with the father and other male members in the
topmost position. “Vertical” social structure means that relationships are clearly defined to
those above or below, a clearly determined line of social status.
 The phrase kodomo no tame ni (“for the sake of the children”) reflects the sacrifices and
hardships families would endure to ensure the success of the next generation. Many of the
activities in the Japanese family occur in both the nuclear family and the extended family.
Problems are handled within this structure, and the achievement or accomplishment of the
individual member is a reflection on the entire family.
- Self-control and self-reliance are valued.
 The younger generation continues to be willing to assist and give more than what is
requested and expected by the older generation. Yet despite a long-standing tradition of
family connection and caregiving, Japanese American families face challenges similar to
those of other populations—aging parents, fewer available caregivers, more women in the
workforce, and geographic mobility. Elders tended to want contact and connection with
family but did not want to be burdensome. Their worries that there could not be
reciprocation of support, and a sense of self-reliance on the part of the elder.
 For some Japanese, the self is viewed as part of a set of interpersonal relationships, of
which the family system is the central core. In this sense, the self is subordinate to the
family social unit, and consequently most Japanese find it difficult to stand out publicly
as individuals. This difficulty is evidenced by the reluctance of some Japanese to give
speeches, talk about themselves in casual conversations, or engage in self-serving
 Fostering of amae, or “interdependency,” is also seen as a method of enhancing group
solidarity and social relationships. This concept is also based on preservation of harmony
and the suppression of conflic. Amae (“passive love”), as defined by , means “to depend
and presume upon the benevolence of others” and is often associated with the Japanese
word for “sweet” ( amai ).
Family System Implication to Nursing Care
University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
 Because many Japanese place a high value on the family system, the nurse should be
aware of the significant role the family plays in providing support, interdependence, and
the fulfillment of duties. Respect is also greatly valued, and the linear relationship
apparent in families and in casual relationships should be maintained and supported when
providing care for the Japanese client and family support system. Although these values
are the strength of the Japanese family, they can create stress and disharmony not only for
the client but also for the family unit, especially with inter-racially married offspring.
 They found that health care providers could play a more active role in assisting families
with service identification, information, and evaluation. Because family name and honor
are important for this group, the nurse should be especially cognizant of the issue of
confidentiality and respect. Information should not be shared with outsiders, even with
extended family members who may appear close to the client. Information concerning
illness is often kept within the immediate family.
Japanese Health Beliefs and Practices
- Health is maintained through harmony with the world. Poor health may be caused through
contact with impure elements such as corpses, blood, or skin disorders.
 Major beliefs that have contributed to medicine in Japan influence the Japanese-American
person’s view of health and illness. In the Shinto religion, people are seen as inherently
good. Evil is caused by outside spirits that cause humans to succumb to temptation and
harm, which can be alleviated through purification rites. Disease is believed to be caused
by contact with polluting agents, such as blood, corpses, and skin diseases, which accounts
for the emphasis on cleanliness
 Another important belief held by some Japanese Americans is based on the traditional
Chinese concept of harmony and balance among oneself, society, and the universe. Some
Japanese believe disharmony (with society or family) or imbalance (as from lack of sleep
or exercise or because of poor diet) can cause disease. Therefore, restoration of balance
should be the major focus of treatment.
- Individuals may also utilize acupuncture, acupressure, moxibustion, and herbal medicine, as
well as traditional Western medicine to restore the flow of energy. Assessment of pain may be
difficult since emotions are often suppressed. Some food combinations may be avoided to
avert poor health.
 For those who still subscribe to the Old World traditional health care practices brought
with them from Japan, the basis for health practices may include a mixture of traditional
medical practices ( kampo ) brought to Japan from China, Shinto beliefs, and Western
medical practices.
University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
 Certain foods have special symbolic meaning for Japanese Americans. Special foods, such
as soft boiled rice and miso soup (a soup made with fermented soybean paste), may be
eaten during illness as well as to promote good health. Traditionally, on their most
important holiday, New Year’s Day, most Japanese Americans eat special foods that have
symbolic meaning for good health, prosperity, and happiness. Such foods include kazuno-ko (dried herring roe) for fertility, mochi (steamed rice cake) for longevity and
prosperity, soba (buckwheat noodles) served in clear broth for longevity and prosperity,
and kuromame (black beans) for good health. Other symbolic foods include ozoni (a
soup with mochi, vegetables, and/or meats) for prosperity, gobo (burdock root)
symbolic of deep family roots, and tai (sea bream, a large red fish served whole) for
happy occasions.
Dietary Considerations
- Asians have a high degree of lactose intolerance. Use of seasonings such as soy sauce,
monosodium glutamate, pickled vegetables and fruits, may cause significant challenges when
placing clients on high calcium or low sodium diets.
- Common maladies and their dietary treatments
"Hot" illnesses include, among others fevers, infections, diarrhea, sore throats, and
constipation. These can be treated with "cold" foods such as vegetables, fruits, dairy products,
and chicken. "Cold" illnesses include, among others, cancer, pneumonia, colds, headaches,
and stomach cramps. These can be treated with "hot" foods such as chocolate, cheese, eggs,
beef, cereal grains, chili peppers, and hard liquor.
Japanese Health Beliefs and Practices Implication for Nursing Care
 The nurse must also remember that some Japanese Americans value self-control,
particularly in areas they believe may reflect weakness or inadequacy. The loss of “face”
and dignity should be especially considered in procedures and treatment. The desire to
gaman may affect the Japanese American’s willingness to request pain medications.
Nurses can offer their time and practice attentive listening skills. Nurses also can make
sure the patients and their families understand that it is expected that they express
concerns and feelings.
 The nurse should inquire about treatments the client is using at home and what measures
are most helpful. Special foods, tea, or herbal decoctions may be important for the client
to have if there are no contraindications.
University of San Agustin
General Luna St., 5000 Iloilo City, Philippines