Question

Conduct a literature search to locate a journal article related to the health or health care practices of Chinese, Japanese, and Filipino people. Present a summary of the journal article, and examine how the information presented may impact your nursing practice. Please provide a copy of the journal article (or hyperlink) if possible.

Answer 1

ANSHER Health status and Health Services Acess and Armong chinese, filipino, Tapanese, Korean, South and vietnamese children in colifornia, utilization Asian, Summary of THE TOURNAL ARTICLE in INTRODUCTZONE - It has been widely documented that Ethnic minority children in the united states have less acess to healthcare than do non-hispanic white children. 'Most studies on health care acess have focused on Hispanic and African American children. Although Estimates derived from the us census Bureall's 2006 American community Survey indicate that people of Asian descent represents only 4.9% of the us population, there has been an almost 50% Increase in the Asian American population since 1990. Despite the substantial increase an population, information on health care Services utilization among Asian is lacking chinese, filipino, and are the largest Asian American united states. the Asian American access and health American Childrer Asian Indians Subgroups in

Health care accese, health insurance coverage, and the use of preventive health seevices are among the use of most challenging health issues facting today's immigrants and ethnic minorities Even though immigrants have lower mortality and morbidity risks than do us-boon Intand children and adults as reported. Additionally, child and parental birth place have been found to affect Insurance Status and access to health Services among lathino children an the US. Health issues are compounded by the problem of adaptation to a new culture for Asian children Particularly those from families with limited English proficiency, Asian children have also been shown to have the lowest utilization those from families of preventive care and to receive the Cowest Quality of primary care compared with other racial / Ethnic groups. Moreover Asian parents are often limited in their ability to act as advocates for their children in the health care Setting .

There is a clear lack of studies on children's health care access that foccus on dissaggregated Asian subgroups, Especially population that have assived more recently. Studies on parental Care utilization and the health of adult immigrates have demonstrated substantial heterogeneity among Asian Ethnic groups One Study found that Chinese, fillipno, and asian Indian children have more difficulty accessing healthcare than do non - Hispanic white Children. California is the state with the largest Asian American population wing aggregated data from the 2003 and 2005 waves of the callifornia health interview Seevey (Cars), the researches, aimed to determine the Social and demographic characteristics of Asian children aged zelo through 11 years, to describe the prevalence of selected team health status ' among them, and to examine adjusted differentials in health and health calle outcomes among Children in Asian subgroups after controtting . Aos Selected Social and demo- Graphic Covariates,

METHODS The data used in this study are delived from the 2003 and 2005 CHES. The Ches, the largest Statewide hearth sulvey in the issues, including health status, health behavides, access to health Care and health care utilization. DATA- CHES is a random - digit - dialed telephone Suevey of adults, adolescents and children. Detailed methodological information is available elsewhere, All california house holds with a telephone comprised the sampling frame. Each computer generated telephone number has screened to determine participant Eligibility and I adult per household was randomly selected to be intelviewed. The researches aggregated the chos data to yield sufficient statistical powee to Examine the health status and health services Characteristics among the Specific Asian American subgroups. The comparison group was non this panic white children Sueveyed during the same period. The researches weighted Estimates to represent all non. His panic

children younger and white and Asian in california. age 18 years MEASURES: al To classify sace / Ethnicity, the parents was first asked if the children was latino; the parent was taken then asked to Identity a race if a children was not latino, at a parent dentitied the child as Asian, he couche was asked to Identity a specific Asian Euthnic group. Alian Ethnicity consisted of 6 groups: Chinese, filipino, Japanese, Korean, South Asian and vietnamese The researches Examined child health status; Physical behavioral, coll mental limitations; and Several measuremen ŷ of health care access and utlization as reported by the parent and coded all measures into dichotomised outcomes, Parent - reported health status (Excellent, very good, com) good velscas fair (OR) poor) was derived from the Question & En general, would you say health is Eucement vely good good fair, col) popp ? Euseesance Status was delived by parent responses to Question "type of health"

