Chinese culture versus Western medicine: Health implications for San Francisco elder Chinese immigrants with heart failure

The purpose of this ethnographic study was to explore cultural beliefs of elder Chinese immigrants toward Western medication regimens as few studies were conducted in this area. Hypertension among elder Chinese immigrants is a growing problem in San Francisco with its leading complication of heart failure. This study was designed to reveal any cultural variables that may promote or interfere with medication adherence in the elder immigrants in San Francisco. Six participants with a history of heart failure were recruited from a clinic in San Francisco. Cultural views were obtained based on data from observation and interviews and grouped into specific categories by software NUDIST with analysis under the guidance of Johnson's behavioral system model and social epidemiological concepts. This study explored inter and intracultural factors that might enable or hinder Western medication adherence behavior. The study found Western medication adherence in elder Chinese immigrants with heart failure can be affected by traditional Chinese and adapted beliefs from U.S. migration toward acute and chronic disease management. This study lends itself to social change by documenting the problems of inadequate communication between Western and Chinese practitioners and emphasizing the critical importance of integration through understanding and utilization of traditional as well as adapted Chinese cultural values. Biases of the study included the convenience and small sample size. As a further step toward social change, the study suggested the importance of future research on Western medication adherence in different geographically located subcultural group of elder Chinese immigrants with heart failure.