Transcultural Nursing

A two-year-old patient presents fever and new-onset seizures to the emergency room. The patient was brought to the facility by the mother, who does not speak English alongside a sixteen-year-old nice, the only one who can speak English. They are also accompanied by their other children aged 5, 8, 12, and other family members. The family belonged to the Hmong culture newly immigrated to the US. The Hmong are an indigenous population mainly living in Vietnam, China, Thailand, Laos, and Myanmar. The Hmong culture emphasizes politeness, respectfulness, pride that lacks arrogance, and strong relationships with families. The Hmong speak two dialects are belonging to the Miao-Yao language; White Hmong dialect (Hmong Der) and Green Hmong dialect (Mong Leng). The language names originate from the colors customarily worn in the different subgroups (Khang, 2010). However, the speakers can understand each other despite the differences in dialects about Hmong subgroups.

Communication Approach

Different communication styles may come into play when communicating with the person. In Hmong culture, you are not supposed to look directly into someone’s eyes when talking, particularly with older people, as that may show disrespect. Hence, it is possible for a Hmong person to look elsewhere, the floor or something in the distance. Likewise, the nurse caregiver should also not look directly into the eyes of any family member, particularly the elderly ones, when communicating as that may make them uncomfortable (Khang, 2010). It is vital to be aware of the body language because Hmong people may try to interpret what the speaker says based on the body language if they do not understand the speaker. Besides, Hmong people also try to be non-offensive and very kind; hence they may say “okay” if they do not want to offend the speaker, but the okay may imply no answers. It is upon the speaker to be as sensitive as possible (Lor, Rabago & Backonja, 2021).

Space Approach

Culturally, the Hmong people value personal space, mainly interacting with unfamiliar individuals of the opposite sex. Besides, Hmong people like strangers touching them, particularly in the head, due to religious beliefs. The head is considered the most secret body part and personal value. Besides, gender role plays a significant role in the culture. For instance, men should not sit closer when talking as that is regarded as inappropriate. Hmong women do not shake hands with men, but men can shake each other’s hands (Khang, 2010).

Nursing Approach

The Hmong culture stresses family bonds, loyalty, and commitment to traditional culture, with less weight on personal feelings. As a nurse, it is essential to evaluate the patient’s kinship relationship and establish the family member most influential in making decisions. The nurse may engage the whole family in decisions and discussions concerning care. As for the case study determines if the nurse can direct most of the question to the accompanying nice who speak English, whether the family trusts her with decisions or everything must be translated (Viste, 2007). It is also possible that the mother or any family member may feel that western medication is too strong for the child and may reduce to give her total dose as prescribed. Hence, the nurse needs to explain to the mother and the family why the dose must be completed and the side effects of the failure.

Patient Education Modification

As for patient education modification, the nurse can use a trained interpreter instead of a family member for translation, ensuring no one gets lost in the conversation. But is essential to take note of the variations in communication styles such as nonverbal and verbal that may impact care.

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Overall, a transcultural nurse requires the nurse to master at least some communication styles of the patient’s culture to facilitate communication and care. Different cultures have different communication cues that the nurse must consider when providing care. Such include avoiding direct eye contact, as in the case of Hmong people.


Khang, M. S. (2010). Hmong traditional marital roles and the pursuit of higher education for married Hmong American women. Unpublished master’s thesis, University of Wisconsin-Stout, Menomonie, WI.

Lor, M., Rabago, D., & Backonja, M. (2021). “There Are so Many Nuances…”: Health Care Providers’ Perspectives of Pain Communication With Hmong Patients in Primary Care Settings. Journal of Transcultural Nursing32(5), 575-582. Viste, J. (2007). Communicating (birth defects) prevention information to a Hmong population in Wisconsin: a study of cultural relevance. Su