the types of Insurance Included children medicaid health insurance program, medicare. Employement based, poivately purchased, and other public Incarance. The usual source of case was assessed from the Question; as there a place that the child would go when he col) che il sice (0) you need advice about this health 9" whether the Children has a physical checkup within the past year was determined with the Question " Duling the past 12 months, did get a physical Exam coey general check up when Che col) She) was not sick cool hurt ?" The numbes of visits to a doctor was deteemined on the basis of the Question: "During the past 12 months did visit a hospital Emergency room & Delayed call forgone medical care coas delived from the following Question: " During the past 12 months, did you delay coll not get any other med care that you felt meeded a such as seeing a doctor a specialist, call other health professional?" Delay filling a prescription was based on the Question " During the past 12 months, did you detay cool not get a medicine that a doctor

prescribed for (child)?" The dental visit variable was delived from the Question" About how long has it been since your child last visited a dentist coll dental clinic & Euclude dental hy gienist and all types of dental specialist, The Covariates included child's age, gender, status, family Citizen ship- nativity povesty status, Insulance status, house hold health composition, and Status, children in families, with Income below threshold welle Coded as pool, children with income 100% rees than 200% of threshold as near pool, and children with income 200% and above the the poveste in families the Povesty in families poverty Threshold as not pool . included because of not Parental colineality Education with was income,

Statistical Analysen: Sample weights, person, level weights, and population weights, were employed. There weights accounted for, among Other variables, non response, multiple telephone lines, and within household probability of selection, and adjunted for gender age, race, ethnicity, Urbanization, no. of children, and no of adolscenta in the household. Because the data were weighted on the basis of the 2000 Census data, the findings are generalisable to children in California The x² test was used to text for etheric differencen an the proportion of binary health status, health access, and utilization outcomes. Logistic regression models were voed to examine the andependent effects of Asian ethnicity on various outcomes. Adiunted odds ratios CAORs) and ast confidence intervals (CIB) were computed by using the reglession beta coefficients and standard errors obtained from the logistic regression model To account for the complex Sample design involving Stratification, clustering and multistage sampling of the CHIS, statistical analyses were conducted with SUDAAN. (Research Tricougle Innfitate, Research Triangle park, Ne). Jackknife replicate weights were applied for variance erstimation as recommended

Results: 1. Demographic characteristica The Demographic characteristica of the Children by ethnicity showed that there were 648 Chinese, 523 Filipino, 235 Japanene, 308 korean , 314 South Asian, and 264 vietnamese Children younger than age 12 years. The Comparison group consisted of 8468 non-Hispanic altite children. Statistically significant associations (by the xtent) were found between ethnic groups and most sociodemographic Characteristien examined (p <ois). Among Asian children, the highest percentage of noncitizen and toliegn-born children were korean to South Asian- South Asians has the highest percentage of children younger than age 5 years. Almost all Asiana American Children resided in metropolitan arean; 4.4% of non- Hispanic White Children lived an nonmefropolitan crear parental education attainment varied substantially among the ethnic groups. More than two thirds of Chinese, Japanese, and korean parents also had atleant a College degree. Nearly 6ol of Vietnamene and nearly half of kolean parenta did not speak English very well" cor) were Considered of limited English proficiency. More than 8d. (

of koreans, South-Abians, and vietnamese Children had a foreign-born parents. About one half of Korean and South Asian children had noncitizen parents. Approximately one sixth of filipino and vietnamene Children came from Single-parent households. 2. Children's Health Status : children's health status and health care accem and utilitation Characteristics by ethnicity. In general, Asian American Children Concept for Japanese children) had a lower prevalence of physical, behavioral, (d) mental limitation compared with non-Hispanic ballite children. Japanene and philipino Children had similar rates of asthma compared with non-Hispanic white children, whereas had lower rates of Children an au other Asian subgroups had to aatema. Ethnic patterni in attention deficit hyperactivity disorder were similar to those for asthma. Rates for ever having been breastfed Caged 1 to 3 years) for all Asian goups were similar to those for non-Hispanic whiten, except for vietnamese children, sul of whom were never breastfed.

