San Fernanao Valley State College
_A
StJil\;13-�t Il��·;-3rL'RUfvft���;pr r:;r) fjJ.:�TF.FJ1'-1I!'l�E ·�?}IS }?I�RCBPI'I();:�•i
requirements
for
the degree of
Master
by
Ear i Bhctkta P:;::adhan
of Science
'I' he
the s -_:_ s
o£ Ha.ri Bhakta Pradhan
""
l. ,,
approved:
San Fernando Valley State College
Febr�tary,
ii
1968
AC.KN OVH_,EDG E.VJ.EN'J'�:;
'I'he vn:-iter wisheti
t.o
a·tion
Lennin H.
encour agemen·t
Glass
appreciation
for l1i.s continual
valuable
_,
sJ_ncere
thesis comr:1it:.V::e
special
A
this
in guid.i.·!1g·
effor·ts
express his
tbe members of his
crit1cal guidance.
to Dr.
to
appr<)��1-···
for t.hei.r
is expressed
�nspiration,
and for his ti:nt,i:t· in::r
suggest.ions,
project..
The writer would also
indebtedness
to Dr.
for criticisms
Patience,
about
a
note of
terms
The writer
lS
Lastly,
IvJ:a.jest:y' s
Agency
so
of
:::nternat.ional
they made availa�le
training
thE! Departrnent
endurance,
wiseness,
and
dearest wife
Pranes,.,;o::-i..
and
and friends
cocmer at. ion.
the writer wishes to call attention �o His
Gove:cnmcnt
for
to
also thankful to his relatives
for thei'::" er.co"Lrc 3.-Jement
v.Jeinej:·
t.ha.t express r11s feelings
ccntc.::_bution of his
·the
John M.
A:Lso the wr i.·ter vvould
t1'1anks
understanding,
are
and Dr.
Suttor-:
and suggestions.
lik-e:: t.o exp:.::-ess
encour:agen�ent1
V:rilfred
Nepal
and
the: United States
De·Jelopment.
to him t:o
unde:c·::;o
for
t.he opport:.unity
this
•,vorthv.rhile
that he might serve his country and
lll
The
au.t.hor
g-rateful
for
Etil-::1
direction. p:r:ov::_ded by Hiss Dorothy
Health Service.
iv
.J.
st.acey
I
Public
J?a.gc
iii.
AHST:FZAC'I'
VJ.
•
l
A.
B.
Importance
,.-,
'-- .
D.
14
A.
The Meaning of Perception
B.
Determinants of ?erceptlon
C.
Per:ct:-�p�...:ic)rl
D.
Pt-3rc:ept.ic;r:� c)f i�2�1).':'l��-t
Preven�ion of Disease
E.
C-::Jncl us .ion
()T:
J-iF::Ez.ltTl ar1c1 Di2easE�
r
Ca1..1��e
1
· a11cl
41
III.
A.
Introduction
B.
Heal�h
rt
..... .
Ana.lysis of t.l:.e Dat.<J
IV.
BIBLIOGHAPHY'"
Information Survey
57
59
A SURVEY INSTRUMEN'l' TO DETEP-J.'V[INE 'I'H:E; PERC.�'::P'J'TOl\f
OF THR.Ei\'l'
CAUSE I
I
He.r:l
hL·TD
Bhakta. Prad.han
Master of Science
1ctJ.is
me1:1t
�
to
s·tlld}'
wa�s
PRE'VEI>JTIO.N OF CHOLERA
in
Science
col!d\J.Ct�ec1 ·tc ,:J_e:� i�j-rl
,3.
S\lr-vf��i i.ll.s-t.I�\1�
��� �--�
det:ermine the oe1.·c:2pt:ion of ·thre<::<t�,
·"
prevention of c:ho1eJ:�a.
-
Difft�rer1·t Ct1..1t:ure.s
respect to health and disease.
control
Health
disease
must
healt.h prog;::c:.ms
it
Then,
-;-e
<:m
developed
effec·t.i
Concepts
cause,
anC1 S1JJ·"c;JJ.--
of health
In order to plae1
differ.
aDd
and
o 1.J_ ::J _L l c�
"
,
.
, c
.L.;..
hec:lt:h educat ior< program might ·be
accordi�gly.
should be te��tcd.
'The purpose of
on
the
crrour..J
•.;
..>..
'r-!here its use
:�e:::t.L:1.::r ',vould be t.o eJ.iminate
vi
is
or
minimize
I
c ••·r"c' "c••r •C•-'·'''''<•,�c••"�'
Questions were
t.hreat,
cau�>e,
It is
., ·
for perception
of
-
preven·t:i.on of choler· a.
suggested thc.tt the ,-:J.ata gat.hered be
according to
pation,
and
deveJ.ope�l to probe
'''"�·· •
variables
and education.
sudh
as age,
Following
sex,
of
the
it might: be possible to ass :i.9n persons to groups
miqht. be
developed
occu-
data
so
for
special educational
prograrm�
purpose of
tha·t group's healt.h behavio.t·.
changing
I
I
analyzed
rel1g1on,
analysis
�
that.
the
II
I
J
CJIA.P'l' F: R
I
I:N'J:.ROD TJC 'I· I ON
anC'l .::·�tt i.t�t�t:1,:;:.s
I.rl
:t:t�SJ)C:c�·L:
t()
1-lf;;o.lt:Jl ar1c1 cJ.j_sease ..
and control disease differ.
illness vary
only
from culture
in ·t·n.e
c.i.j_ff.eren·t gro1.111S
aro..c;LlSJ
ideas
not
1
habi l::.s,
custorns
might be harmful
or
Therefore,
hea.l·th proc�p�c:tn:·:s
consider "'/il.a�_:
1
1n
at tl tude�::;
are
lac·k .irtg ..
san,_e
cu].ture, but also
to
cu.lt.1..1r(.:; ..
for maintaining healthful
order to plan properly far public
it. becorncs
inc:c":asi.ngly -irnpor:t.2.1l.t.
the ordinary person - think.s and does
c.;: peopJ.s:
a::;_d
and values ·that. go with e acl1 group
beneficial
Health edu�ation
and
Concept.lons of hea.J.t1'1
in the 1960's
serves
i::O\·lards be.:tl.th
as
to
about:
a basic
if such thing.s
.
behavior
int.o pc,si t.ive
nr
favorabl.e
r:.nes.
