Psycho-cultural constructs of illness in a chinese population: illness beliefs, attributions and coping

Lau, Bernard Wai Kai (1998) Psycho-cultural constructs of illness in a chinese population: illness beliefs, attributions and coping. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

In view of the growing Chinese communities all over the world, it is apposite to investigate how the Chinese perceive, explain and respond to their illness, as this has tremendous implications on the health care planning and service delivery to this ethnic minority in countries outside China.

A cohort of consecutive patients with psychiatric disorders was included into the study and every effort was made, by increasing the size of the sample, to make it a good sample the results of which were inferential and representative of the population from which it came.

A multi-disciplinary approach was adopted and a methodology, mainly a mixed semi-qualitative and quantitative design, was chosen for the purpose. A pilot study preceded the study proper, and the sample comprised a non-patient normal as well as the proband (patient) respondents. Some pains was taken to examine the cognitive factors in their illness behaviour. As far as possible, patient-centred views were focused and emic perspectives were assumed in a socio-cultural context. While primarily employed to tap the three variables in question, instruments were devised to take all this into account and tailored to this end. Though illness beliefs, attributions and coping are capable of social, psychological and anthropological investigation separately, they were in reality entwined.

It was found that irrespective of the nature of the psychiatric conditions and other demographic variables, culture exerts a dominant effect, even more than the mental illness itself, on the belief system, causal attribution and coping pattern of the respondents, thus confirming the observation that in a collectivistic and cohesive culture such as the Chinese, the thinking processes and the behavioural responses of the members are substantially shaped and influenced by the cultural learning. Like medicine, religion is a part of culture and has appreciable relevance with the traditions. It both provides a way of understanding the patient and allows an acceptable or sanctioned avenue to make sense of and cope with the illness.

Clinical implications were discussed, not only in the clinical setting, but also in the sectors of health prevention and education, health care planning, service and research. Cultural background was acknowledged as a vital factor indispensable in the consideration as regards medical management and community services of persons in need.

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