Culture, Experience, & Identity

    

    Disease and illness are experienced by patients, existing in the human’s body as a physical condition from the clinician’s perspective, whereas for the patients who are suffering from the illness, the disease is a part of the self as a mental state and simultaneously a physical issue as well (Good, 2005). Illness experience, I think, involves patient’s subjectivity and is given meanings through the cognitive representations and images that developed after understanding their illness condition. Pain, as an essential part of illness experience, is also subjective, which feeling is hard to be measured (Jackson, 1992).

    As two parts in medical systems that possess different medical knowledge and perspectives, Physicians and patients have different ways to translate signs and categorize symptoms; therefore misinterpretations and misunderstanding are normal in health communication. On the other hand, the distinction between so call reality and subjective illness experience increases the difficulty of management pain in health care. In different institutions where produce the ideology of the systems they are engaging in, how do physicians understand the subjective illness experience of patients? Even for patients themselves, they have confusion about pain problems. The confusion is caused by pain’s features of invisibility, subjectivity, and stigma. Pain can not be observed, hard to be described, and the extent that people can endure is different. For instance, in many cultures, boys and men are supposed to hide and bear their pain in silence. They may have difficulties when expressing their pain experience in the process of discourse with physicians.

    Indeed, patients and physicians have trouble understanding each other. Narratives in their relationship are effective tools toward shared decision-making, meaning efforts to describe pain and experience in details. By open conversation with patients, physicians could find out patients’ interests and needs, in which process consideration of role of culture is important. Health practitioners encounter challenges when translating between objective medical theories and local cultural forms of knowledge, which are culturally diverse.

    The ways in which we perceive self – identity – are developed in daily behaviors we perform in the context that culture offers, are associated with our constructing and interpreting meanings of health and disease, and influence the relationships with others in health care systems, in cultural communities. For example, a person who see himself or herself as a follower of a religion tend to adapt to the ritual procedures and healing tradition practice in the religion. Religion practice is a process of fulfilling the needs of connecting with one’s culture, with the past, and origins of the religion. I was enlightened by the assumption of Airhihenbuwa (1995) that we should emphasize the political aspects of culture when dealing with the identity and distinction within the contexts of power and agency. Culture is political. It is based on the foundation of the institutions where people engage in, such as agencies, families, religions, and schools. Cultural identity is established, developed, and changed by different contexts. Thus an individual may identify with sorts of cultures, for example, the social group they participant, the religion they follow, the companies they work in. The degree to which a person identifies with a certain culture may influence his or her health behaviors and outcomes.

Culture: Epistemology & Ontology

    

    The important role of culture has attracted increasing attention as a factor influencing healthcare and health communication, as well as a consideration of developing effective health communication programs and intervention (Airhihenbuwa, 1995). So what is culture? Why does it matter in health communication? I can’t agree more with the point argued by Bauman (1999) that culture is a set of things that people keep in mind guiding their perceiving and interpreting events, the world, and themselves, in order to act in a way acceptable to the members in the same group. Culture is mirrored in a group’s norms, values, beliefs, and patterns of communication. For instance, cultural groups have their unique ways to overcome challenges, according to their shared values and norms, such as would be the case if a cultural group uses traditional practice to promote a certain disease. Thus consonance between health care intervention and the cultural traits of target group increases acceptance of health programs. That’s why health intervention and programs aim to be culturally sensitive and meet cultural groups’ psychosocial needs.

    The culture-centered approach introduced in Dutta’s book Communicating health (2008) deepened my understanding of health and health communication that are constrained and developed within cultural contexts and values. The contexts of culture endow health communication with health meanings of how group members interpret and understand health and illness. These meanings may enable or limit their health behaviors. For example, alterations to the genitals of male and female are defined differently (Darby, 2004). Female genital alteration (FGA) is considered as a harmful surgery to female, which damages their integrity. On the other hand, male genital alterations (MGA) are called circumcision, which seems to be less serious. In this way, male genital mutilation is always ignored whereas female genital mutilation is recognized. The distinct definitions raise some questions in my mind. Whether these meanings of genital alteration are associated with sexual function in society? Is circumcision is discriminatory? What is the standard? Are there double standards? I think there are. They are probably caused by the potential medical and physical benefits of MGA as Darby claimed. However, these “benefits” also could be the products of cultural norms. A cultural group dedicates to seeking evidence proving their customs are reasonable, in order to be accepted by the members. Moreover, a cultural practice may be viewed as a violation of human rights in other culture’s perspective.

    Therefore, the study of culture is essential in understanding health communication. As the culture-centered approach (CCA) proposed, there are also three key concepts upholding the construction of culture: structure, culture, and agency. These concepts and their interplay remind me that the voice of marginalized groups is mute. They have difficulty to access services, lack capacity to engage in health behavior. As a researcher, what I am intended to do is to understand their culture contexts, address the structures that constrain their behaviors, and enable cultural members to perform beneficial health related actions. The epistemology and ontology of culture is the first lesson, the first entrance, and the first illumination on the long way.

Introductions

My independent study "Culture and Health" is coming! 

Be more independent and strict!

I am on the way..