However,
t.1�te
success of heali:h education in affe�::ting health behavior
is dependent upon careful plan�ing of educational progr
l
,-,
/.,
o;�
a.
def:Lnin:::r
problem,
of the problem,
selecting '�'Jhat
explo��J.ng
various
considering
appears
tllC'
to be
nat1.u:e
and scop2
solution;:;
·to
it:,
a feas i.bJ.e soJ.ut::ion,
and
a.ct.io11 \·Ti th ref.>pect. to the solut.ion chosen.
taking
( 22; 92) has
McCorm:ick
summar .ized
tb:� follovring
five
essential
planning,
basic st.eps in suc·h p1ann.jng.
1.
Collecting
informatio-r!.
for
such as educational level, k.novi'Jedge and
beliefs abo1-1."t.:. disea�;e, social and economic
life, et.c.
2.
Establishment. of
3.
the bar::::·ier:-s t.o healU-.. education. ::tnd
,Assess:i.ng
how t.hey rn2.y be
4.
objectives.
overcome.
Appraising apparent and potential resources
( org· artiz a tic)IlS, pE;l�- SC)f1I1E!l1 n:a·ter i als, .�n.d
funds) .
De'..reJop5. ng
che detailed edt-tCdLLonal plan of
OfJCr.:J..·tions ( incl ud ing a defi.nite mechanism
fer con�inuoils evaluation) .
5.
Before
.st<�.rt.ing
should be
formation
knowledge,
starts.
In
usually be
iL
c�
on
th,.:dr
,
specific health probiE"c::m
and practices before a program
situation
assumed
at.
a baseline of
the beginning
of
att.i tudes,
be
By so doing,
zero
cannot
a program.
and behavior,
sent. knm,7lec1ge,
determi.ned.
ln-
commuc:it.y u s u a lly have sorne health
a t. !: i t u d e s
such
edtlcation prograrn,
g a th e r ed c:oncern.ing <,/hat people know,
hm·J they feel and act.
Individuals
any healt.h
therefore,
it eventually becomes
Pre-
ITl1_l_St.
·
:r:eservoi.:t"
of cholera
is an
··Contaminated TvJa.te:c
of
the
an infected person_,
the sCJur.ce
i.mpoLLan·t mode of'
t.:ransmir:.�sion
disease.
patiend
may
.:i.s
food.
to
also help
in
Cholera,
countries
such
of food by cont.amina!.::.ed har:ds
HancJling
spreading
disease .
the
longer
problern in ad'Iancsd
t:hougl1
no
as
United States,
tne
a
continues to be
great pr oblem in many developing countries.
(9:43)
poir,ts
out
that:.
extensive outbreaks
Iran
and
during the years of
ro
Ehrlich
thE�re '-''Jere 4?, 000 cases
the World Health
•
\.., ..
'1 ')
· ..�._) )
1965 and 1966.
"'
.. , "'
lJ.C-.0
Jordon
Syria,
·•_·.n
. .. -.. .i r<
<. ' . (-d
E' ri
(,_..,
..!._•1
,A, c�"-:;.._.._
•
and 4, 000 death.s
Organiza·tion
Eh:clic-i--;
Iraq have suffered
Cases have also been repo�ted in T urk e y ,
and else\·.There.
d
_
_
1_
c. 'o
..
- o
JU
�ceport.s:d to
from different nations,
as requirec'l by t:he rn·ternationo.l Sanitary .Regu.lat.:ions.
He
also
to be
sw,;g(<;ts
the
Vietn am ,
t:he mos�c endemic na·ti.ons continue
that
P h i l ip p i n e s
,
Pakistan,
India,
ar:cd pre�ournably China
Eastern cou.n+.:.ries
along,
(9:43).
Indonesia,
All
the NecU.ten:ar�ean
the 11iddle
are
considered
vulnerable.
Improper
pure water
for
the
d i s po s a l
supply system
spread of
Most. people
in
the
of human
are
the
w a s tes
and lack
of
a
factors responsible
cholera in the developing countxies.
affected
co1.mtries
are
ignorant
c.bout.
the actual
cultures,
cause
c�Ild sup<'�r:st:.itions vihich often tend to ke(�p
them Lrorn t.hink:Lng
abm..1t the
cau.se
and prevent. ion of
vvor: ld
Heal U1 Org aniz2,tion,
lai::L:)ns
remain
body,
or
properly
hyglene.
even t:he
tlw
best� sani t:<:.ry i.ns·tal-·
enLLght.ened public "J.-L r;;-:. ;::; l th
mea.su.res
_
employed,
(24:265)
as
bei:1g· norma.l
necessary to gatht-::r
accompanied by
It is
also
difficult to
or
t:hey
unavoidable.
ln
ordex:
that might help prevent
being
2s
accept
Thus
information conce�cniny
of cholr�ra by ·the people
p:t:ograms
or
t:.heir health or vih 2.t:her
threat. t.o
condition
the.-:
it becoraes
t:he percepti(.>n
t:o plan heal·U-t e:ch.:tc::;.tion
o:c
e r c:d i c a te t.he
disease.
