moglobin E trait are the most common causes of microcytosis in Southeast
Asians. Microcytosis may be incorrectly diagnosed as anemia and consequently
inappropriately treated with iron. Therefore physicians should be aware that
erythrocytic microcytosis in Southeast Asians is most likely a reflection of the
presence of thalassemia or of hemoglobin E trait ( Luan, 1969). These conditions
are usually harmless and do not require treatment ( Sutherland et al., 1983).

Results of a study by Chung and Kagawa-Singer ( 1993) indicated that Viet-
namese women were more likely to experience distress than their husbands.
They also found that regardless of the number of years in the United States,
premigration trauma events and refugee camp experiences served as significant
predictors of psychological distress for up to five years after migration. Results
of another study ( Buchwald, Manson, Dinges, Keane & Kinzie, 1993) also noted
the prevalence of depressive symptoms among Vietnamese Americans. Although
physical symptoms that created anxiety about health status existed, psycholog-
ical and emotional symptoms were much more prevalent. However, Ganesan,
Fine, and Lin ( 1989) observed that Vietnamese Americans tend to refuse mental
health services until symptoms are severe.

Generally major beliefs are related to religious affiliation. Some Vietnamese
Americans believe in the constant presence of ancestors' spirits. Buddhists up-
hold the theory of reincarnation ( Fabrega & Nguyen, 1992). Mourning families
may wear white clothing or head bands for a certain period of time. Vietnamese
generally bury their dead, whereas Cambodians and Laotians tend to prefer
cremation. Some Vietnamese Americans may express grief as somatic com-
plaints ( Lawson, 1990).

Vietnamese Americans generally have small body frames and are seldom
overweight, except for some Vietnamese-Chinese individuals. Vietnamese skin
color is light to medium, with yellow tones. Eyelids have an epicanthic fold,
noses may be small, and teeth may be proportionately large. These character-
istics are typical of Asian individuals ( Stauffer, 1991; Williams & Westermeyer,
1986).

Buchwald D., Manson S. M., Dinges N. G., Keane E. M., & Kinzie J. D. ( 1993).
Prevalence of depressive symptoms among established Vietnamese refugees in
the United States: Detection in a primary care setting. Journal of General Internal
Medicine, 8( 2), 76-81.

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