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.