Puroose
..--...J...:--�---
-·
The
instrument
cause,
B.
c; f
disease.
·the
if many persons percelve of cholera
determine
A.
aspects
j_ne:f fecti ve w11cn t.hey· a:CE.! not accepted by evc:r�"!·--
personal
a
t.he most
and
sc ient:if ic
put:'pose
to
of
this
study is to design a su:cvsy
determJ.n.e: ·thE: perception of t.he threat,
and pre"v'C!"ltion of choJ.era by community rnernbers.
Im�ort.c:mce
.t:::_
__
____________
The
survey
inst.rument.,
da·ta at the besrinning of
·to prm7ide da.t.a aft.er
As
a
the
in
adcU.·U.on
proqram,
to providinq
can also be used
an educational program has been
result,
change,
if
any,
may be
evalua.ted.
p:t�O:bl.enu:;
so
far
:=-;.s
its basic design is conr.:e:cned .
.Nece:::;sar:Jl mo·5ifica.t.ions W()'J1d have t.o be� made accor:d3.nJ
to
the
or �:he con<rnunit.y and its heal·t.h problem
ne::.t1.:u:.-o:�
Limit.at:Lon
C'
'l'he p:.�opose:I
s'.::rvey· in�3t:r:�.;.r.nent
gat.her all. of ·tl,e kind3 of
or
i.nfonaat.ior"s
However,
p::og-r <:nn plannin(J.
J.s
it could
nc)t expect.ed to
for
ne�':!ded
serve
as
a
tot.a.l
basic
significan:t pa:ct. of the dai:.a--qathering process.
developing
D.
count�ies
Nona.l.
as
The Se·t'�i.ncr
Nepal
is
.
million psrsoc.c.
soro.e
�evelcping country of approximately
a
LEl-L.SS
56,300
wi·th
such
t.o'dn;::
'
(16:11)
arcd
c..
a:nd has
It
flO_LJt1.lat.::.ori
is
a
of about
ten.
country of villages
few cities.
Trans--
portat;ion and cc>m;·allnicc-:.: tion systerrts
Khatri
a.r.::;
( 16: 32) has pointed out tha'::. mo:re than 90
per cent people of Neoal are engaged
and
livestock production.
indepe.nc�er�i::.
inadeqt:�at:e due
ln
Tl1e peas.:1n.ts
i.n their econorr:.i.c
life,
agricultural
u.re
alnlc)st
vvi"ch most of �_::hr�-:
7
in,
and smaLl . olot.s of l and
income,
people
however,
fall
into
is
t;he majority of t�be
lmv and middle
cent.
soc.io-·economic cla;=js.
the people
of
�L'he
of
st:.ill
::u:-e
Nepal
Females have been tradit.ional.ly discouraged
illit:erate.
This
from getting an education.
education
g:r:m,r food ·to eat..
Thu.s,
small.
the
Abou·t 80 per
to
is beginning
effo:c�t exerted b:i
is now chanaincr.
to improve
J
due
to
Fublic
-'
·tremendous
the
the go\7i2::Cnment and "che public.
Schools
are being es tabl i;:;hed t.hroughout. the count.L-y.
Nepal,
linguistic,
ethnic,
t.he different
underst.c:md and
srnall
and
as
they are.
almost
the
all
In spite
Nepalese
In
can
spi:te of the socL::.l
Nepalese have
a
desire
to
and t.he ab2.lity to accept: cond love ot.he1.:s
a.Jctr ibut.es h.::�ve enabled them to
These
and peacefully,
crea.ting
of nat.ionali ty a:J.c1 n.at_ional progress
feelin':.r
some :cac :Lc:.l,
t.�1e nat.ional lang·uz,l.ge.
in all scho8ls.
together successfully
entire
exhibits
cultural diversity.
speak J:�epaJ.i,
and cultv.ral di,rer�i ty,
respect others
country,
mother tongues.
is taught
Nepali
c";.
th:::>l.J.gh
1 i'le
a strong
among
the
population.
NE.�pal is
Khatri
Hindus
the onlv Hindu king·:'J.cm
(15:50) point::>
and 8. 5 per
balance
society,
are
CJ<.xi:.
c e nt
Moslems.
::.:ha•: there
Rnddhi..sts
in
are
";:-he world.
90 p er
cen·::
in t'he ·.::ount.ry.
ThE::
Though predominant.J.y a HindiJ.
tr>e Hind·,_d_sra and Buddhism
in Nepal are very
8
No sharp line of distinclion
.simila:c.
between
Lhe
relig.ions,
'c.vlo
faiths ha.ve bE::come mc)r:e or
practices
equally honored �by
- .
.
re.Llg·1.cus
a.nd
dc�\.telopcd
act.<.:!c'!
t.he
·::;::li c'h
beliefs.
are
as c'b.olera
make
and
to hea.lt.hfu.l
the
is
it without
after
food
eat:irtg
item
a.;�·e
nat:ure a.nd ha\Te
in
living
ar'!.d
to
do
sanit2.ry
are belie'J. 'ed
many
the
as
The
of disease.
a particular
itself
no
or have
s�1c�l1
Diseases
caused by
t.o be
spirit by makicFJ
a result,
As
c on c er n
and
rrhe trE!�itlrt(�.il.·t t.herefore is to
please
holy.
not believe
t.heory of disease.
diarrhea
of them do not have
water
people
and other vegetables.
river water
in
of l)(Ylh
the hig-h illiteracy rate,
evil spirits.
an effort.
as rice
sl.:rines
still hold the age-old traditional ideas
Most of
or
t\vO
In the £Iindu cul tu:ce
supe:cst.it.icrus
knov1ledge of t:he germ
ghosts
\:h<:!
fused.
e.nd
people.
