SINGAPOREAN CHINESE ILLNESS COGNITIONS : A LOOK AT INDIGENOUS CONCEPTS AND HELP SEEKING BEHAVIOUR

Abstract

This study explores indigenous cognitive dimensions used by Singaporean Chinese in their conceptualisation of illnesses. These cognitive dimensions are in turn studied to investigate their relationship to help seeking behaviour. There were 242 participants who rated the similarity/dissimilarity of pairs of illnesses. Multidimensional Scaling of these similarity ratings revealed that there were three indigenous dimensions. The 22 attribute ratings when regressed unto these dimensions enabled the labelling of only two of the three dimensions- Traditional Chinese Illness Concepts and Extent of Bodily Distress/Infliction. The first dimension proved to be a mixture of Eastern and Western concepts, thus, attesting to the integration of modem atttributes within a traditional framework. The second dimension was more of a American-Singaporean cultural dimension as it had been discovered in earlier American studies (Bishop, 1987) and local studies (Tan and Bishop, in press). Therefore, replication of this dimension in this study proved itself to be a robust culture-free (in terms of the Singapore and American cultures) dimension. To assist in the naming of the third dimension, cluster analysis was performed. It was discovered that the illnesses were clustered according to whether they were caused by obstruction of air, blood or qi. There were 4 main clusters- urinary, respiratory, cardiovascular and abdominal. Therefore, it appeared that the last dimension was "Obstructed Systems". There were three basic forms of help-seeking behaviour - curative, preventive and maintenance which were either of modern type (Western General Practitioner I Western Over the Counter Medicine [OTC]) or of additional type ( Sinseh I Chinese OTC) or non-medical actions (Home Remedy). When these 16 help-seeking behaviours were regressed unto these three dimensions, it was found that tmditional curative and preventive help seeking behaviour as well as Western maintenance help seeking behaviour were related to dimension I. This suggests that people seek both Western and Traditional medicine when the illness is conceptualised in indigenous terms. This demonstrates the complementary relationship that Western and Traditional help seeking behaviour have with each other as they operate on different levels of illness behaviour. Traditional help seeking behaviour was also related to a mix of Traditional and Western attributes within dimension I whilst Western help seeking behaviour was related to Eastern attributes. This again expresses the complementary relationship as they operate on different attributes within the same dimension of the same illness. The last dimension was negatively related to two tonns of Western help seeking behaviour (curative and preventive) as well as being positively related to traditional curative help seeking behaviour. The last relationship shows the generalizability and wide applicability of Western help seeking behaviour to specific Chinese Illnesses as well to the continued strong presence of traditional Chinese curative medicine. These results show that not only do people have different combinations of illness representational dimensions but different combinations affect help-seeking behaviour. It is precisely because help seeking behaviours are operating on different dimensions, on different attributes within the same dimension or on different levels of help seeking behaviour (cure, prevention and maintenance) that modem and traditional help-seeking behaviour can co-exist side by side. Implications of these findings and suggestions for future studies are discussed