Galore International Journal of Health Sciences and Research Vol.2; Issue: 3; July-Sept. 2017 Website: www.gijhsr.com Review Article P-ISSN: 2456-9321 Approach to the Chinese Patient Domingo Ly-Pen1,2 1 Emergency Department, Hospital Universitario “Ramón y Cajal”, Ctra. de Colmenar Viejo km. 9,100, Madrid 28034, Spain. 2 Emergency Department, Royal Glamorgan Hospital, Ynysmaerdy. Llantrisant, CF72 8XR. Wales, UK. ____________________________________________________________________________________________________________ ABSTRACT About 92% of China’s population is Han Chinese. There remaining 8% is Background: The number of Chinese people is divided among Zhuang, Uygur, Yi, Miao, increasing every year all over the world. Mongolian, and Tibetan ethnicities. [3] The Chinese ethnicity is the sixth most common vast majority of Chinese in the UK are Han, ethnic group in the UK. Even Chinese patients are not the most frequently attended in most which represents the oldest Chinese Western countries, they might be one of the community in Western Europe and the groups with the most difficulties to second or third largest group of overseas communicate with, mainly because of the Chinese in Europe (after France and extreme differences in culture and language. Russia). Objective: The main objective of this review Traditionally, Chinese immigrants in article is to give all doctors working in Western the UK arrived from the British colony countries (above all family physicians / general (from 1841 to 1997) in China, namely, practitioners), a brief introduction about main Hong Kong. In recent years, plenty of customs and behavior of Chinese patients. In Chinese immigrants arrived from Mainland this way, they can get a realistic idea of Chinese China as students. [2] patients´ thinking and ideas about diseases. This should be very helpful in their clinical approach. Medical aspects and clinical interview: In this Sociocultural Aspects review article, we explain (among others) In all provinces of China, the Chinese´s sociocultural aspects, their general surname (first syllable or character) is medical problems and ideas about disease and named first, followed by the first name, their clinical peculiarities of clinical interview. which may be of one or two characters. Most frequent diseases: At the end of the Second-generation Chinese, or first- article, a practical review of the literature about generation Chinese who have spent many the most frequent diseases in Chinese ethnicity, years living in the UK, have adopted our with their clinical implications. customs, so they may have Christian names (or associated with their Chinese name) KEY WORDS: Chinese Ethnicity, Frequent Diseases before their last name. There are numerous languages and BACKGROUND dialects in China. Nonetheless, the official Chinese ethnicity is the sixth most Chinese language or common language common ethnic group in the UK. (“Putonghua”) is Mandarin, which is the [1]Although the Chinese are one of the UK’s most spoken language worldwide. There are smallest minorities (only 379,503 people: eight main languages in China (Wu, Hakka, 0.72% of England’s population), [2] they Cantonese, Minan, Minbei, Gan, Xiang and might be one of the groups with the most Mandarin), with different pronunciations difficulties to communicate with, mainly that do not allow understanding among because of the extreme differences in them; nonetheless, the written language is culture and language. [3] the same for all of them, being fully understood by all literate Chinese. Chinese Galore International Journal of Health Sciences and Research (www.gijhsr.com) 15 Vol.2; Issue: 3; July-September 2017 Domingo Ly-Pen. Approach to the Chinese Patient immigrants from Hong-Kong, Macau and along with what they are doing and will not Canton speak Cantonese. Chinese from cause any trouble. Mainland China and Taiwan speak If you receive a gift from a Chinese Mandarin, as well as their own local person, the item must be handled with both language. The phonetic transcription of hands (even if of small size) and must never Chinese phonemes to Western language or be opened in his/her presence. romanisation is called “pinying”. Chinese food is known for its Compared with other ethnicities, the variety. Chinese people usually eat more Chinese retain a socio-familiar structure and vegetables than the average Briton. Other cultural activities, with little contact with ingredients that are seldom used in the UK social activities of the country they are but are consumed by the Chinese include living. [4] The family is the main nucleus of soybeans (and all its derivatives), bamboo, their social life; it is the essential, basic, fish and monosodium glutamate. traditional and strongest institution. First- Tea