Becu.use of
and
less
d:cawn
prac t.lees,
<:ls ba1::·r·ie:c �-;
ideas
in. rnany placeE;
for.
viell. as t'be gods
a::�
can be
foo d ,
Nepa:Lesr:; believe
they drink
idea
'
of food
'
SlC.K
to 'b lame t:he
being staJ.e or undigestible.
any
that
and bathe
If thc:v becor::e
they tend
such
offE;rs
.i:<lost
contamination
or
pollution.
High illiteracy,
medical.
and poor
fac j_li t.i2s,
low economic
lack
status,
limited
of adequate health kno\,Jledge,
sanita.t.ion have led t:o ma'.'ly healtJ·1 problems.
"'•' �;-u·•·,·--··•·-,--��..�-·-•-
'l'here
�"'' , •�•·-·�·--�=��,··�---•<•u..�.��-���-�·�··=�----·�'Oh"u�"'-·•-'-'�•-�� ••-�---.��--�-� �ru•--��--·-••·•�--�"-•�··�•--•
arf.::
sma1l····pox ep idem i c
d.oc·tor s
I
I
t:.rated in "che cities.
However,
have been broadened
t.he
units
health
education
u�
in
the
t:o
Pulbaza.r
"'' • -�� •��·�=-•�---.,•••-.-.��-=·-�-V-·-·��-�m••
t.}!})11C> iCl
Of ·t}lCYfl
count.ry ·by
f��v1
a
tCY:J!1S
is here and
in
is
a
fairJ_y
C�)DC.':81'l.-­
So
but
are
far 1
tTy to proviCi.e
eight
a pro g ram
typical
are
1 .-. --� -:j '1
_;_.,__L,.:c• •L
rural
p::-:ccr:cams
cDmrrnm:Li::.',r in
are
It
needc:d.
�1ere h e a lt h
aurveys
det.e1:mine barrie:r::s to improving
abcut. 500 residt:�nt:.s,
commm1icy has
from the
sc"hool,
.
.
.
lO\iV soclo-econom�c cLass.
but some
children
are
able to
go to primary and even secondary schocJ.s 1n Banepa,
'I'he
used as
a
cormm.J.nj_t.y
the
river as
the river
is
situa-ted �.sax
source of drinking
to pollution
lS
as the
.line
coming
z.:
river >,vhich
The river
people have n�ct.i.n taineci
a.n open
used
water.
for
community
bathing 1
for the disposal of garbag·e.
water
«
·Organized public heal.t:.h
con�unities
similar
'l'he
is no
o.·�
cou:.:-1tr_'{.
conducted
mos·t of 'llhorn
and
I'
estal)l:Lshing
a.nd cit:.ies.
educators
Nepal where heal.t:.h educa.t:i.on
'l'he.·ce
-
programs were starbod around 196 1 ,
en·ti:re
should be
•
public healtl1 acLLvities
areas.
t:he rural
·trained pub lic health
for
�--
on1y 200 med.ic'Et1
.
the ent;ire population,
for
! s·till limi t.ed
!
ou·tbreaks of chr..>J.er :C!,
oc�casio11al
from ano·ther
latrine.
\.,'ashing
lS
a
J..::o
open
ths b a nk ,:Jf
In addition,
of
clothes,
and
The community also has
village v-ihich serves
a
:ts
10
al!:.iO
subject. ·tc
where t.he wate:r
same way
t;j_nce
poLlution
.., 1 �- ,-..
o.. .. :-.>..':'."-'
-;lpr)l
ool.
U.J:"' J::- .-- ;--
l.S
·
b
the people of t�h.e viJ..:Lage
in t.hF.!
p<.)l.1L1t:.e
as the peop le of Pulbazar.
The
re1ir:=;ious
and
cultural background
of t.he
munity of Pulbaza.r is similar to t.hat of che
iY[c,st
goddesses.
quite
of
cholera,
as
typhoid
ar.cl oth er
fever,
communica.ble
and dysent.e.:c ies
of
available through
Howeve:>:·,
dispensary.
the
many cases
Some
they
of
a
clJ.sea.ses
are
are
They
folk or
Medical serv-
misf.d.on hospital
most of
facilities.
the practit:ioners
a
and
small
t.he people do not seem
are more inclined
inc,ige:::lous
to
:rr..e.dicine.
tc
use
In
tend ·to neglect ill health conditions.
comrrunit::l p e o p le
interest in having
a.
does
the
represent:
in Pulbaza:r: h ave expressed
pure 'dc:ter
supply.
Hmvever,
pre'Jalent t.hinking.
is ne e d .:� d t.o determine barriers to
of health
ac tiv i t y .
encourage
the
ment of a
pure water supply.
Appropriate health
community members
change knowledge,
to
this
type
edu ca tio n mav
achieve the deve l op-
Education efforts
a t ti t udes
this
in-
Hore
forma-tion
try to
c1n.d
gods
the cosmuni t.y
a::vJ may lack health kr�owleclg·e.
materials,
not.
1.·eli.g ion,
the:{ have not been exposed to health-· related
liter at.e,
ices are
rest of
are t.:caditional, supe:t>-
·the people
'Though many _people
cornmon.
utilize
J.n
•
dir.;eases
PaLasitic
such
lc•
>:J
'l'h.ere
the count-ry.
com-..
