Health Seeking Behaviour among People Suffering from Cardiovascular Disorders

Abstract

The study explores health seeking behaviour among people suffering from cardiovascular disorders in the New Juaben Municipality of Ghana, as a result of relationship between their personal experiences and their cultural worldview. This study was undertaken in an environment predominantly inhabited by Akans who hold the notion that health is maintained when there is a harmonious relationship between the individual and the environment and that there is no distinction between the physical and the supernatural worlds. The worldview that guides the people is the supernatural attribution to various health-related issues and that helps them to deal with matters related to their health. This contrast the views held by western trained clinicians who use solely the biomedical approach to explain health and illness and that this approach fails to take cognizance of the cultural explanation and local explanations of diseases into consideration. Limited studies on how such cultural beliefs influence health seeking behaviour for cardiovascular disorders, and that the few that have been undertaken have heavily relied on western conceptualisations to explain health and help seeking. Using a concurrent mixed method design, this study set out to understand health seeking behaviour using both qualitative (study 1) and quantitative (study 2) approaches. Study 1, was made up of (n=46) participants, involving 33 participants for focus group discussions and 13 key informants. The study explored the cultural values and belief systems that influence health seeking behaviour for cardiovascular disorders. Participants were of diverse age, sex, educational and occupational background. Using the thematic content analysis, the study showed that cultural factors such as definition, aetiology, enemysm and sale of diseases, communality, spirituality, relational tensions and multiple health seeking influence health seeking behaviour for cardiovascular disorders. To cross validate the findings of the qualitative study a quantitative study (study 2) was undertaken to explore health seeking behaviour for cardiovascular disorders. Quantitative data was collected from a different sample of 560 respondents. Hierarchical and categorical multiple regression and t-test were used to analyse the quantitative data. Results corroborated the findings of the qualitative study that cultural values and beliefs including belief in the supernatural aetiology of cardiovascular disorders were found to significantly influence health seeking behaviour. Results further showed that local definition of a disorder influences that choice of healthcare. Again, the role of traditional healers in the provision of holistic care is significant because of their ability to provide culturally accepted service to clients. On the basis of the findings, a three dimensional linear decision making process namely causal attribution, social persuasion and spatial dimensions and a model for health seeking were proposed. The findings are discussed within the framework of existing theories.