Cultural Interview



Thehigh rate of immigration increases the need for cultural competenceamong the health care providers in order to enhance their capacity tohandle health problems of patients from different culturalbackgrounds. The paper contains information obtained from a culturalinterview with Bachiko Azami, a Japanese woman who emigrated fromJapan to United States one and a half years ago. The permission toconduct this interview was obtained from the university’s researchand ethics board. In addition, the interviewee gave a written consentand agreed to participate in the interview voluntarily. The interviewwas conducted within the premises of the local health care center.However, there was no connection between the interviewee and thehealth care center. The center was selected because it was easy toget an immigrant with a health problem. This paper will focus on the12 domains of Purnell Model, appropriate nursing intervention,transcultural nursing standard of practice, and cross culturalexperience of the interview.

Purnell’s12 domains

The12 domains of Purnell Model are appropriate for assessing differentcultural aspects of the interviewee. These domains are used toorganize and present the information obtained from the interview asfollows:

Overviewof heritage

Bachikohad never travelled outside Japan since she was born, and she onlydecided to so at the time of emigration in the United States. Thismeans that she lived on the Island of Shikoku before migrating to anopen mainland and a country neighboring other dray lands. Bachikonever got a permanent or a well paying Japan since she graduated witha diploma in public relations from a local college. She decided tomigrate to the United States to search for a better job. Although shehas acquired an employment opportunity as an assistant publicrelations officer with a U.S. based company, she is advancing hereducation with an objective of increase her job ranking. This impliesthat fewer career opportunities in Japan and cumbersome bureaucracy,and unfavorable academic atmosphere are the major causes ofimmigration of most Japanese in the United States (Hazen &ampAlberts, 2006).


TheJapanese are social people whom, in most cases, are willing to shareall they know during the interviews. Bachiko spoke in a low tone anda soft voice while avoiding eye contact. She was not in a hurry toanswer questions and she could look up from time to time with eyesslightly closed as she tried to retrieve information from her remotememory. Nonverbal communication (such as facial expression andmovement of hands) is used selectively and matched with what onewants to communicate. She often expressed dissatisfaction whenever Itried stopping from taking too much time on one question, but triedto hide this by giving a smile. This means that the Japanese areinterested in social instead of structured conversations. In overall,the conduct of the interviewee was consistent with the availableliterature on the Japanese conversation. For example, the Japanesegauge emotions using voice tone and rarely focus on facial expression(Greynium Information Technology, 2010). Verbal communication is moreimportant compared to nonverbal communication.

Familyroles and organization

Althoughthe Japanese culture has undergone significant changes, there aresome aspects of old culture that are retained to-date. For example,the husband acts as the head of the family who is expected to givedirection and provide for most of the needs of the family. The wife,on the other hand, is expected to assume most of the house chores(such as cooking and washing), but they are currently allowed topursue professional careers (Makita, 2010). Social behavior among theJapanese is governed by the code of etiquette. Some behaviors thatchildren are taught as part of etiquette include avoiding eye contactand eating all the food served before they are excused from thedining place. Similar to other communities, Japanese set family goalsand determine priorities depending on the specific needs of eachfamily. Although Japan remained isolated from the rest of the worldfor many years, most of the alternative lifestyles perceived to be ofwestern origin are being adopted in Japan. For example, gays andlesbians started organizing themselves into groups in 1990s(Sugimoto, 2010).


Japaneseintegrates most of their cultural practices into workplaceenvironment, which blurs the boundary between work and life. Forexample, the cultural aspect of gender roles is seen in the Japaneseworkplace where women are assigned simple clerical tasks while men dothe technical jobs. In addition, the Japanese workers emphasize onethical communication where people work in teams and start theworking schedules by greetings. Group members greet by exchangingtheir business cards and bending slightly to show respect. Inaddition, the Japanese believe in the autonomy of all members ofstaff who are given the right to make contributions irrespective oftheir rank. For example, a junior member of staff (such as clerk) hasthe freedom to exchange ideas with the chief executive officer(president) of the organization (Miller, 2002).


Onaverage, the Japanese skin color is yellow peril, but the majority ofthe Japanese prefers a light or white skin color. Consequently, manywomen and young girls use cosmetics to change their original color,but men do not mind about their skin color (Bifue, 2013). Moreover,the Japanese women prefer being slender. It was not possible tosource some information (such as heredity, genetic topographicdiseases, and drug metabolism) because the interviewee had limitedknowledge of biological facts about the Japanese.