,
which
anc,-1 behavior m&y
carr i.ed
11
1· 51.1.E:··�"TE:i:,�' i:>ei5:�:5·:r.2·-�ir·e··a::w;;:r:l2�o-r--- rT17i�i:·r···(�1�1Tr�u:r_=,E····a.i1c:r··r,�acTT:c:r::)�;
I
and
so
they
i::o })<::� re.1.ur..::-t2mt
seem
I
cha:agc:�3
!
t:}-1(-� heaJt:� £�dJJ.CCi·-�.i.(Jll f)rogr2rn
I
2.ccepL IYcop.xc;c,3
co
c..nd evai.uation c•f
P:co�x.:�c pl.::�nninq
fJ�OTtl c:ut:si.de.
bL�Si2
C�..1::e
2C�i-tie·v(�
t.Cl
StlCC�f.;:�s
in respEJ�t b:) change.
E.
Defini·tion of
� A:�:_!:it�=��:_;-·
!on attLt.ur:L::
I
I
I+-�O�N a.r.o
'
I
Terws Used:
----- ····-----
t.hG.
-�- ---
-�-·---·�---�---···-�-"··-� ··-·� ---�- ·----·-
-
i ,,
....... �
::1
r.l -...�--.
.:,Outt.�
.,., ,... "' '"' ..l'" c.r,
J.Lt-c-:.v.oJL .J.. � ._.. .._...
--....<:.-.. L
-- .. ,...,
"
,t<c>OL
·
"D'J
a
tendency
.t. . . • -· ' .:!
,_-�.;
.�.
J. L
L.l .::t"C .LOn
-..4
0.L
·
is
'
l 1'r'1
a�·-1
.... _. J'. �ll.
.......
· -- c�.. 11
-·-···!""
L-�,_.,_#
I ,._,
,-,
--- ..
Cl.l:
to
act:
n
'-'b-!
) e'-
C.
v·
0.-
'""1·' ·
·i
l.-,
o,'n a··
·' or.
J..JC
.v __
in some \·j·ay
. nd" .
-, ...
r.:.•,.L
'rL-.. d.
J.u•::<
� >.?
C'
..J...
-+-
l.
,_
,.n"' ,
:) ....,�-...
I direct.ed.
!
. �e-�i����j�:-
I
J
peoo l c::o
Beliefs
a pa]�"t oi
are
have dev3.sc:d to
fit:
the cultural fabric ·,,;-hi.ch
�-.heir p;;,rticuJ..ar
adaptat.ion
to J.ife.
C O!:fl£0:::!n �.:t:.Y.:
·-·
'T b.:'?
t -e n1.1
c oHm '-ln it y
:r::.:. fer s t :J
al 1 t.1H'! r· eof·' 1 e
Contamlnation:- The
a.n
infectious 2gent .
learn in
common
,,vi-t.h other: Ule!:rtbers of
the
•:Jroup
to wh ich
th.e�i be.long.
the
economy
portation
is
and
agrar:i an,
where
cornmun ic at: ion
act
Jj_mit.at.ions
of t:cans­
as primary obs i::ac 1e.s
infectious
disease and
to
,
1.2
rate,
mortality
and �1ere most people are still illiter-
ate <:md ignorant.
disease i
about
the
but. pro�rressing
of determining
the value
sci·2nt.ifi.c knowledge
tov1ards thei r
of
improvement..
or amount: of su c c e ss in a.chievir,,:;;·
a predetermined objective.
Heal-th ed'J_cation:- Healt.h edl.lcc:d:ion
providin<J experience
for
influenc:i_ng knowledge 1
th0
lS
purpose
at
· tit:Ude�:;
1
the
process
of
of favorably
and prac·ticeS
1
relating
to individual and community hea.l-t.::h.
that
people have
in re1atic;L
t.o healt-'h may be called
health knmvledgs.
responses
Pel�S':!:'T'.:.�i�_l�-�--
Fe:r.:·sonal
described as
perception.
but
not necessarily infectious
Practices:-
The term is used
l.n
t.o st irau lu s may be
agent.
relatior1
to health.
'l'herefore,
it is defin(-'!d as behz,:-.sior or conduct in all
situations
involving
Surv�:-
individual
an.d community heal·th.
The term survey implies t.o the ga·thering of
data by means of
a questionnaire.
l3
Tlili.f_:-·
A
vacclne containing ant::Lge:as for typhoid,
parat:yphoid,
and. cholera is called ':[',�BC.
V�lue:- Value refers to sornet.h .ing impm:·tani.: to ·the
individual or group concerned.
REVIEVv OF
of PerceyYticm
l_
The Mcaninc
,_;:1
A.
____________
____________
The behavior
them.
LITF:RA'lT;T?J:�
_________
of an
· · ···-
unique percep-tions of l:lim;��e1f
the rneanin·:JS
lives,
( .::>: 18)
�
an
.
•
. ::J
saJ.... '-t
1tla.vt.:-:
·-�
individ1...:.aJ.' s
and
thin<:TS have
• h -· ·'-r:._1ac
.J..L.l
.·h c
behavior
�·
--
·-
the 'dorld
1.n
which he
:for him.
_t.JC.L..;:;una
�- -
govsrned by his
J,S
individual
·-
l
gover:n
ar-c what. psychc1or.::rists ca.il
perception.
things
feel,
look
to the individual,
taste,
un.derst-.ar:(.Ii.nt;r,
of these
:=�.·v..:.�..L'2I12E:S,
'
Ideas,
'
transcend the
to
to scrne degree,
tTl':?!arll.rig,
a.
sounc.,
C)Y:
a
an
:r-ecogr1.it�io:r�
.