Except for Japanese children, children in all Asian subgroups were more likely to be an fair col) poor health compared with non-Hispanic white children. In particular, one quarter of vietnamene Chidren were reported by their parents to be an fair (8) poor health. lalith respect to health care accens, korean, filipino, and vietnamese children were more likely to be without health insurance at the time of the interview than were, non-Hispanic White children. Nearly 3% of Korean Children were uniusured - Approximately Ulf of korean Children and 13% of Filipino children did not have contact with a health profesional within the past tar ast 12 months Rorean and Vietnamese children were more likely to be without a usual place for health care e and and to have had no to ha Contact with a health profeasional within the past la months than were non-Hispanic white children. Filipino, korean , and vietnamese children were mole likely to not have had a well-child visit within the past 12 months than were non-Hispanic white children. - Encept for South Asiana, children in all Asian group were

lean likely to have had an emergency room visit within the past year than were non-Hispanic white Children. More than one third of South Asian Children aged syear and older had never seen a dentist.

3. THE ODDS RATIOS3- the odd ratios Cors) from logistic regressº on for health status and health Services outcome 8 while Selectively Controlling for children's age, gender, Citizen ship- nativity, family Poverty Status , health insurance, household Composition, and parent - reported child health StatuB. Korean children were 3.5 times more likely than were non a Hispanic white children to be without health insurance CoR: 3.67; 95% CI: 1.96, 6:15). South Asian and Vietnamese children were less likely to report delayed Care because of lack of and insurance high cost ( South Asian OR = 0-388; 95%CI:0.16,0.91", Vietnamese OR = 0.19; 95% CI: 0.07, 0:50). Filipino children were almost twise as likely as non-Hispanic white children to not have had contact with a health Care Professional within the Post 12 Months Cor: 1.81, 95% CI:1.18,2.78) Chinese and Vietnamepe children were less likely to have delays in acquiring Prescribed medications than were non - His Panic white children (Chinese OR 0.60 ; 95% CI = 0.37, 0-98; Vietnamese OR -0.16; 95% CI 20.06, 0:47)

- Chinese , Korean, and vietnamese children were likely less to have visited the Emergency room within the past year than were non. His Panic white children C Chinese OR = 0.60 ; 95% C7- 0.43,0.85; korean OR = 035) 95% CI: 0,21,0.58 ; Vietnamese OR = 0.30', 95% cr :0.17.0.156) → vietnamese children were less likely to have never visited a dentist than were non - His Danic white children Cor= 0.32; 95% CI: 0.17; 0.59) → Compared with us-born children, non citizen immigrant children were he times more likely to be without health insurance COR = her299, 95% CI: 2.35, 7.8 he) and 3,5 times more likely to be without a ubual Source of Care (OR= 3.418 ; 95% CI: 1.87.6-33) the naturalized immigrant children generally did not differ Significantly from Us-boin children on all out comed their parent & , however, were much less likely to report them as in farr, or Poor health than were Parent 8 of non-Hes Panic white Children COR: 0.10; 95% CI: 0.03. 0.37) - Compared with children who were insured uninsured children were Il times more likely a to be without usual Source of Care (OR: 11.29; 95% CI:6-67,19.08) e more times likely to not Physical have had a Examination within Part 12 months (OR = 4:07; 95% cIalogh, 8.50), and 3.5 times more likely to not have had Contact with a health Professional within the past 12 months (or = 3.47; 95% CI = 2.22. 5.41).

→ children from single -Parent house holde were more likely to Experience fair or poor health (OR=1.69:95% C1 = 1.12, 2.5h); more likely to have had delayed Prescriptions CORE 179; 95% CI = 1.21, 2.66); and more likely to have used the emergency room in the Post la months CORE 1.58, 95% CI:1.275,1.97) → Family Porenty status baß in de Pendently associated with most of the Out Comes the age differences in the Prevalence of health outcomes were as expected. of Particular interest Ose the significantly increased risks among children aged 5 to Il years for Emergency room Use, a lack of Usual Source of Care, and no Physical examination or contact with a health Professional in the past 12 months they also were less likely than were children in other age group to gender Patterns are also worth noting, such as Significantly higher risks of girls lacking health insurance and Physical Examinations in the past 12 months and Significantly lower incidence of Emergency room use and their Parente reporting that they were in farr or Poor health compared with boys.

DISCUSSION: the results show important differences in health status and health care access and utilization among Children from the 6 largest Asian ethnic groups in California and among non-Hispanic White children. The researchers demonstrated that large heterogeneity exists amona Asian ethnicities to the extent that late could draw few Peneratizations about all Asian groups although after controlling for socio demographic variables, relativaly fewer Significant differences persist. the researchers also found worse overall parent reported health status among children in most Asians groups Compared with non - Hispanic white children, coith the exception of Japanese children, a group with the least proportion of recent immigrant families. the findings did not lend Support to the healthy immigrant hypothesis. The Asian groups with the highest proportion of recent immigrants were not the ones reporting better health Statás. Howere, it has also been suggested that self reported health Status May be influenced by different perceptions of health rooted in culture and language unique to Asian ethnicities.

