Rural Greeks and illness: an anthropologist's viewpoint

Backache in Greek Immigrants to Sweden: A Cultural Interpretative Approach

Scandinavian medical methods for treating musculoskeletal pain have often proved unsuccessful with immigrant patients. This study examined the perception and meanings of back pain among Greek immigrants to Sweden to identify possible causes of this poor outcome. Fifteen Greek immigrant patients on long-term sick-leave because of backache and 21 strategi cally selected members of a Greek cultural association in Stockholm, Sweden, not on sick-leave received semi-structured interviews about backache. In addition to a content analysis, a cultural approach was used in the interpretation of the mate rial. On the whole, pain was considered as something dangerous, inevitably leading to permanent disability if the suf ferer should deliberately aggravate the pain. Persistent pain was also linked to the tendency to worry and obsess in a way that would eventually make one ill. There was little confidence in doctors' examinations and physiotherapy. The study provides a possible explanation as to why Scandinavian medical treat ment of backache is less successful in this immigrant group.

Traditional Herbal Medicine in the Korean Community in Australia: A Strategy to Cope with Health Demands of Immigrant Life

The strands of medical social science based on such social theories as postmodernism and poststructuralism have tended to mystify what really affects health care use patterns including the simultaneous use of biomedicine and traditional medicine. The small amount of research on the use of traditional medicine among recent immigrants in the West which has been conducted has often tended to be dominated largely by interpretivist perspectives, which neglect the underpinning political-economic aspects of health and health care. The data for this article come from interviews with three different groups of Korean men (17 illegal/amnesty, 14 skilled and nine business migrants), using open-ended questions. Analysing the processes of adjustment to a new country and the constant involvement in hard manual work and long work hours, the article explores how Korean men in Australia make use of all the available resources to stay healthy. They have fully utilized the ‘freely’ available biomedical services under government subsidized Medicare although illegal migrants restrained themselves from using it until the time of obtaining legal status. However, Koreans have also utilized Korean traditional herbal medicine and acupuncture and other informal remedies despite their high cost, bearing in mind that health is a ‘capacity to work’ under the current environment.

Pain behaviour in young immigrants having chronic pain: an exploratory study in primary care

Pain behaviour can hamper rehabilitation. The aim of this study was to explore the phenomenon of pain behaviour in an unselected group of immigrant patients on >6 weeks of sick leave before and after a transcultural treatment programme in primary care. Anxiety about pain and pain behaviour-i.e. > or = 1.5 points on the University of Alabama in Birmingham (UAB) scale with scores of 0-10-were noted before and after treatment. The sex-adjusted odds ratios (OR) for pain behaviour, before and after the treatment, were calculated using logistic regression with 95% confidence intervals (95% CIs). Forty-nine men and 102 women having a mean age of 38 years participated. Their mean sick leave was 46 weeks. All reported psychosocial stress, one-quarter were depressed and social functioning was generally low. The pain was mostly caused by muscular insertion lesions (entesopathies). The frequency of pain behaviour and anxiety about pain declined after treatment (from 68% to 54% and from 76% to 50% respectively). Duration of full-time sick leave and among men also decreasing social functioning were correlated with the UAB score. Those who reported persistent anxiety about pain, or men who were depressed, had higher scores. Only persons on full-time sick leave >1 year had a significant OR for pain behaviour before treatment (OR 3.23; 95% CI 1.17-8.85, adjusted for sex). After treatment, only persons reporting persistent anxiety about pain showed a significant OR for pain behaviour (OR 3.05; 95% CI 1.49-6.23, adjusted for sex). In conclusion, pain behaviour was common in this group of immigrant patients < or = 45 years of age on long-term sick leave. Anxiety about pain and full-time sick leave for more than 1 year significantly predicted pain behaviour.

Greek women and broken nerves in Montreal

In this paper, I examine the importance of class, ethnicity and gender in the causation and meaning of somatization for Greek women in Montreal. I argue that nevra--a form of psychosocial distress experienced by many of the women--is a phenomenon of the poor working conditions, low wages and gender relations in the Greek community. Data is based on interviews with 100 Greek families in Montreal and 45 patients in two different clinical settings. Comparing results with material on nervios and nerves from Latin America and the United States, I concur with Low (1985) that nerves should be viewed as a 'culturally-interpreted symptom' rather than a 'culture bound syndrome'. It is further suggested that the importance of social and material conditions and gender relations in mediating the cultural interpretation must be stressed. Failure to do so often results in the medicalization of nevra and the creation of a chronic sick role for the patient.

Compensable back pain and migrants

Ten years of cases of compensable back pain from a rehabilitation centre were reviewed for evidence that is relevant to the strongly negative stereotypes that are held commonly about migrant workers. The prevalence of migrant workers with back injuries was found to be similar to that in the occupations with higher accident liabilities in the surrounding municipalities. The relative proportion of musculoligamentous injuries and the more objectively confirmable back injuries was not related to the country of birth. Better predictors of treatment outcome were: the time that had elapsed between the injury and admission to the Centre; whether the referral was direct or indirect after the previous treatment; and the degree of fluency in English. It is concluded that the stereotypes that describe migrant workers as accident-prone or malingerers cannot be supported and that the vulnerability of migrant workers to the "accident-victim syndrome" can be accounted for without reference to ethnic characteristics.

Consulting rates of general practitioners by demographic groups in a defined community

The demographic characteristics were recorded of 4798 patients aged from 15 to 69 years who consulted, for any reason, the general practitioners of 97% of the practices in the Perth Statistical Division on one day in 1971. A consulting rate in terms of the population at risk was calculated for patients of different sex, age, marital status, country of birth, and social class. Certain characteristics of the general practitioners were also related to the demographic characteristics of their patients.