.
pc-;.r· c�erJ c .t c··i12
'
experience
re 1 a.-t.J..c)nsn.lps,
the T,v2y ·tl-1ey
invcives,
t.. ,=:_ J.z e �;
and to·u.ch.
1e arned
or�
obj ·?.cts
perception
the ffiere
It
s�ell.
or
or
or
sighL,
values.
and meanings
heari�g.
concepts,
are
snell,
-;....... +,.,,..
we
act
14
taste,
2erception of
added and as
limita-t:i_o:cts of sense organs.
say a!::: out.
e.xi:�.211.c� beyortd
a result
Kohler
and sueak accard1ngly .
new
ide�s
and co n c ept s
percept.ions of people t.oday.
Hovl
cl
t.o be
t.ends
person behctves
i:r.,
accord
that: situat:.ion.
exist:
for hilll.
11
are
matter-of-fact
(5:92)
\,lith
respe.:�t:
to a.nv s:Lt.uat.ion
vri t�h hcnv he perceives and deLLnef:>
v�'hat� he does not. percei·'le does not
It makes
no
ano·thej_',
may be
defined l:y
Foster
illustrated
difference
hou the sit:uat:ion
even a cornpetent:. obs0rve:c.
this concept in the
follmving· way:
... The U.S. Navy landed on a Pacific island
in Wo:cld war II.
The heal"ch officer felt: t.l1a·t
the presence of flies const i tut.ed a health pro-­
blern that, with the assistance of the n2. t ive s ,
co;�ld. be eas i l.y (�<)nqtlerec1.
lie:; ct.skt�d the ch i_ef
to assembL':'! his people, ·to whom he gave a health
lec-ture illtJ_strat.ing the horrors of f ly --bor ne
diseases v/it.h a foot.-lcug mode} o£ the common
He believed he had made his po int
housefly.
un·til ·th e cb. ief replied,
"I ca!1 '.'Tell underst.an.d
your p1�eocc'L1pation vv:Lth flies in America.
v'Je
have fli(c':S here,
coo, but fortur:a��e.l-y t11ey are
just: lit.tle fel lo w s , n and he gestured wi t.h thumb
and forefi.:1ger to show their small size and, by
(10:122)
implicatior1, lack of m en ace to health.
Since perception is
the
personal,
two persons
H.i t'h
same sys terr. of perct:-:pt.s v1ill still p0::ceive t�e sam;:.;
situation differently because of different hopes,
and expect.2.t ion:3
with th(-;:;m.
similar
fashion.
situation
tvJO
Ruch
they have brought
(30:302)
into
fears.
the s itua.tion
describes perception in a
He suggested tha·t
the
same
objective
may be _pr2r·ce:ived in b;o different ways by
different people or even by the same person at two
different
times.
J.. 6
.Percept� ion uE;es bot.h sensory d<:'t ta £rom pr(:::s enL
stimulation
C aat.ril
and
(4: 67)
the l e ar ning
ha;:;
explained
g·a.:Lned frcm past exper:i.ences.
that v,;hat
a man pe:r.ceives
is not. deb;�:cm.ined enti:ce ly by th e nat;.l:ce of what is
ou ·t there or by his sensory processes.
he brings
from
pas·t experiences, because they have
generally proved reliable,
per cept ion
The ass'..�mptlons
are
also
involved
in eve:r.y
.
Knutson SlF:Jges·ted ce ri:. a in steps which mc.;.st be
pleted before
mean i ng
·the
1.
3.
the environment.
Scanning
Searching
for meaning.
the sense data indir:ectly re­
sense recept.ors into fi.g<J.re
and ground and into form cmd shape.
Organizing
ceived b�z
·the
4.
De·termi.r.:ing \•7hat
5.
degree s of significance be­
tween c.t1ternat.ive possible meanings.
D e c iding to whic h of many sense modali·ties
6.
�
8.
9.
attend to <:u1d '.vhat t.o
Determining
to
give
primary
attention.
Integra·ting wi ·th i'le!nory
eX})erience.
tY.a.ces of pas·t
O ri en ti ng in terms of expectations.
Predict.ing ·the acti o n that offers tbe
highest. pr o bab i l i -ty of succsss for the
Knutson
out. 1 i ned .
them.
(20:169-2.70)
(20: 170)
not distinct
among
to
ignore.
individual.
are
pe1:ceived or acquired
individual has
1:·egar:·ding h i s environment.:
2.
7
corn-
There
nor
exp l a in e d that the s·t.eps described
clearly discernible and ordered as
does,
hovvev"':r,
seem
to be a flow proce�1s
! ..,
�-I
Man's
psrceptual
interests,
erned by personal
disE!ase
.
other
aspects
cult.u.ral
King
lined
is
cor,r:it.�c·ted.
and
·to be av1are of that
tends to
living
or
t.he pres<:"nce
forget even
needs..
that perception of an
influenced by
b,-Jo
factors:
and
by
those
thirst,
factors.
2
st.u.dy
the person2lity·
th ey
fatigue,
Levine,
by
He out.-
saw.
scclOC'..1lt.ln:·a1.
:>rv.3. sexual drive ar:e
�t.
aL
students
finished
(21:283--293)
ware comp are d
eating.
