Socio-Cultural Perspectives On Health and Illness: Malathi G. Nayak, Sharada, Anice Geroge
Socio-Cultural Perspectives On Health and Illness: Malathi G. Nayak, Sharada, Anice Geroge
Socio-Cultural Perspectives On Health and Illness: Malathi G. Nayak, Sharada, Anice Geroge
nurses can affect the nurse-patient, family relationship and Health perceptions and health beliefs vary across the
quality of care delivered. To provide the most effective care lifespan.4
the nurse needs to understand the relationship of different
Sociologists have demonstrated that the spread of diseases
needs and the cultural factors that determine the priorities
is heavily influenced by the socioeconomic status of
for the family2.
individuals, ethnic traditions or beliefs, and other cultural
Culture refers to the values, beliefs, and behaviors that are factors. The prevalence and response to different diseases
shared by members of a society and which provide varies by culture. Sociologists agree that alcohol
direction for people as to what is acceptable or consumption, smoking, diet, and exercise are important
unacceptable in given situations. Because even the issues, but they also see the importance of analyzing the
smallest decisions of a person's everyday life are influenced cultural factors that affect these patterns. Social factors
by culture, quality health care cannot be provided without play a significant role in developing health and illness.
a consideration of the client's cultural background. Herbal treatment is one of the primary medicines used to
treat HIV in Africa. The study of hypertension within the
Much research has focused on how persons come to make
United Kingdom has turned to examining the role that
judgments of their own health status. Many studies
beliefs play in its diagnosis and treatment. There were
suggest that judgments of health and well-being and
differing reasons for non-compliance that involve the
interpretations of sickness are shaped by factors beyond
patient's perception and beliefs about the diagnosis.
those traditionally captured by biomedical conceptions of
Patients commonly believe that high levels of anxiety when
illness. The identification of the exact psychological and
first diagnosed are the major cause and think that when
social factors responsible for self-assessed health,
stress levels decline so too will their hypertension5. Limited
however, remains elusive. Some have suggested that
knowledge about DM, based on beliefs about health and
individuals take into account important social and
illness including biomedical and traditional explanations
psychological resources, such as social support, feelings of
related to the influence of supernatural forces, e.g. fate,
control, and optimism, when making judgments of their
God etc., were found, which affected patients' self-care
own healthand that these psychosocial resources
and care-seeking behaviour6.
provide protection against morbidity and mortality3.
Statement of The Problem:
Health and illness behaviour studies make clear that the
An explorative study to assess the socio-cultural
forces affecting health and treatment outcomes transcend
perspectives on health and illness among adults of rural
medical care and the transactions that takes place between
areas of Udupi district.
doctor and patient. Studies of health and illness behaviour
teach the importance of moving beyond initial complaints Purpose of The Study:
and narrow definitions of problems and toward examining The present study extends existing research by broadening
the broad context of individuals' lives and the factors that the focus from examining concepts on health and illness.
affect social functioning and quality of life. A medical care The aim of the present study is to explore beliefs about
system responsive to these broad concerns would be health and illness that might affect self-care practice and
better prepared for the impending health care challenges health-care-seeking behaviour among adults who live in
of the new millennium. The literature of lay beliefs suggests selected villages.
that the concepts significantly affect a population's health
Objectives of The Study:
and illness behaviours, health consciousness and risk
The objectives of the study were to
perceptions. Therefore, a growing emphasis is now being
1. Explore the perception on health and illness among
placed on detecting lay beliefs of health, disease and risks.
adults
2. Identify the health care seeking behavior collect the data from the concerned authorities. The data
3. Determine the perceived health risk among adults. was collected after obtaining the written consent from the
4. Find the association between perceived score on health eligible participants. The data was analyzed using
and illness and selected variables. descriptive (frequency and percentage) and inferential
statistics. The analysis was done based on objectives and
Variables:
hypothesis by using SPSS package version 16.
Key variables Perception on health and illness, health
care seeking behavior, perceived health risks. Results
Sample characteristics:
Selected variables - Age, gender, religion, type of family,
Among 75 adults, majority (69.3%) of them were in the age
education, occupation, exposure to mass media, income of
group of 25-40 years and 66.7% of them were females, 90%
the family.
were belongs to Hindu religion and living in a nuclear
Delimitation: family. Majority of the adults received information from
The study is delimited to adults of selected villages of Udupi the health personnel and from mass media (Table 1). The
District study showed that majority of them had perceived their
health status as average, decision taking by self to seek the
Research Methodology :
medical help and availing the treatment from the private
A community based explorative cross sectional survey
clinics. Most of the adults reported reasons for not seeking
study was carried out in Hirebettu village of Udupi District.
help that diseases are not sever enough (70.7%), unable to
A non probability purposive sampling was used to select 75
pay medical expenses (62.7%). Majority of the adults
adults by using structured and validated questionnaire on
perceived that when they feel sick then only they approach
perception on health & illness, perceived health risks and
(90%) health care (Table 2). Results shows that 84% of
on health seeking behavior.
