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Health, Psycho-social and Cultural Determinants of Medication Use by Chinese-Canadian Older Persons

Published online by Cambridge University Press:  31 March 2010

Erin Yuet Tjam  and
John P. Hirdes
Erin Yuet Tjam*
Affiliation:
St. Mary's General Hospital, University of Waterloo
John P. Hirdes
Affiliation:
University of Waterloo
*
Requests etc: Dr. Erin Yuet Tjam, Director of Research, St. Mary's General Hospital, 911 Queen's Boulevard, Kitchener ON N2M 1B2, ([email protected])
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Abstract

Variations in health and medication use exist across cultures. Medication use among Chinese-Canadian older persons is complicated by many factors including combined use of Western and traditional Chinese medicines (TCM). There is little research on health, psycho-social and cultural determinants of medication use in the Chinese. A cross-sectional census study of community-based Chinese-Canadian older persons in the Kitchener/Waterloo area was conducted using the Minimum Data Set for Home Care and a supplementary questionnaire for cultural issues. The response rate was 89.1 per cent with 106 participants using face-to-face assessments. Socio-demographic and cultural variables were summarized. The multivariate logistic model for TCM use included pain symptoms and being hospitalized, and a curvilinear association between TCM use and health beliefs. For combined medicine use, living with a child, pain symptoms, hospitalization, and social isolation problems were the main effects. Living with a child, physical health problems and number of diseases were associated with Western medicine use. Health, psycho-social and cultural factors were significant determinants for medication use. Education programs for both Chinese-Canadian older persons and health care providers are necessary to understand the appropriate use of Western and TCM treatments.

Résumé

Il existe des différences en matière de santé et de médicaments entre les cultures. Plusieurs facteurs viennent complexifier l'usage des médicaments que font les personnes âgées sino-canadiennes, y compris l'utilisation combinée de médecine occidentale et traditionnelle chinoise (MTC). Peu de recherches ont été effectuées sur la santé et sur les déterminants psycho-sociaux et culturels des médicaments utilisés par les Chinois. On a mené une étude de recensement transversale sur les personnes âgées dans la communauté sino-canadienne de la région de Kitchener/Waterloo en utilisant un ensemble de données minimales sur les soins à domicile (Minimum Data Set for Home Care) et un questionnaire supplémentaire sur les incidences culturelles. Le taux de réponse a été de 89,1 pour cent et 106 participants ont utilisé l'évaluation personnelle. On a résumé les variables socio-démographiques et culturelles. Le modèle logistique à variables multiples utilisé pour la médecine traditionnelle chinoise relatait des symptômes de douleurs, l'hospitalisation et une association non linéaire entre l'utilisation de la MTC et les croyances reliées à la santé. Lorsque les deux médecines étaient combinées, vivre avec un enfant, les symptômes de la douleur, l'hospitalisation et les problèmes d'isolement social étaient les principaux effets. Vivre avec un enfant, les problèmes de santé physique et certaines maladies étaient associés à l'utilisation de la médecine occidentale. La santé, les facteurs psycho-sociaux et culturels étaient des facteurs déterminants reliés à l'utilisation de médicaments. Des programmes d'éducation tant pour les personnes âgées sino-canadiennes que pour les fournisseurs de soins de santé s'imposent si l'on veut comprendre l'utilisation appropriée des traitements occidentaux et de médecine traditionnelle chinoise.

Keywords

Traditional Chinese MedicineMinimum Data Set - Home CareCultural FactorsEthnicityMedication Usemédecine traditionnelle chinoiseensemble de données minimales – soins à domicilefacteurs culturelsorigine ethniqueusage de médicaments
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 1 , Spring/Printemps 2002 , pp. 63 - 73
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*The authors gratefully acknowledge the financial support of their project through the Seniors Independence Program (SIP# 4687-06-93-458) and through a Canada's Drug Strategy - Community Health Researcher Award to Erin Y. Tjam (Grant #6606-5560-603). Dr. Hirdes' work was supported by the Providence Centre Foundation and by interRAI. Translation of the MDS-HC into Chinese was completed by Erin Y. Tjam and Iris Chi.

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