When Healthy Image Isn’t Enough
by Teddi Fine 
Among the Korean immigrant population, projecting a strong, healthy image is culturally important. Yet, when it comes to personal health, the desire to ‘keep up appearances’ can spell disaster. All too often, it acts as a barrier to learning about and managing chronic disorders such as hypertension and Type-2 diabetes, both growing problems among Korean Americans. “Wellness can be achieved when a chronic condition is properly managed,” says associate professor Hae-Ra Han, PhD, RN, FAAN. “This is best achieved when our patients work together with healthcare providers who understand their culture.” According to a new study by Han, professor Miyong T. Kim, PhD, RN, FAAN, postdoctoral fellow Hyunjeong Park, PhD, MPH, RN, and others, clinical awareness of and sensitivity to unique cultural issues like identity and image can help nurses improve self-care among patients diagnosed with high blood pressure or diabetes. The treatment room gives nurses an opportunity to explain that when patients become partners in care, appearance can become reality. [“Maintaining an outward image: A Korean immigrant’s life with Type-2 diabetes mellitus and hypertension,” Qualitative Health Research, June 2012.] 
Yet, for any treatment to be successful, a patient must be able to understand and process health information—a capacity known as health literacy. Generic efforts to improve health literacy often fail. People generally will work to increase their health literacy only when the focus is of particular relevance. That’s why Kim, Han, postdoctoral fellows Hee-Jung Song, PhD, RN, Soohyun Nam, PhD, RN, Youngshin Song, PhD, RN, and Tam Hieu Nguyen, PhD, MSN/MPH, RN, and others developed and piloted a hypertension-specific tool to measure print and functional health literacy among Korean Americans. They believe it can help prevent both research and clinical assumptions about consumers’ health literacy. But their work isn’t stopping with the single pilot study. The team currently is analyzing promising data on Vietnamese Americans that may demonstrate the tool’s utility beyond Korean Americans. Kim says, “We believe this tool can provide an important puzzle piece to a long-standing problem regarding communication challenges that face many first-generation immigrants as they try to navigate the healthcare system.” [“Development and validation of the high blood pressure-focused health literacy scale,” Patient Education and Counseling, May 2012.]