Stella R. Quah

THE HEALTH BELIEF MODEL AND PREVENTIVE HEALTH BEHAVIOUR IN SINGAPORE

Every theoretical model in the social sciences confronts a common challenge: to maintain its explanatory power in different cultural contexts. This is, of course, only one of many challenges faced in theory building. But, this discussion shall focus only on the possibility of a cultural bias. More specifically, the aim of this paper is to discuss some of the findings from a test of the Health Belief Model (HBM) in a multi-ethnic society, Singapore. The HBM is a theoretical framework frequently used in the analysis of health-related behaviour. The discussion will be divided into four sections. The first section will present briefly the components of the HBM. The second section will summarize the procedure used to conduct the empirical test of the HBM. And the third and final sections shall deal with the comparison of preventive health behaviour among three ethnic subpopulations in Singapore, highlighting the main findings of the test of the HBM.

Ethnicity and Parenting Styles Among Singapore Families

Abstract Despite the hopes for an enlightened 21st century expressed by some scholars and observers, and despite the undeniable technological progress of humankind, culture or ethnic divide will not go away in the foreseeable future. Although each generation of parents tends to differ from the preceding generation in its approach to parenting, the pace and nature of change across generations is restrained or mediated by culture or ethnicity and by level of formal education and other factors. More specifically, within the context of continued social change and change within the family as a group of interactive individuals, it is expected that parents with (a) different ethnic backgrounds, and (b) different levels of formal education, differ significantly in their parenting styles.

Accessibility of modern and traditional health services in Singapore

While accessibility to health services and medical care, defined by the supply of facilities, manpower and cost, has received due attention in Western sett ings[l] , its study has been neglected in Southeast Asia. This paper will describe the accessibility of health services in Singapore. The criteria for assessing whether a health care system is accessible to all groups in the population have been delineated by J. H. Babson:

Public image and governance of epidemics: comparing HIV/AIDS and SARS.

Abstract A comparative analysis of the 2002–2003 infectious disease outbreak, severe acute respiratory syndrome (SARS), and the HIV/AIDS epidemic that has affected the world over the past two decades reveals the significant role of socio-cultural beliefs and attitudes in the shaping of peoples lifestyles and approaches to the control and prevention of epidemics. The main research question is: what can we learn from the SARS experience about effective prevention of HIV/AIDS? The sources of data include population figures on the development of these epidemics and findings from two sociological studies of representative samples of Singapores multi-ethnic population. The comparative study illustrates the impact of cultural beliefs and attitudes in shaping the public image of these two different infectious diseases; the relevance of public image of the disease for effective prevention and control of epidemics.

Short-Term Trajectories of Depressive Symptoms in Stroke Survivors and Their Family Caregivers.

GOAL We utilize group-based trajectory modeling (GBTM) to delineate depressive symptom trajectories among stroke survivor-caregiver dyads, to identify predictors of the delineated trajectories, and to assess the influence of time-varying covariates (stroke survivor depressive symptoms and functional disability, caregiver depressive symptoms, and foreign domestic worker [FDW] assistance) on the level of the depressive symptom trajectories. METHODS Data on 172 stroke survivor-caregiver dyads in Singapore, for whom depressive symptoms were assessed thrice (baseline/3 months/6 months), were utilized. GBTM was applied to delineate depressive symptom trajectories, and to identify their predictors and time-varying covariates. FINDINGS Three stroke survivor depressive symptom trajectories (low and decreasing [47.6%], low and increasing [43.1%], and high and increasing [9.3%]) and 2 caregiver depressive symptom trajectories (low and stable [71.5%] and high and decreasing [28.5%]) were delineated. Caregivers with chronic diseases were more likely (odds ratio [95% confidence interval]: 8.09[2.04-32.07]) and those caring for older stroke survivors (0.94[0.90-0.98]) were less likely to follow the high and decreasing than the low and stable depressive symptom trajectory. An increase in stroke survivor functional disability and caregiver depressive symptoms led to a rise (~worsening) in stroke survivor depressive symptom trajectories. Whereas an increase in stroke survivor depressive symptoms led to a rise in caregiver depressive symptom trajectories, FDW assistance led to a decline (~improvement). CONCLUSION Care professionals should be mindful of heterogeneity in depressive symptom patterns over time among stroke survivor-caregiver dyads. Reciprocal association of depressive symptoms in the stroke survivor-caregiver dyad suggests that addressing mood problems in 1 member may benefit the other member, and calls for dyadic mental health interventions.

