title: Working with culture: culturally appropriate mental health care for Asian Americans.
abstract: OBJECTIVE
  The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans.
  
  
  BACKGROUND
  As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines.
  
  
  METHODS
  Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007.
  
  
  RESULTS
  Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided.
  
  
  CONCLUSIONS
  Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice.
authors.affiliation: Department of Psychiatry and Behavioral Health Sciences, University of Washington, Seattle, Washington, USA. parkm5@uw.edu
authors.forename: Mijung
authors.initials: M
authors.lastname: Park
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Chesla
authors.forename: Roberta S
authors.initials: RS
authors.lastname: Rehm
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Chun
mesh_terms: D000069:Acculturation; D000368:Aged; D001213:Asian / Q000208:ethnology* / Q000523:psychology; D054521:Cultural Competency; D005192:Family Health / Q000208:ethnology*; D005202:Asia, Eastern / Q000208:ethnology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012495:San Francisco