is the most popular brew in generation Chinese immigrants value China, even more than in the UK; it is also responsibility in their children, so they are consumed before meals. The Chinese drink taught this value early in life, such as by very hot tea without milk, lemon or sugar. It going alone to school at an early age. For is also used when cooking numerous dishes. young people, respect for parents, older Tealeaves are composed of water, tannin people and authority figures, such as (7%–15%), caffeine (1%–4%) and other teachers, monks, doctors and nurses, [4] are a alkaloids, such as theophylline. The very important part of their attitude to life. presence of tannin implies some diaphoretic Unfortunately, such practices are not always effects by dilating the superficial vessels, observed nowadays in the society in which causing perspiration and astringent they are transplanted. [4] properties. Although the content of The Chinese are usually very theophylline per cup of tea is about 1mg, diplomatic, especially when speaking to a great tea drinkers can achieve plasma Westerner. When addressing a Chinese concentrations close to the therapeutic level. individual, we should always refer to We should remember that it’s therapeutic him/her as “Mr.” or “Ms.” with his/her range is very narrow (10–20mg/ml). surname; never call him/her by his/her first Irritability, nervousness, insomnia, name. They always greet by shaking hands headaches and seizures can be assign of or with simply a bow. overdose. Simultaneous administration of Britons might stereotypically believe some substances (coffee and erythromycin) that the Chinese people possess the may increase serum theophylline levels, following characteristics: first-generation whereas administration of some enzyme- Chinese run a self-employed takeaway inducing drugs, such as Phenobarbital, will restaurant. They are business oriented and decrease theophylline levels. These types of family focused, hardworking, thrifty, interactions are generally not clinically friendly but very insular, inscrutable, relevant among moderate consumers of tea socially conservative, apolitical and non- but should be considered in patients threatening; they do not try to impose their simultaneously treated with theophylline. [5] values but keep to themselves. Second- Westernfoodsthatdonotusuallyhavem generation Chinese students are quiet, shy, uchacceptanceamongtheChinesepopulation usually “light drinkers”, non-smokers, (not acclimated to Western flavors) are as outstanding students and easy-going follows: cured (hard) cheese, milk (thrifty individuals who never get into trouble; if lactose intolerance), jam (raw meat) and they are international students, most likely legumes (peas and lentils). Western food is they only blend with other Chinese, will get generally considered too salty, and desserts are too sweet. Rice in China is usually Galore International Journal of Health Sciences and Research (www.gijhsr.com) 16 Vol.2; Issue: 3; July-September 2017 Domingo Ly-Pen. Approach to the Chinese Patient cooked well done, softer than in Western environment or macrocosm. Both are countries. constantly changing and formed of matter In Chinese cuisine (especially and energy; the interactions between these Cantonese), sugar is added to plenty of two are the basis of vital phenomena, and dishes (beware diabetics). A condiment that energy is what gives life to the matter and is wide lyused, especially in urban areas of the body. [5] China, is monosodium glutamate (vetsin, The second idea is the “Tao”, which ajinomoto). Therefore, by introducing low- is defined as “the unchangeable course of sodium diets, we must remind our Chinese Nature” or “what happens by itself”. This patients not only to avoid salt but also idea is manifested mainly in two aspects, the monosodium glutamate and soysauce. “yin” (representing the dark, the moon, The native wine in China is made femininity, passivity, what yields, etc.) and from rice (probably the world’s oldest “yang”(representing the clarity, the sun, the alcoholic beverage) and generally has a high masculine, activity, what resists, etc.). They alcoholic content. “Medicinal” wines, which are neither opposites nor contraries, but are prepared with lizards or snakes complementary and interdependent macerated in brandy, reportedly possess principles. [5] The yin is as important as the healing and invigorating properties. Ginseng yang, and the total absence of one cancels wine is also widely celebrated by those out the other. The light is not the opposite of same properties. The Chinese believe that the shadow, nor what gives in, it is the cold drinks can induce bad digestion, so opposite of what resists. In a healthy person, some spirits and wines are served hot. [3] yin