PhD

dissertationThis study examines the Cambodian refugees' use of traditional and cosmopolitan (American) health care systems, as well as state and city/county health department nurses' perceptions of the refugees use of the cosmopolitan system. Data were collected through the use of observation as participant methodology. Cultural information on the actual household health practices, definition of illness, etiology of illness, treatment preference and sequence, major health concerns with appropriate intervention and conceptualization of an ideal culturally appropriate health intervention are presented. Forty-one families were contacted with 35 of these families participating in the study; the total number of adults was 175. Other participants were two Krus (traditional healers) and a monk. Twenty-five community health nurses also participated. Results of this study indicate that the Cambodian refugees' use of both health care systems suggests consistency with their cultural matrices for defining health and its maintenance. In conceptualizing this use of health care modalities, a theoretical framework (therapeutic syncretism) is proposed. This framework is a coherent, rationally purposive, phenomenologically ongoing dynamic, consisting of ambiguous, coexisting elements foreign to each other (traditional and cosmopolitan), standing side by side, without attempting to reconcile or give priority to either one. Not only is this decision making activity shown to be rooted in Cambodian culture but it is an integral part of a broader Wetansuchauung, due to the refugee experience. Therapeutic syncretism is a natural part of the cognitive adjustment and coping strategy adopted to maintain health