Question

Japenese Case Study #1

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This case study is a composite of actual situations. Marianne, who is American, and Ken Shimizu, who is Japanese, have worked in Tokyo for over 30 years as Methodist missionaries. They have annual furloughs and occasional sabbaticals, during which they visit relatives and sponsoring organizations and engage in continuing education in the United States. They met as college students in the United States, and their three grown children have established their own careers in the United States.

Ken’s 98-year-old mother resides with Marianne and Ken. She is not Christian but has always been extremely supportive of Ken and Marianne’s work. Ken teaches at a large Christian university, whereas Marianne has served in various church-related positions over the years. As missionaries, they live in subsidized post–World War II housing near Ken’s university. Marianne has been a frugal housewife, preparing local foods in the Japanese style for her family.

Ken, who is nearly 60, recently learned that he has glaucoma. By the time it was discovered, he had lost a significant amount of peripheral vision. Although Marianne delivered all three children at a Christian hospital in Tokyo, she gets her annual physical examination when visiting relatives in the United States. She has never believed that the Japanese health system is as proactive as that in the United States. On her most recent visit to the United States, Marianne learned that she has hypertension. Her physician prescribed a medication that is readily available in Japan, but the physician was concerned about the level of stress in Marianne’s life. Mother Shimizu is quite confused and requires considerable care, but it is unthinkable for Ken, the only child, to put his mother in a long-term-care facility. Even if he would, the

quality of facilities in Japan leaves much to be desired. Most of the responsibility for Mother Shimizu falls on Marianne, in addition to her work. Marianne’s relatives are urging her to consider placing Mother Shimizu in a church-related life-care community near Marianne’s family in the United States, where Marianne and Ken would like to retire. Marianne’s own parents lived in this facility at the end of their lives. She is considering these issues as she returns to Tokyo.

1. Identify some of the cultural issues that may lead to conflict in this international family.

2. What are the family resources for this international family?

3. What factors within the Japanese health system may account for the late diagnosis of Ken’s glaucoma?

4. What practical issues might arise for the Shimizus if Mother Shimizu were placed in a long-term-care facility in the United States?

5. What dietary factors may contribute to Marianne’s hypertension?

6.In what ways might you consider Ken to be countercultural as a Japanese man? 7.What social pressures might Marianne have faced, given some of her choices, as a housewife in Japan? 8.What pressures will Ken likely experience as he considers how to meet the needs of both his mother and his wife? 9. Compare and contrast the fertility and mortality rates of Japan and the United States. 10.Do the traditional Japanese maintain sustained eye contact with strangers? Why or why not? 11.To which drugs might Japanese people have greater sensitivity than that of white ethnic populations? 12.How do most Japanese people meet their need for calcium?

Answer 1

1Self care is an important aspect of the American culture because independence is valued highly.But the japanese usually believe in interdependence rather than independence .American culture is based on egalatarian approach and considers everyone as equal.But in japanese culture there is a clear hierarchial structure in which the male dominates the family .But japanese Americans tend to be modest with their family mmembers.

3 The japanese health system is based on herbal therapy ,Acupuncture and moxibustion .Traditional east asian medicines is based on holistic principles and the goal of the therapy is to restore the energy within the body and between the humanbody and its environment .They beleve that certain qualities such as food,weather conditions,types of activity and when human relations are out of balance ,the flow f energy within the body is impaired

4.One of the major issues would be related to culture.They believe in physical boundaries.So before performing physical examinationrequest permission to touch the client before doing so.if possible a female client prefers a female heal care provider.Encourage family involvement.

5 Food preferences are based on origin and many members prefer items containing carbohydrates and red meat items.The health risks are hypertension,cancer,heart disease,diabetes mellitus and obesity.Most of them lead sedentary lifestyle and addicted to fizzy drinks,fried and junk foods.Frozen pizza,canned soup are some of the items which is included in a normal American diet .This ,ay be one factor which resulted in hypertension.

6In japanese culture the elderly or the husband is the head of the family and plays a dominant role .But here Ken is quite considerate to Marianne and gives her enough freedom to visit her family in US .Ken respects Mariannes Amrican culture.He even allowed her to get treatment from US.

7In japanese society emphais is laid in interdependence rather than on independence,which is in contrat to the American culture where they give importance to personal autonomy.Marianne also has to face this situation and she embraced the japanese interpersonal style positively.She also had to cope up with the societal pressure of discarding her home culture inorder to be accepted by the social group .But she withstood all the major obstacles

8It will be a hard decision to choose between his mother and his wife.Marianne has just been diagnosed with hypertension and the physician expressed his concern for Marianne as she has ben under stress.She has the additional duty of looking after her in-law who require considerable amount of care .it would be better for Ken to put his mother in long term care facility in US and lives their rest of life hazzle free in the midst of her relatives.Kens mother will get good care and attention and he could continue his treatment for Glaucoma.Marianne will be happy that she is now near to her relatives and will be able to follow her culture without any pressures.It will also help her to lessen the stress level

10 No,Japanese individuals often exhibit less eye contact than individuals from Europe or American cultures.They believe that individuals from japanese culture percieves anothers face as being angrier ,unapproachable and unpleasant when making eye contact as compared to individuals from wesern europe culture

11Eplerone has been effective in lowering BP in japanese patients with hypertension,including those with low renin HTN.These patients had a larger decrease in BP in response to isradipine than seen in whitepatients in US.

12 As like that of western societies japanese people usually take diets with low calcium.They tend to skip milk and milk products ,as majority of them face lactose intolerance.They build up their level of calcium in their body by consuming soy and fish.It isshown that it is beneficial for improving bone density.