ABSTRACTS
CULTURAL HEALTH BELIEFS IN A RURAL FAMILY PRACTICE: A MALAYSIAN PERSPECTIVE.
Understanding the socio-cultural dimension of a patient’s health beliefs is critical to a successful clinical encounter. Malaysians, comprising a multi-ethnic population of Malays, Chinese and Indians still use a wide variety of traditional healthcare systems in spite of having a remarkable modern rural health service. Patients’ perceptions of health, expectations of healthcare, treatment choices, advances in health care, and other aspects of care are influenced by class, culture and religion. Clinicians may be inadequately trained to face the challenges of providing quality care to socially and culturally diverse populations.
This paper highlights some of the health beliefs, perceptions and practices relating to a variety of common illnesses encountered in the authors’ rural practices. Some aspects of traditional healthcare are discussed in an attempt to explain these health beliefs and practices, in the context of the traditional worldview of the patient and scientific viewpoint. Issues discussed include traditional practices of ‘hot and cold’ notions of ‘Yin-Yang’ and the Ayurveda system, how the mystery and speculation of the inner structure of the body influences people’s perception and presentation of body symptoms and why somatisation is common among Asians. ‘Health precautions’ taken by women during their menstrual periods and taboos about diet, dress and behaviour during pregnancy and childbirth that marks the transition of a social status of woman to that of a ‘mother’ are discussed. The authors attempt toaddress and explain the following questions. What is their approach to truth telling, collusion and advanced directives when dealing with their loved ones with terminal illness? How is death anxiety related to their cultural beliefs? How does cultural healing help patients with neurotic disorders, psycho-physiological problems and somatised syndromes? When and why do patients turn to alternative medicine?
Modern and traditional medical systems are potentially complementary rather than antagonistic to each other. Understanding the different cultural background and traditional practice of patients will help to promote better communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoid cultural blind spots and unnecessary medical testing and lead to better compliance of patients with treatment. It is hoped that ethnic and cultural considerations can be integrated further into the medical curriculum and modern health delivery system to improve care and health outcomes.
Reprints request: Dr Khoo Siew Beng, Department of Family Medicine, Penang medical College, No 4, Sepoy Lines Road, Penang 10450, Malaysia. E-mail: sbkhoo@pmc.edu.my