Each group
ambiguous pic tures covered by a ground
The
'The
students were asked to describe
hungry groups more
and
of t�he pe:r.ceiver:.
similar view.
a
social
the effect. of h u nge r on
of hungry
who had just
screen.
and
regard:i.!l9
Groups
presented
of
out
psycholog·ic,
perception.
what
an epidemic
three kinds of determinants of perception:
physl.olog ic
glass
·Lends
(18:34-35) has presented
Hun·:�rer,
was
During
anxieties,
pointed
custom,
ph:::-sio1.og ic,
with
He cannot
concerns,
no-t cl.ea::-:ly _percei'Ie
his d a i ly
of
(15:494)
individual
a man
oti1er diseases
of
Katz
, ·
and
particular dis·2a�:;e
nature
selective�
wants,
and expectations.
hopes,
a p art icul ax
or
is
vJha·t is pf�1:ceived tends ·to be gov�
in equal. em_phas is.
fears,
process
frequently
no·t
t.h a.n d i d ·th o s e v1ho wel7 e
l:mngr y ;
even t.h o ugh
the
G i'7S D
s ame p i c tur e s had b e e n pre s e n t e d to both g r oup s .
a
s i t u c>.t i o n one rnigh·t
s im i l ar
s u spec·t that me s s ag· e s
p r e ve n t ive he al t.h me a. s ure s
r eg ar d i ng
u.L.· e
me an ing f u l ·to p e o p l e who
m ig"11 t b e
le s s
c on c E-? r n e d wi th othe r
overwhe ln:. ing prob lerns .
K ing
m i n ant s
atti tude s
a.
are a s :
p sycho g e n i c
and d e fe n s e me chan i sms ;
and be l ie f s ,
o f p e r c ep t ion
ad aptive
need s ,
in·to
th r e e
and v a l u e s .
R sychog e n i c n e e d s
A c c o r d i ng
by a p a r t i c u l ar
to K ing ,
fe e l i ng
s ome t ime s we ak o r
g ive s
rise
change
or
d i v i d e d the p s y cho log i c de te r -
( 18 : 42-- 4 3 )
Acco r d i ng
l a tent .
d om i n an c e
t r e a t ing
the
to h im p s y chog e n i c
( 18 : 4 3 - 4 4 )
and
A
for
t ime w i th
de f e r en c e
s u f f i c i ently
to
2.ppe a s e
( 18 : 43 )
need may be man i fe s t o r
phy s i c i an w i t.h h igh ne e d s
a
and
wh i ch m av
s t·. i l l the need .
a u t o n omy m ay hav e
a p a·t i e n t w i th
and e v e n th o1.l<Jh
f '3 n t a sy ,
c Lc cums t <in C e 3
o r g an i sm a�1d
a c c omp an i ed
i t. ·u s u a l ly· pe r s i s t s
overt. b eh av io r or
to
a much e a s i e r
b y ne e d s
emo t i on ,
or
mcrne n t a r y ,
th e ext.:. e 1: n al
s a t i s fy
p s ychog e n i c ne e d i s
for
a very d i f f i c u lt. t ime
s im i l ar p at -'ce r n o f nee d s ,
.
and
. ,
a pat ient ch. ar a c ·te r i ze d p r J.m a r l ..:..y
and p a s s i v i ty .
...l. . C•
-"
b.
Ad a>.:->t. ive
d e fe n s e m e ch an i sm
a.nd
�---i.·---- -·---- --'--�---,-�---�--- -----------
d i f f e r e nt ne e d s
People h av e
at: the s ame t. ime ,
tll at may be
s ome man i f e s t. ,
f ac t. ion o f
ope r a t in r:r
be f o r e
one
t:.l1e
A rn an wi·th
pro f � t
v.rh c.t.
is
·th i s
ox:
th e s a.t. i s -t.hu. s
de fe n s e mechan ism .
may be
a h igh n e e d
wh e r e in
the r e j e c t ion o f ano t.h ex: ,
c on s t i t u t e s
adapt ive
O ft.en
l at e nt. ..
s orP.e
th e ne e d s ope r a'L<:c. a·t c ro s s purp :) s e s ,
oper at ing
a.s
t. e:cmed_
fo r
s e le c t: ive
a cb i <-.:= vement m ak e s
p e :r.· c ept: J. on .
a
s i z ab l e
a l and tr an s a c t ion at t�e expe n s e o f a c l o s e
on
f r i end a n d n e e d f o r a s s o c i at i on .
Be l i e f s ,
att i t u d e s ,
c o nt i nu ity from o n e
s i tu at i on
•
1.-
indiv i du a l
1. n
that
a r ou n d h im .
occur
The
are a
in
th e
where
r e s or t
f a i le d
.
11 ls
to
at: t empt. s
•
e f f e c t.
of
the
ne xt ,
a t t i tud e s
on
is
go
a ft e r
to
u s u a l ly
to g ive
a
They a i d ·the
.f i n d me an ing
l !.l
t:he
event s
p e :1::- c e p t. i o n m ay be
A
f o l lowing m a n n e r .
i l ln e s s
r eme d i e s wi l l
las t
to
s e r ve to p r o v id e
t o ml.e ' s p s y ch o log i c a l '.Vo r l d .
s t r u c ture
tr a te d
and v a ltie s
p a t i e n t from
a
i l lu s -..
rur a l
t r e a·ted by p:d.m i t ive
the d o cto r or h o s p i t a l only a s
all
oth e i.·
Ano ther p a t i e n ·t
u t i l i z e s mocl. e r n me d i c a l
r e ad i l y
t. e l l hirn
th at. h e h a s mo r e
wh en
an
urban
pr o c � du r e s
h o sp i t a l
tre a tment s h av e
t. r a d :L t i o n a l
f rom
s t abb i ng
th an
ar e a vv·h o
\vi 1 1
abdomin a l
a n up s e t
a
come
r·ou t i n e ly
to
pains
the
and
s tomach .
n au s e a
?0
The
f i r s t p a t i e nt may pe r ce ive h o sp i t a l p r o c e d u r e
h av ing ·the be l i e f t.h at. doc·tor s o ft en
on
expe r im e n t
s e cond pat i en·t
The
as
a
t r 11s t
a
i£ th ey
e spe c i a l ly
may pe r c e ive
s t r ange r s .
are
o r:
t.he ho sp i t. a l
s o u r c e o f h e lp a n d 'rJ i l l s ubm i t
do c i.:o:r
to pJ: o c e d u. r e wi t:h
�
Ie1
c an
p e op le ,
'"J a·'l
s ame
tlH=''
the
e f fe c t
of
\1 '-'� J u e s
be i .l J. u s t.r ated by s eve r a l e x amp l e s .
