Traditional Chinese health beliefs take a holistic view that emphasizes the importance of environmental factors in increasing disease risk. According to Quah (1985), these factors influence the balance of body harmony, yin and yang. These are two opposite but complementary forces that, together with qi (vital energy), control the universe and explain the relationship between people and their environment. Imbalance in these two forces, or in qi, results in disease.
To restore balance, traditional recovery practices may be necessary. For example, excess ‘hot’ energy can be counteracted with cooling herbal teas, and vice versa. These beliefs are deeply held among the Chinese and have been found to have not changed after migration to Singapore.
Lee, et. Alabama. (2004), found that patients with specific chronic diseases, namely arthritis, musculoskeletal diseases, and stroke, were more likely to use Traditional Chinese Medicine (TCM). This was strongly determined by the ‘chronic disease triad’, perceived satisfaction with care, and cultural beliefs about health.
Therefore, the use of TCM is not associated with the quality of the doctor-patient interaction. Astin (1998) also agreed that it was seen as more compatible with patients’ values, spiritual and religious philosophy, or beliefs about the nature and meaning of health and disease.
In traditional Chinese culture, taking medication is believed to be aversive, so medication tends to be taken only until symptoms are relieved, then discontinued; if symptoms are not obvious, medication may never be taken.
Regardless of parental cultural beliefs, minor side effects of certain antibiotics, such as upset stomach, can contribute to poor medication adherence. The use of “leftover”, “shared” antibiotics and the purchase of antibiotics without a prescription by parents are common situations in the community.
They think that their children suffer from the same diseases judging by the similar symptoms, so they would give the “leftover” or “shared” antibiotics to their children and only take them to their doctors if there is no improvement (Chang & Tang, 2006). . ). This can cause your conditions to deteriorate and may require aggressive treatments later that can have unnecessary side effects.
However, there are small groups of Chinese who also attributed ill-health or misfortune to supernatural forces, or divine retribution, or the malevolence of a ‘witch’ or ‘sorcerer’ (Helman, 1994). Such groups will generally look to their religions for cures.
In Singapore, the Ministry of Health has developed the Code of Ethics and Ethical Guidelines for Traditional Chinese Medicine Practitioners to prevent unscrupulous practitioners from taking advantage of their patients and taking advantage of their beliefs, for example by harassing ignorant patients. .
The degree of acculturation has been evidenced in the following case. An elderly man was brought to our hospital with a week-long history of malaise, nausea and vomiting, and sudden jaundice. He was diagnosed with an obstructive mass in the liver.
A biopsy revealed hepatocellular carcinoma. Serologic testing suggested active chronic hepatitis B. When he told his son the news that his father had cancer, he asked her not to tell his father.
When we discussed end-of-life issues, such as hospice and DNR orders, the son tried to steer the discussion to other topics, such as when his father could go home.
Cultural issues that may be involved in this case are:
The Chinese tend to protect the elderly from bad news.
Believing in karma: older people believe that talking about illness or death brings bad luck. They think that talking about something bad will make it come true.
There is a higher incidence of liver cancer as a result of hepatitis B due to delayed treatment in the elderly, as it can take a long time for them to accept the initial diagnosis.
Reference:
Astin JA. (1998). Why patients use alternative medicine. J Am Med Assoc 1998; 279: 1548-1553.
Chan, GC & Tang, SF (2006) Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary health care clinic in Malaysia. Singapore Medical Journal, 47(4):266
Helman, CG (1990) Culture, Health and Disease. Wright, London.
Quah, SR (1985) The health belief model and preventive health behavior in Singapore. Social Sciences and Medicine, 21, 351-363.
Lee GBW, Charn TC, Chew ZH and Ng TP. (2004). The use of complementary and alternative medicines in patients with chronic diseases in primary care is associated with the perceived quality of care and cultural beliefs. Family Practice, 21(6): 654-660.