adults have high perception and 16% of adults have
The Inclusion criteria a adults who were aged about 25yrs average perception on health and illness (Fig 1) and 45% of
and above, living and working in village area, present at adults believe that disease are caused by wrath of the
home during the time of study and willing to participate. god/goddess, 26% of them reported leprosy/TB caused
due to their past sins, 48% believed that epilepsy are due to
Demographic Proforma consisted of age, gender, religion,
ghost intrusion, 38% had given the report illness can be
type of family, education, occupation, exposure to mass
traced by enemies and 36% adults perceived that diseases
media, income of the family. Perceived health and illness
are caused by their 'karma' (Table 3). The Mean and
tool had 36 items on likert scale and categorized as low
Standard Deviation of Perception on health and illness was
perception (<48), average perception (49-96) and high
104.97 and 12.44 respectively.
perception (>96). Perceived health risks had 27 risk factors
and were categorized as high risk (>54), moderate risk(28- The data shows that adults of rural areas, they perceived
54) and low risks(<27) and health seeking behavior had that smoking, alcohol intake, drug abuse, using unsafe
total 5 items. water and food and multiple sex partners were the high risk
for the health and illness (Table 4). The Mean and Standard
Validity of the tools were established by submitting to five
Deviation of perceived health risk was 59.32 and 7.79
experts and there was 100% agreement on all items with
respectively. Chi-square was computed to analyze the
minimal correction. Reliability was established by
association between perceived health & illness and
administering the tool to ten adults, reliability coefficient
selected variables, results shows that there is a no
of the tools were computed by using chronbach's alpha and
significant association between perception on health and
was ( = 0.82). Administrative permission was obtained to
illness and selected variables. Thus the null hypothesis was adults of rural areas, perceived that smoking, alcohol
accepted on regard to these variables and alternative intake, drug abuse, using unsafe water and food and
hypothesis was rejected (Table 5). multiple sex partner were the high risk for the health and
illness. 26% of them reported leprosy/TB caused due to
Discussion and conclusion :
their past sins, 48% believed that epilepsy are due to ghost
In the present study 45% of adults believe that disease are
intrusion, 38% had given the report illness can be traced by
caused by wrath of the god/goddess this supports the
enemies and 36% adults perceived that diseases are
study findings by Katarina Hjelm, Karin Bard, Per Nyberg
caused by their 'karma'. Cultural and religious distance are
and Jan Apelqvist explaining the cause of Diabetes Mellitus
essential for understanding self-care practice and care-
(DM) as 'the will of Allah or God7.
seeking behaviour, and need to be considered in the
The spread of diseases is heavily influenced by the planning of care.
socioeconomic status of individuals, ethnic traditions or
Table 2: Health seeking behavior:
beliefs, and other cultural factors. Results shows that
SI.No Area f %
Table 1: Sample Characteristics 1 Perception of own health
Good 30 40.0
SI.No Category f %
Average 43 57.3
1 Age in years
Poor 02 2.7
25-40 52 69.3
2 Decision taking to seek medical help
41-60 22 29.3
Parents 17 23.6
>60 1 1.3
self 53 70.0
2 Gender
siblings 05 6.4
Male 25 33.3
3 During illness where do you take treatment
Female 50 66.7
Public centres/hospitals 7 9.3
3 religion
Private hospitals 27 36.0
Hindu 68 90.7
Nursing homes/clinics 36 48.0
Muslim 6 8.0
Home remedies 5 6.7
Christian 1 1.3
4 Reason for not seeking health care
4 Marital status
Feeling that diseases are not severe enough 53 70.7
Married 62 82.7
Unable to pay medical expenses 47 62.7
Unmarried 8 10.7
Unreasonable charges in medical institution 24 32.0
Widow 5 6.7
Knowing how to deal with disease themselves 28 37.3
5 Educational status
Having no free time 26 34.7
Primary (>5th std) 22 29.3 Long distance from medical institution 13 17.3
Primary (5th to 7th Std) 17 22.7 Complicated medical procedures 25 33.3
secondary 36 48.0 Long queuing and waiting time 32 42.7
6. Type of family Poor services 3 4.0
Nuclear 42 56.0
Joint 32 32.7 Fig 1: Perception score on health and Illness (%)
extended 1 1.3
7 Employment status
Agriculturist/tailoring 52 69.3
House wife/coolie 23 30.7
8 Income of the family per month in rupees
< 2500 46 61.3
2501-5000 29 38.7
9 Information received on health and illness
Health personnel 65 86.7
Neighbor/friends 39 52.0
Family member 51 68.0
Average Perception
Mass media 58 77.3 High Perception
Table 5: Association between perceived health & illness and selected variables
SI.No Category Average High c2 P value
Perception Perception
1 Age in years
25-40 6 46
41-60 6 16 2.97 .22
>60 0 1
2 Gender
Male 4 21 1 .63
Female 8 42
3 Religion
Hindu 12 56
Muslim 0 6 2.57 .27
Christian 0 1
4 Marital status
Married 12 55 2.96 .23
Unmarried 0 8
5 Educational status
Primary (>5th std) 7 31
Primary (5th to 7th Std) 5 20 4.62 .099
secondary 0 12
6. Type of family
Nuclear 8 34
Joint 34 28 .739 .390
extended 0 1
7 Employment status
Agriculturist/tailoring 6 6 .763 .519
House wife/coolie 40 23
8 Income of the family per month in rupees
< 2500 7 42 .305 .742
2501-5000 5 21
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