Paper Spirits and Flower Sacrifices: Hmong Shamans in the 21st Century.

INTRODUCTION: Fresno, California, is home to more than 30,000 Hmong. The purpose of this research was to explore the utilization of Hmong shamans 40 years after the first Hmong immigrants arrived in the United States. Hmong shamanism is examined to identify and analyze changes to shamans' practices or patients.
METHODS: Using grounded theory, semistructured interviews were conducted with a convenience sample of 20 shamans in their homes. Transcribed data were qualitatively analyzed.
RESULTS: Shamans continue to train and practice in this community; utilization by older patients persists while young adult patients have become the fastest-growing group of users. Healing rituals have changed in response to the legalities of animal sacrifice in urban areas and the time demands of work schedules. DISCUSSION: Nurses' awareness that the availability of biomedicine does not preclude the continuing or recurring utilization of traditional healers can facilitate understanding of culturally defined health care needs.