top of page

Resources

Vietnam is a country located in the Southeast Asian peninsula, and the national language is Vietnamese [1]. Buddhism and Catholicism are the common religions along local practices of ancestor worship [2]. Most Vietnamese came to the U.S. through 3 separate waves: post-Vietnam War 1975, the refugee years in 1979-1983, family reunification programs in 1988 - 1989 [1]. 

​​

Due to the extensive history related to the Vietnam War, there remains tension between American-Vietnamese, who are still associated with the Republic of Vietnam, and Vietnamese associated with the Communist Party of Vietnam [1]. 

Health Beliefs

  • Generally, younger generations do not have any specific health beliefs. However, major medical decisions tend to be made by the collective with the oldest male having the majority say [1].

  • Vietnamese health beliefs share some parallels with Chinese health beliefs. A major concept of harmony between Yin and Yang, which implies a discourse of these natural forces can result in illnesses [1]. Western medicine is often considered to be disruptive to this balance, which makes patient adherence to medication to be quite difficult [1].

  • Some folk medicine techniques are often used by older Vietnamese, such as dermabrasive procedures (coining, use of a spoon) are believed to help with nausea, headache, or motion sicknesses by relieving “trapped air” [1]. They can result in cutaneous hematomas on the face, neck, and body (except for genitals). However, please do not misinterpret this for abuse when seen on children! (see Figures 1 and 2 below)

Social Traits

  • Age hierarchy

  • Gender roles  

  • Filial piety

  • Stoicism

  • Concepts of face 

  • Collectivist

Implications for Health Practitioners/Health Questions

Greeting: Following the age hierarchy practice, elders are to be treated with respect [1]. During examination, ask permission prior to touching someone’s head as it is an important part of the body [3]. 

​​

Vietnamese patients can be avoidant or appear compliant without voicing any disagreements when in the presence of a physician. This can result in a paternalistic relationship with the physician or noncompliance by no longer returning for care [4]. 

​​

Mental Health: Mental health is a stigmatized topic in the Vietnamese community [1]. However, it is especially important to consider the impact of mental health in the overall health of these patients due to generational trauma resulting from the Vietnam War. 

​​

Diet: Rice is typically included in every meal, which can affect diet modification recommendations in patients with diabetes [1]. However, Vietnamese home food often offers a diverse selection of vegetables and meat. Thus, it is generally considered to be healthy. Hospitalized patients might receive food from their family as their way to take care of the patient [5].

Questions/Education

  • Healthcare Challenges:

    • Describe the differences between short-term treatment and long-term treatment to aid patients’ treatment adherence [1].

      • Some patients may expect medicine to work instantaneously, so it is important to explain why they should complete or continue taking their medication for chronic conditions or infections.

      • At home, in addition to the treatment we are giving right now, is there another treatment that you are planning to follow? 

      • For example, are you planning to use herbal remedies/oil, coining, acupuncture or cupping?

        • It is important to ask about herbal remedies to ensure that none of the ingredients will interact with prescribed medications.

        • The pediatric population may also receive these folk medicines.

  • Social History:

    • What are your thoughts about smoking/drinking?

      • In the elderly population, asking a patient to stop smoking/drinking may be difficult due to strong cultural habits [1].

    • In one day, how often do you smoke? If not, how about the people around you?

    • Have others expressed concern about your smoking/drinking habits?

  • Women’s Health: 

    • Be mindful of patients’ sexual history and sexual health education.

      • Talk about the importance of Pap Smear

      • Risk factors associated with cervical cancer

      • Vietnamese American women have higher rates of cervical cancer than any other racial or ethnic group [6].

Health Challenges

  • Smoking and drinking are common social practices in Vietnam, which represent a form of bonding between men [1]. 

  • Patients may expect treatments to work instantaneously, so it is necessary to educate the patient.

  • Individuals from Vietnam are likely to be affected by infectious diseases such as tuberculosis, hepatitis B, malaria.

    • Most Vietnamese immigrants are vaccinated with the BCG vaccine for TB [7].

  • Vietnamese children might be exposed to lead due to wearing traditional amulets, which is commonly seen in Southeast Asia practice [1].

Women's Health

  • Domestic abuse exists across cultures. However, marital conflicts and domestic violence in Vietnamese household are not often reported as they are considered to be private and can be seen as shameful (concept of face) [1].    