Caring for persons with schizophrenia at home: examining the link between family caregivers' role distress and quality of life

Abstract This article re-examines the link between role distress and quality of life of family caregivers of a loved one with schizophrenia by exploring the impact of role overload (defined as spending 7 or more hours daily looking after the care recipient). Role theory and symbolic interactionism provide the conceptual background to this study. The research question is: under what conditions does role distress reduce quality of life? The answer helps us identify circumstances under which caregivers may be able to carry out their stressful caregiving role while minimising a decline in their quality of life. The data are from a purposive sample of 47 family caregivers in Singapore who were interviewed in person using a semi-structured questionnaire. The data analysis includes non-parametric tests, exploratory factor analysis and relative risks estimates. The findings show that the inverse association between role distress and quality of life found in most studies of family caregivers changes when hours of care are taken into consideration. While role distress is found among all family caregivers it only reduces the family caregivers quality of life in situations of role overload. The implications for the situation of family caregivers are discussed.

Ethnicity, HIV/AIDS prevention and public health education

Assesses the health belief model and its application to the perception of HIV/AIDS prevention through public health education. Investigates the concepts of stigma and blame among the Chinese, Malay and Indian Singaporeans. Describes the methodology and data analysis used. Analyses the findings – that the significant majority believe HIV/AIDS sufferers to be risk‐takers (rather than deviants) and that the most effective preventive measure against AIDS is to change sexual behaviour. Compares findings across the three ethnic groups – Malays believe that the individual is personally responsible for contracting HIV/AIDS, they also recognize the seriousness of the disease; the Indians had a sense of concerned responsibility, partially as a result of public health campaigns; the Chinese also had a sense of concerned responsibility, but not gleaned so much from health campaigns. Reports that, across the communities, younger people attribute HIV/AIDS to deviant sexual behaviour, while older people think of HIV/AIDS sufferers as victims of accidental infection and are therefore more sympathetic. Attributes ethnic differences to two facts: the first is that, in Singapore, people regard dual identify as important – on the one hand helping to shape Singapore’s national identity and, on the other hand, retaining strong values of ethnicity; the second fact is religion, particularly the way Malay Muslims attribute HIV/AIDS to personal responsibility.

Racism and Health

Since the early 1990s, the explicit examination of racism as a determinant of health has emerged as a novel area of research within the substantial literature on racial/ethnic disparities in health. This article reviews how racism has been conceptualized, operationalized, and characterized as a determinant of health in this body of research, as well as the main findings, limitations, and future directions in this nascent field of study.

Health policy and traditional medicine in Singapore

Abstract Singapores degree of government intervention into health policy can be seen as intermediate between the bureaucratic and market strategies which Alford delineates. In this approach, the government takes a quite tolerant if not directly encouraging approach to the several forms of traditional medicine of the several important ethnic groups in the country. To some extent this approach reflects a solution of sorts to the shortage of qualified medical personnel.

Values and Development in Asia A Historical Illustration of the Role of the State

Two city-states in Asia, Hong Kong and Singapore, are discussed as historical illustrations of different roles played by the state in the process of economic development and globalization. The analytical comparison is guided by a proposed set of five dimensions of the global city: the economic, political, administrative, socio-cultural and physical dimensions. The findings from the comparative analysis supported three assumptions: that the most realistic alternative for the economic development of the city-state is globalization; that state intervention is an important but not always a determining factor in the process of globalization of the city-state; and that the political dimension helps to explain the different paths toward globalization taken by Singapore and Hong Kong before the latters transition into Chinas Special Administrative Region.