Cultural beliefs have a significant effect on health. They influence the patient perception of disease etiology and pain, health-seeking behaviors, and health care preferences, among others. Cultural competence is required to include such beliefs in evidence-based diagnosis and treatment. Adequate knowledge of a patient’s culture can help provide optimal care that meets his or her needs. This paper discusses the health care beliefs of people of German and French-Canadian heritage and their influence on evidence-based care delivery, the similarity with those of the writer, and the preferred choice and rationale.
Although the German Diaspora often practices Western medicine, conservative groups still hold on to their cultural beliefs. Low German (LG) Mennonites, a community that settled in Canada in the 1800s, are known to be highly religious (Kulig & Fan, 2016). As such, they view psychological health from a spiritual context. Kulig and Fan (2016) found that LG Mennonites believe that mental wellness results from a divine will. They attribute the development of psychological disorders to have weak nerves or ‘narfun trouble. Their perspectives on the level of control a patient has over his or her condition are also significant. They consider mental illness genetic, and therefore, it cannot be controlled through conventional interventions (Kulig & Fan, 2016).
LG Mennonites also associate psychological disorders with drug use, stress, and domestic violence. Spiritual wellness is considered important for mental health and the two are interdependent (Kulig & Fan, 2016). Thus, this group regards religion (prayer) as a protective factor against stress that predisposes a person to mental illnesses. LG Mennonites do not feel that autism and Alzheimer’s disease are psychological conditions that require medical attention. They also believe that a person’s life and experiences, including psychiatric conditions, are predetermined and result from sin (Kulig & Fan, 2016). Therefore, stigma and shame are associated with mental illness in this community.
The beliefs and attitudes of French-Canadians towards healthcare affect the diagnosis and management of different conditions. In particular, their limited awareness and perceptions of chronic pain (CP) result in underreporting and suboptimal treatment of this condition (Lacasse, Choinière, & Connelly, 2017). They are unaware that CP is a post-surgical complication, reflecting a significant knowledge gap. Many French-Canadians believe that healthcare professionals are not skilled in CP management and feel that CP treatment leads to medication (opioid) dependence and psychological services are reserved for depression (Lacasse et al., 2017). They also show negative attitudes towards people complaining of CP, indicating limited social support to such patients in this community.
Cultural variations in health beliefs exist between Francophone groups and First Nation Canadians. The French-Canadians are more inclined to individual wellness than on family and community health (Levesque & Li, 2014). Thus, they are less likely to engage in activities meant to support the health of others in their locality. However, compared to indigenous communities, French-Canadians value physical health, reflecting the body-centered view of people of this heritage (Levesque & Li, 2014). For them, health promotion efforts must encompass traditions and cultural integrity. Like Anglophones, French-Canadians place a higher emphasis on healthy lifestyles. They believe that healthier meals, exercise, and adequate sleep are critical to physical health (Levesque & Li, 2014). This view reflects their individualistic values and autonomy common to people of European heritage.
The beliefs about the etiology and symptoms of mental illness, predetermined life experiences, stigmatization, and a perceived limited level of control of a patient may affect the utilization of mental health services among people of German heritage. Therefore, LG Mennonites may reject evidence-based psychotherapy (CBT) and medication if delivery is not sensitive to their spirituality. For the French-Canadians, their limited understanding of CP and negative attitudes may impede family or social support for people suffering from CP. However, they value physical health; hence, they may be receptive to interventions that promote healthy eating and exercise.
The healthcare beliefs of the two cultures discussed above bear significant similarities with my heritage – Peruvian. First, people of German descent and those from Peru attribute illness to forces beyond personal control. Additionally, in both cultures, ill-health is viewed as having a spiritual component and physical and psychological dimensions. Thus, seeking traditional treatments in addition to conventional therapy is a common practice. Second, Peruvian migrants and French-Canadians associate chronic pain with the presence of disease; thus, less severe painful sensation may not be reported.
Cultural beliefs about disease causation influence the utilization of health care services. I would choose the health care beliefs of people of German heritage because they exhibit a collectivistic orientation. In particular, the (LG) Mennonites emphasis on prayer and family support is consistent with holistic care principles. Perhaps because of my Peruvian background, which centers on community needs and traditional healing, I would choose the health care beliefs of LG Mennonites in Canada.
Culture defines peoples’ perception of health and wellness, disease causes, symptoms, and care utilization. From the discussion, people of German heritage believe in a spiritual basis for illness, limited patient control over psychological conditions, and the protective role of prayer. In contrast, French-Canadians are unaware that chronic pain is a post-surgical complication, associate medication use with addiction, and emphasize physical wellness. Cultural competence and sensitivity are required to provide optimal care to these groups.
Kulig, J., & Fan, H. Y. (2016). Mental health beliefs and practices among Low German Mennonites: Application to practice. Lethbridge, AB: University of Lethbridge.
Lacasse, A., Choinière, M., & Connelly, J. (2017). Knowledge, beliefs, and attitudes of the Quebec population toward chronic pain: Where are we now? Canadian Journal of Pain, 1(1), 151-160. Web.
Levesque, A., & Li, H. Z. (2014). The relationship between culture, health conceptions, and health practices: A qualitative-quantitative approach. Journal of Cross-Cultural Psychology, 45(4), 628-245. Web.
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