It was also found that a high number of korean children lack insevance. This has been attriboted to the lack of employer based insurance Korean Communities. Non citizen Children also lack insenance and a usual Source of Care More than 3 to 4 times as often as do Citizen Children. A lack of insurance resulted in low health care access and Cotilization, and this effect was much larger than those found in a previoos Study using National Health Interview Survey data. Children from poor or single parent households were also More likely to have had adverse indicators. The gender Patterns that emerged were particularly worth noting. Girls were significantly at higher risk of lacking insurance and physical examinations and had lower emergency room Use than did boys and parents were less likely to report girk as in fair or poor health this may suggest a o for the male child within the groups Studied preference on The researches observed individuals who experienced Hope deprivation expressing fewer health care needs and having lower expectations of the health care system. Also worth noting are Ors that were nearly significant : they include chinese and South Asian children never Visiting a dentist, corean Children without a usual Source of care , filipino children with delayed care, and Vietnamese Children never having doctor checkups.

the researchers also found that the naturalized immigrant children were in better health than were the Us- born children and that the non citizen children did not have this advantage. This May be because of the changing demographic Composition of the recently arrived immigrant population in Califania ..

Limitations! the results of this Survey may not be generalizable. to the United states as a whole. Health Care Provider's In other state, may be less accustomed to serving these Individuals, and our findings Eu Colfosinia likely underestimate the risky Experienced by Immigrant Population nationally, the researchers were also unsure How adequately the survey respesents the conditions of undocumented Emmigrant Chillsten, who are likely to have more Severse needs. Conclusion: Despite these limitations, chis is the best Available Survey uniquely suited to studying the Health of Specific Asian American Sub goroops. &t over sampled Asiau sub groups and Provided language translations, En contrast to other Surveys that Systematically Excluded Asians with limited English Proficiency on Suppressed Asian Ethnicity in the public use data. The study found Considerable Socio demographic heterogeneity among the Ethnic group studied. 1.

many of our findings may reflect Culture and histossical lavriations En health Care - Seeking behavior. The differential Patterns observed Suggest that health Care out reach& observed Suggest that health Care out reach to Asian Ethic groups should be customized according to their specific needs. families who are les familiar with the use Health Care System Especially need linguistically and Culturally alloropriate Services, REFERENCE: Services Stella, m. yo. (2010) Health status and Health Access and Utilization Among Chinese, filipino, Japanese, ko reau, South Asian, and Victnamese Children du California American Journal of Public Health, 100(5), 823-830 * Impact of the study on nivorsing Practice! this study clearly explains about Importance of tran culturial Nursing. According to Madeleince leininger, the pioneer of triangalterial nursing, &t iga substantive area of study and Practice that focuses on the comforative Cultural of Caring the beliefs and practices of shdividuals or groups of Simibror different colturies. Tran Scultural

Noorsing is an essential aspect of health Care Today. * Norges should leon Cultural differences, Nursing En other Contries, International health &sug, and International health Organizations. * The Norge should render Con golvent Nursing Care, and to provide culture specific, and universal huising Care Practices for the health and well-beings of People or to aid them &u facing a dvorse human Conditions, &t nasa death du culturally meaning for ungerne * Trans culturial norsey should act as specialisty, generalists, and Consultants In orders to study the Interrelationships of Culturally Constituted care from a norsing Point of view, * They should provide knowledgeable, Competent, and Safe Care to People of diverse cultures to them Selves - and other * The Ever-&ncreasing multicultural population &n the united State Posay a significant challenge to nusises providing audividualized and holistic Care to their patients,

*The Nurses Should recongnize and appreciate Cultural differences &u Health Care Ialway, belief, and Customs. * Norges must be aware of the different Cultural Parctices, acquire the Necessary knowledge and Skille. Su coltura Competency and accept the Patients as they are * Culturally Compentent Nursing Core heilg Ensure . Patient Satisfaction and Positive outcomes.