Highrisk behaviors

TheJapanese, similar to other communities, consider substance abuse tobe a risky practice. However, trends show that substance abuse amongthe Japanese youths has been increasing consistently (Kino, Else &ampAndrade, 2013). Other health risk behaviors among the Japaneseinclude unsafe sex and reckless driving. In terms of health carepractices does not differ significantly to the rest of the world. Forexample, the Japanese health care facilities address the key healthproblems affecting the society, including rehabilitation of substanceaddicts, chronic, and preventive health care.


TheJapanese, including pre-scholars take adorable and elaborate mom-mademeals known as obento.This serves as the connection between home and other places, such asschool and workplace. The Japanese cooking styles are simple, butintegrate a high level of craftsmanship. Sushi is the most commontype of Japanese foods that is prepared both in homes andrestaurants. In addition, the Japanese believe that one should eatthe whole amount of food served and people are allowed to bend thebowl to seep last drops of soup. Slurping is considered as a means ofenjoying the meal and showing gratitude. The Japanese avoid eatingindustrially processed foods that are considered to increase healthrisks, but this practice is being overshadowed by the introduction offast foods to the Japanese communities. The type of food given to thesick persona depends on the type of illness and recommendations bythe health care professionals.

Pregnancyand child bearing practices

Mostof the Japanese are opting to remain single while the married peoplegive birth to a few (one or two) children. It is considered shamefuland dishonorable for a Japanese woman to become pregnant beforemarriage. However, birth control measures (such as the use of oralcontraceptives and the use of intrauterine devices) are recommendedfor married couples. Although sexual intercourse before marriage isconsidered to be immoral, many Japanese youths engage in sexualpractices and use birth control measures such as condoms. Expressingthe feeling of pain verbally and minimal noise, especially during thelabor is acceptable and excessive noise is considered to be shameful(Hawaii Community College, 2014).


AlthoughJapanese are members of different religious groups, the golden ruleplays the major rule in the interpretation of issues of death andlife after death. Nearly all Japanese believe in the existence of theworld of the living (called Konoyo)and the world of the dead (called Anoyo)irrespective of their religion (Crystal Tokyo Anime, 2014). Death isviewed as immigration from Konoyoto Anoyo,but it does not result from individual’s misconduct. The olderadult prepare for the death by writing wills. Death practices andbereavement rituals are conducted for a period of 49 days from thedate of death. This is because the Japanese believe that the spiritof the dead takes 49 days to reach Anoyo.


Althoughthe majority of the Japanese do not believe in a specific religion,about 34 % of them and Buddhists, which is the dominant religion. Theuse of prayers among the Japanese varies with the religious groups ofindividuals, but even non-believers attend public player meeting(such as new years) organized by different religious groups (CrystalTokyo Anime, 2014). The meaning of life among the Japanese is mainlybased on moral and not religion. This implies that very few Japanesesource strengths from religious leaders, but they believe in doingwhat is right and showing respect for all irrespective of theirreligion.

Healthcare practices

Traditionalbeliefs that illness resulted from personal misconduct of a cuss fromthe forefather and the tendency to seek for medical help fromtraditional healers has become an outdated practice among theJapanese. Currently, all Japanese have primary responsibility to seekfor medical assistance in formal health care facilities. In most ofthe Japanese families, it is the responsibility of women to take careof the health of their children. Despite the high rate of theJapanese embracement of the formal health care services, about 8 % ofthe Japanese practice complementary and alternative medicine (Suzuki,2004). Some of these folk practices include herbal medicine,chiropractic, flower therapy, art therapy, and thalassotherapy. Someof the key barriers to health among the Japanese include the highcost of health care services and cultural differences for theJapanese living in multiethnic parts of the world. This implies thatnegative cultural beliefs and attitudes towards formal health is nolonger a major challenge. The fact that Japan has some of the worldclass transport and blood transfusion personnel and technology meansthat the Japanese have embraced these types of medical interventions.

Healthcare practitioners

Japanhas world class health care practitioners with only about 8 % whopractice traditional methods of treatment (Suzuki, 2004). Theseproviders serve in different health care facilities (private andpublic) and at different departments, including the general anddental. Their compensation and social status vary with the level ofexperience, education, and the health care facilities they work in.


Thereare three key nursing interventions that can be used to help theinterviewee when seeking for health care. First, giving her enoughtime to express her feelings without interjections can create aperception that she has been accepted and what she is saying isappreciated. This can increase her collaboration with the health careproviders, thus improving the treatment outcome. Secondly, givingher permission to express pain, both verbally and a reasonable levelof noise can act as a way of allowing the patient to express herinternal feelings (Hawaii Community College, 2014). This can increaseher confidence in the formal health care services, thus enhancing hercollaboration and treatment outcome. The three interventions fallunder the first modality (culture care perseveration) of Leininger’sTheory. This is because the three interventions preserve the culturalbeliefs of the patient with an objective of improving her treatmentoutcome.