  • Vietnamese women often follow Western standard practice. However, they might experience familial pressure to follow certain traditional practices [1]. 

    • Female care providers are preferred over males in most healthcare scenarios. 

  • According to the Fred Hutchinson Cancer Research Center’s cancer registry in 2010, Vietnamese American women have higher rates of cervical cancer than any other racial or ethnic group [1,6]. 

Family Structure

  • Most Vietnamese families are patriarchal, patrilineal, and patrilocal [1]. 

  • The collective health of the family unit often supersedes the individual’s [1]. 

  • It is common for the elderly to be taken care of by the younger generations, and the idea of ‘filial piety’ is strong [1].

Conclusion

  • Traditional Vietnamese views of medicine contradict Western medicine, which makes it especially important to investigate the health beliefs of Vietnamese patients.

  • Patients may expect medicine to work instantaneously, so it is necessary to explain the importance of completion of the treatment.

  • Cupping and coining may result in bruises on the skin. Do NOT mistake this for abuse in a child.

Figure 1 (left) and 2 (right) shows marking left by coining and cupping, respectively [8,9].

 

  • Cupping would appear as large circles, usually in a symmetric pattern and coining should appear symmetrical as well with horizontal and vertical red lines on the skin.

Resources for Patients

  • National Cancer Institute

    • Educational document by the National Cancer Institute written in both Vietnamese and English.

    • Link: Cervical Cancer – What Vietnamese Women Should Know

  • King County

    • Subsection for hepatitis B facts translated into Vietnamese.

    • Link: Hepatitis B Facts in Multiple Languages - Public Health, Seattle & King County

  • St. Francis Community Services

    • A ministry of the Catholic Archdiocese of St. Louis that serves vulnerable populations.

    • Link: https://sfcsstl.org/

    • Address:  4222 Delor St. St. Louis, MO 63116

    • Phone: 314-932-3300

    • Email: sfcs@ccstl.org sfc

This information was collected and organized by our team. As of this time, we have not yet been able to connect with any individuals in this community that could review this article. If you are interested in reviewing this article, please contact kaitlynn.borik@health.slu.edu

References

(1) LaBorde, P. (2010, December). Vietnamese. EthnoMed. Retrieved March 21, 2024, from https://ethnomed.org/culture/vietnamese/

(2) 2018 Report on International Religious Freedom: Vietnam. (n.d.). U.S. Department of State. Retrieved March 21, 2024, from U.S. Department of State.

(3) Vietnamese Culture. (n.d.). Cultural Atlas. Retrieved March 21, 2024, from https://culturalatlas.sbs.com.au/vietnamese-culture

(4)Zivkovic T (2019). Lifelines and end-of-life decision-making: An anthropological analysis of advance care directives in cross-cultural contexts. Ethnos. 2021;86:767–785. doi: 10.1080/00141844.2019.1696857. 

(5)Tran, Q. N. H., Dieu-Hien, H. T., King, I. N., Sheehan, K., Iglowitz, M. L., & Periyakoil, V. S. (2019). Providing Culturally Respectful Care for Seriously Ill Vietnamese Americans. Journal of pain and symptom management, 58(2), 344–354. https://doi.org/10.1016/j.jpainsymman.2019.03.012

(6) Beliefs influence Pap testing among Vietnamese-Americans. (2021, September 21). Fred Hutch Cancer Center: Hutch News Stories. Retrieved March 21, 2024, from https://www.fredhutch.org/en/news/center-news/2007/01/beliefs-influence-testing.html

(7) Zwerling, A., Behr, M. A., Verma, A., Brewer, T. F., Menzies, D., & Pai, M. (2011). The BCG World Atlas: a database of global BCG vaccination policies and practices. PLoS medicine, 8(3), e1001012. https://doi.org/10.1371/journal.pmed.1001012 

(8) Vitale, S. A., & Prashad, T. (2017, September 20). Cultural Awareness: Coining and Cupping. International Archives of Nursing and Health Care. Retrieved March 21, 2024, from ClinMed International Library.

(9) Carter, A. (2019, December 10). What Exactly Does Cupping Do?. Lakewood Ranch Acupuncture & Wellness. Retrieved March 21, 2024, from https://acupuncturesrq.com/what-exactly-does-cupping-do%E2%81%A3/

bottom of page