Cross-Cultural Indicators of Help-Seeking Behaviour in Aggressive General Hospital Patients

Abstract

In this study the authors researched cross-eultural identification of aggressive behaviour disturbances as identifying factors for patients' family members to seek professional help for the patients. Patients (N = 40), mainly Zulu-speaking were drawn from the outpatient clinic of a large academic general hospital. In all 23 (57,5%) of the patients and 25 (62,5%) of the relatives were urbanized. A comparison was made between what the patients' families considered problematic as opposed to formal professional diagnostic and aetiological considerations in the same patients. Several trends emerged from the results. It was demonstrated that the behavioural disturbances formed the most important set of identifying criteria for the family of the index patient. It held true for people in various stages of urbanization. Cognitive, mood and perceptual disturbances were of a lesser identifying value to families. Predictably, there were some differences between urban and rural families. Rural families were more attuned to the patient's problems but generally remained more tolerant of the aggressive behaviour and were less ready to seek professional help. These findings, some known from clinical observations and anecdotal communications, have seldom been objectively analysed -particularly in Africa. Implications for management, along with various related crosscultural issues, are discussed.In hierdie studie het die outeurs die kruis-kulturele identifikasie van aggressiewe gedragsverteurings nagevors as identifiserende faktore vir pasients se gesinslede om professionele hulp vir die pasianta te versoek. Pasisnta (N = 40), hoafsaaklik Zulusprekend, is geneem vanuit die buita-pasiente kliniek van 'n groat akademiese algemene hospitaal. 'n Totaal van 23 (57,5%) pasienta en 25 (62,5%) gesinslede was verstedelik. 'n Vergelyking is getref tussen wat die pasienta se gesinne as problematies beskou het teenoor formeIe professionele diagnostiese en etiologiese oorwegings in dieselfde pastente, Verskeie neigings is deur die resultate uitgelig. Dit is gedemonstreer dat die gedragsversteurings die belangrikste stel identifiseringskriteria vir die gesinne van die lndekspasiente was. Dit was die geval vir individue in verskeie stadia van verstedeliking. Kognitiewe, affektiewe en perseptuele versteurings was van minder identifikasie belang vir die gesinne. Soos voarspel kon word, was daar verskille tussen die verstedelikte en landelike gesinne. Landelike gesinne was meer ingestel op die pasienta se probleme, maar verdraagsamer teenoor die aggressiewe gedrag oar die algemeen en minder gewillig om professionele hulp te bekom. Die resultate, waarvan sommige bekend was a.g.v. kliniese observasies en anekdotiese kommunikasies, is nog seide objektief onteed veral in Afrika. Implikasies vir behandeling, sowel as verskeie kruis-kulturele aangeleenthede word bespreek.

Cultural discourses in apartheid-era psychology, 1980–1994

“…The person is seen as a whole and at one with his or her ecological, social and religious environment. (Schlebusch, Wessels, & Rzadkowolsky, 1990, p. 225)It would seem fair to assume therefore that the traditional culture of Africans, or more appropriately, the traditional cosmology, has changes that come with the technology of progress. The broad cultural structure provides some firm standing ground so to speak, and indeed, rootedness.…”

“…The person is seen as a whole and at one with his or her ecological, social and religious environment. (Schlebusch, Wessels, & Rzadkowolsky, 1990, p. 225)…”

“…Despite this, mental disorder exists and is recognized by all cultures, from the most simple to the more complex, although its expression and identification vary. (Schlebusch et al, 1990, p. 230)The variation in systems of meaning that different cultures use to ascribe meaning to events [. .…”

“…In Discourse 3, “culture” was conceptualized in terms of a dilemma facing South African psychologists. For example, various authors described a tension between cultural essentialism on the one hand and constructionism (e.g., Bodibe, 1993; Kottler, 1990) or universalism (e.g., Schlebusch et al, 1990; Swartz, 1991) on the other. Similarly, the following excerpt describes the dilemmatic and politically problematic nature of “culture”:If one accepts the relativist position that different cultures exist which give rise to unique illnesses, one is in danger of lending support to the Apartheid ideology notion of “separate but equal.” On the other hand, the universalist position is unsatisfactory because it seeks to impose the western medical model on all societies and cultures, thus ignoring the important differences.…”

“…In Discourse 3, "culture" was conceptualized in terms of a dilemma facing South African psychologists. For example, various authors described a tension between cultural essentialism on the one hand and constructionism (e.g., Bodibe, 1993;Kottler, 1990) or universalism (e.g., Schlebusch et al, 1990;Swartz, 1991) on the other. Similarly, the following excerpt describes the dilemmatic and politically problematic nature of "culture":…”