Culture and quality of life

Chapter 1 described how health itself is viewed slightly differently in Western

and non-Western cultures, with individualistic Western views and more col-
lectivist Eastern views of health being identified. Yan and Sellick (2004) point
out that culture influences many factors relevant to quality of life judgements,
such as responses to pain, attitudes towards and use of traditional versus
Western medicines and treatments, concepts of dependency, and the culture of
communication. While their longitudinal study of Chinese cancer patients
revealed many of the same physical, psychosocial and emotional responses to
gastrointestinal cancer reported in Western studies, the authors note that their
sample differed from Western samples in their emphasis on family support,
and in the patients’ indirect indication of distress through symptom report
rather than through direct interpersonal communication. The role of culture and
the underlying values and beliefs about health, illness and QoL must therefore
be considered in terms of their influence on self-reported QoL. As Bullinger
(1997: 816) observed: ‘If disease, as anthropo-logical research suggests, is so
very much culture-bound, how could quality of life be culture free?’
Conceptually, the meaning of health and illness has been shown to be affected
by cultural norms and experiences of health, illness and health care, as well as
by different belief systems, such as the Chinese belief in the need to maintain a
balance between yin and yang, or as in some tribal beliefs in the supernatural.
We described many such different beliefs in the opening chapter. Cultural
differences also affect how QoL can be assessed (see the section on measuring
quality of life, below).