摘要：This article reports qualitative interviews from an ethnographic study that explored in part, the health seeking behaviors of and for older Hmong Americans with chronic illness. The study occurred over a 36-month period in the St. Paul / Minneapolis area of Minnesota. The majority of interviews were conducted in the Hmong language and lasted approximately three hours. Participants included 35 older Hmong Americans living independently with chronic illness. The majority of these older adults were female (n=25, 80%) with a mean age of 78.43 years. Interviews also included 33 family members (n=25 female,75.75%) with a mean age of 75.75 years, who provided a minimum of eight hours of in-home care for an older Hmong American with chronic illness. Due to the significant role of shamans in the spiritual well-being of older adults, three shamans (two male, and one female) were also interviewed. All (mean age 83, range 65-99) had been "chosen" to become a shaman while living in Laos and had resided in the United States an average of 4 years 5 months (range: 1 month to 13 years). All shamans reported having an active practice, with comments such as "I have so many [patients] I do not count." More specifically, one shaman stated that he performed 20 to 40 healing ceremonies per year. One shaman explained his role by stating "I heal the weak and the lost spirit." The majority of older Hmong Americans (74.29%) and family caregivers (57.58) had retained the spiritual beliefs of animism and ancestor worship. Findings report that 18 (51.43%) older Hmong Americans compared to 21 (63.3%) family caregivers sought the services of both a physician and a shaman for treatment of the older person's chronic illness. Fourteen (40%) older Hmong Americans compared to ten (30.30%) family caregivers sought the services of a physician alone. Only 3 (8.57%) older Hmong Americans compared to 2 (6.06%) caregivers consulted the services of a shaman alone. Many older adults and family caregivers voluntarily discussed the important role of shamanism during the Hmong New Year in promoting the spiritual well-being of family members throughout the coming year. In conclusion, although Hmong Americans have access to biomedicine, the majority of participants continued to utilize shamanic ceremonies in combination with biomedicine. The reliance on shamanism became stronger when biomedicine was viewed as having limited effectiveness or when the cause of the affliction was perceived as being spiritual in nature
关键词：Hmong Americans; health and medicine; shamanism