Transculturalnursing standards of practice

Thetranscultural standard of practice developed by the American Academyof Nursing Expert Panel is one of the most appropriate plans in thepresent case. The standard of practice has 12 standards, but two ofthem are directly related to the present case. The third standard(transcultural nursing knowledge) requires nurses understandtraditions, perspectives, practices, family systems, and values ofdiverse communities, families, and individuals. This can help thehealth care professional in integrating cultural values and beliefsthat can help the client to cooperate irrespective of their culturaldifferences. The fourth standard (cross cultural practices) requirenurses to apply cross culturally sensitive skills and knowledge inapplying nursing care that is culturally congruent (Douglas, 2009). This can be achieved by avoiding practices that may offend the clientor doing what is consistent to their cultural beliefs and values.

Analysisof cross cultural experiences

Theinterview was warm and informative. The interviewee (Bachiko) wascooperative and willing to share information freely. Unlike thewestern communities the interviewee avoided face to face contact andminimized the use of body movements during the conversation. Some ofthe key barriers that could limit her cooperation, including thetendency to conduct the interview in an official way instead oftaking it an opportunity to socialize. Some of the communicationpatterns that had to be changed during the interview to accommodatethe interviewee include the moderation of voice, tone, and avoidingeye contact to make Bachiko feel comfortable. The ability to fit intoher communication style resulted in the collection of much of theneeded information. However, it will be reasonable to allocate moretime in the future interviews to allow the interviewee to express herfeeling and opinions without interjections.


Culturalcompetence is one of the most important determinants of successfulconversation between individuals of different cultural backgrounds.This is because cultural beliefs, values, and perceptions affect theway people express themselves and the way they receive the views ofothers. In addition, some practices may be considered right by somecultural groups and bad manners in a different cultural. For example,slurping shows gratitude and enjoyment among the Japanese, but it isbad manners among the western communities. Differences in culturalbeliefs and practices can have a significant effect in the healthcare setting. This implies that the application of appropriatestandards of practice to enhance providers’ cultural competence isnecessary.


Bifue,U. (2013, October 31). The fair face of Japanese beauty. Nippon.Retrieved June 11, 2014, from

CrystalTokyo Anime (2014). Japanese death belief and custom. CrystalTokyo Anime.Retrieved June 11, 2014, from

Douglas,K. (2009). Standards of practice for culturally competent nursingcare: A request for comments. Journalof Transcultural Nursing,20 (3), 257-269. Doi: 10.1177/1043659609334678

GreyniumInformation Technology (2010). Japaneseread voice tones while Dutch read faces to assess others’ emotions.Bangalore: Greynium Information Technology.

HawaiiCommunity College (2014). Japaneseculture.Hilo, HI: Hawaii Community College.

Hazen,D. &amp Alberts, C. (2006). Visitors or immigrants? Internationalstudents in the United States. Population,Space, and Place,12, 201-216. DOI:10.1002/psp.409

Kino,J., Else, N. &amp Andrade, N. (2013). A confirmatory model forsubstance use among Japanese American and part-Japanese Americanadolescents. Journalof Ethnicity and Substance Abuse,12 (1), 82-105.

Makita,M. (2010). Gender roles and social policy in an ageing society: Thecase of Japan. InternationalJournal of Ageing and Later,5 (1), 77-106.

Miller,R. (2002). The quiet revolution: Japanese women working around thelaw. HarvardWomen’s Law Journal,26, 163-215.

Sugimoto,Y. (2010). Anintroduction to Japanese society.Cambridge: Cambridge University Press.

Suzuki,N. (2004). Complementary and alternative medicine: A Japaneseperspective. Evidence-basedComplementary and Alternative Medicine,1 (2), 113-118.

CulturalInterview – Grading Rubric




  • How you obtained permission

  • Where and when conducted

  • Intro of that the paper will cover


12 Domains

  • Adequately covers relevant domains

  • Adequately explains if/why any domains are not covered


3 Nursing Interventions

  • Adequately describes nursing interventions


Standard of Practice

  • Adequately describes an appropriate Standard of Practice


Communication experience

  • Adequately describes experience

  • Shows insight

  • What worked well

  • What you would do differently



  • most important thing learned


Minimum 3 References

1 Peer-Review Reference

Adheres to page limit


APA, Writing Mechanics, spelling, grammar