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Holistic Nutrition Degree! Again, for I know. Ready to share new things that are useful. You and your friends.Traditional Chinese health beliefs adopt a holistic view emphasizing the significance of environmental factors in addition risk of disease. According to Quah (1985), these factors affect the balance of body's harmony, yin and yang. These are two opposite but complementary troops and, together with qi (vital energy), they operate the universe and illustrate the association in the middle of habitancy and their surroundings. Imbalance in these two forces, or in the qi, results in illness.
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In order to restore the balance, primary healthful practices may be needed. For example, excess `hot' power can be counterbalanced by cooling herbal teas, and vice versa. These beliefs are deeply ingrained among the Chinese, and have been found to be unchanged following migration to Singapore.
Lee, et. Al. (2004), found that patients with exact lasting diseases, namely arthritis, musculoskeletal diseases and stroke, were more likely to use primary Chinese rehabilitation (Tcm). This was strongly determined by the 'chronic disease triad', perceived pleasure with care and cultural health beliefs.
Hence the use of Tcm is not related with the quality of doctor-patient interaction. Astin (1998) also agreed that it was seen as being more compatible with the patients' values, spiritual and religious philosophy, or beliefs about the nature and meaning of health and illness.
In primary Chinese culture, taking medication is opinion to be aversive, hence medications tend to be taken only until symptoms are relieved and then discontinued; if symptoms are not obvious, medications will probably never be taken.
Apart from parental cultural beliefs, minor side effects of confident antibiotics such as stomach upset may contribute to the poor adherence of medication. The use of "leftover", "shared" antibiotics and over-the-counter purchase of antibiotics by parents are tasteless situations in the community.
They think that their children suffer from the same illnesses judging by the similar symptoms, so they would give the "leftover" or "shared" antibiotics to their children and only bring them to their doctors if there is no revision (Chang & Tang, 2006). This may cause their conditions to deteriorate and may necessitate aggressive treatments later which may have unnecessary side effects.
However, there are small groups of Chinese who also blamed ill-health or misfortunes on supernatural forces, or on divine retribution, or on the malevolence of a 'witch' or 'sorcerer' (Helman, 1994). Such groups will commonly seek cures from their religions.
In Singapore, the Ministry of health has drawn up the Tcm Practitioners' Ethical Code and Ethical Guidelines to forestall any unscrupulous practitioners from preying on their patients and taking advantage of their beliefs, for example, molesting ignorant patients.
The degree of acculturation has been evidenced in the following case. An old man was brought into our hospital with a week-long history of malaise, nausea and vomiting, and sudden jaundice. He was diagnosed to have an obstructive mass in the liver.
A biopsy revealed hepatocellular carcinoma. The serological test suggested lasting active hepatitis B. When the news broke to his son that his father had cancer, he requested not to disclose that to his father.
When we discussed end of life issues such as hospice care and "do-not-resuscitate" (Dnr) orders, the son tried to divert the discussion to other issues such as when his father could go home.
Cultural Issues that may be complex in this case are:
The Chinese tend to protect the elderly from bad news.
Believing in karma - the older folk believe that discussing illnesses or death/dying is bad luck. They think that talking about something bad will cause it to come true.
There is an increased incidence of liver cancer resulting from Hepatitis B due to delayed rehabilitation in the elderly, as it may 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, G. C. & Tang, S. F. (2006) Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore healing Journal, 47(4):266
Helman, C. G. (1990) Culture, health and Illness. Wright, London.
Quah, S. R. (1985) The health reliance Model and preventive health behaviour in Singapore. Public Science and Medicine, 21, 351-363.
Lee Gbw, Charn Tc, Chew Zh and Ng Tp. (2004). Complementary and alternative rehabilitation use in patients with lasting diseases in primary care is related with perceived quality of care and cultural beliefs. Family Practice, 21(6): 654-660.
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