A
on
p e r c ept:.:i o n
per son wi th
t ime or i erJ.·tat: ioil. toward the o:re .s e n t wi l l h ave d i f f i c u l t.y
in
s ee inr;r
th e
v a l. u e
f: t.rt u r e bene f i t .
j ug a ::-. e d
not
to
of
imnn:..n i z a t ion
a
Also ,
p e r s on
1
s
v i e"''
tll i:J.t:. mc,.n i. s
any med i c a l h e l p
s e ek
i n t ime o f d i s e as e .
th a t the ine v i t ab le
n a ture m ay
over comins
s o ci e>. J.
de t e r m i n e
l ive
K i ng
C u l ture
( 18 ; 6 5 )
v a::c i e ty
an-::1.
s ub -- c u. l t:. u r e
-- - - ·
c o n c e pt s
anch o r ing
points
and
l iv e s ,;
v a r i ab l e s
fo lkway s
und e r s t and i ng
Ro l e s
and
are r e ar e d
factors
that:
and o f s ub s e quent:
fo 1 l ow ini.�J
s o c i a l ma tr i x ;
the i r
of
t.h e
to
and
a
pr o v i d e
l i st s
imp o r t ant
the
in lr/h i ch i n d i,l idua l s
th e p:c o c e s s o f pe:c c e}J t i o n
beh av i o r .
a .s
a c t J_n 2 qu i·te opp o s i ·te v1a.y .
nd. l ieu
U:.s y
i n wh i d:.
m an
D e term in an t s
S o c i o c u l tur a l
The
He
f c;,te c anno·t b e ove r come .
On the uthe r h and , th e ind iv idu a l v:ho v l_e\'lS
and
s ub-
t.o t.he :r: u le of n at u r e m ay le ad the indi vidu c-. 1
wou l d be l ieve
3.
a
c.g a i n s t d i s e as e ,
of
f ac t o r s :
th a t
are
th e b r o a d
- - - the
org an i z e
and e th n i c 9 r oup
po s i t i o n ;:;
a r ound �1 i ch p e op l e
Soc i a l
class
-· - · - ­
t.h a. t s 'l::. r at i fy or d iv i d e p e op l e ;
and mo r e s
g u i d e s for b eh a v i o r .
- ·- -·
21
a.
Cu l t:.u_r e a n d s ub -· c u l t.u r e
P e op le
th i ng s
in
d i f fe r e n t
c u ltur e s
N e ad
( 23: 2 2 8 )
d i f ferent. ly .
t:o c o n v j_ r; c e
s ome
to i n c:c e a s e
the wa·ter
ob j e c t e d
surface
s ·t a.t. e d
·that
prov i d e d
g r o up s
e xt.en L to wh i ch
con s ·t i t.ut.ir1g
Ph i l ipp ine s
i n ·the
s upp ly .
.
it
I f he h ad wanted
for
e f fort. s
to b�):r: e v.:e .1. J c,;
1' r ibal memb e r s
to
the p e op l e
or
events
de s c r ibe s
God want e d wa·t e :c
o£ Uw g r ound
wou l d h ave
c u l tur a l
t.r ib e s
p e r c e ive
who
:r un o n t.l"l E:
it
in h o l e s h 2
i n ho l e s .
S ub -
i n a g iven c u lture a l s o v ary i n t� e
the y p e r c e iv<:.'!
i l ln e s s
or
a
h e a l t.h .
s e t.
of
c i :r cums t. an c e s
S aunder s
(31 : 17 3 )
as
has
s t ated ·tha t rn idd l e - c las s I•,1e xi c an - Am2 r i. c a�l. i:-5 g· e ne r a l ly
acc ept. e d Ang lo me di c a l
Ame r i c an s ar e rr.or c;
r e l y he av i ly
l ike ly
Acc ord ing
in
att: i t ude s ,
a
e x amp l e ,
th e
mump s .
lead her
to
't:o b e l i <�v·e
Me.x i c an - ·
in m ag i c and to
and
t::::· e a tment
on
and p rac t i c e s .
K i ng
soc ial
l o-,·rs r - c las s
(1 8 : 70)
s y s t em ,
po s i t io n
refers
a c t i v i -t i e s
th at
c ar e e r wom c:-m w i th
i n p e r c e iving wh at
to
vJh i l c r o l e i s Uw s e t o f
C:!on s t i.tut:e
the:
th e p e r s o n o c c upying tha-t. p o s i t i on .
of
the
to
v a J.ue s ,
b eh av i o r
d i f f i c u lty
wh i l e
f o r me6 i c a. 1 knm\7led�re
f o lk medi cal b e l i e f s
l o c at i o n
v·T a':/ S ,
For
sma Ll ch i ld r e n may h ave
to do v1hen th e y deve l o p
The
exp e ct a.t. i o n s o f h e r moth e r r o le wou ld
see
her
p l ac e
as
at h ome ,
yet
the e xp e ct a. t. i o n s
o f h e r c ar e e r
r o l e -vm u ld l e ad h e r
a
good
nur s e
Cl. .. J
one :cequ i r inq
CtY).
:L I':: t· r::·�_r' f e r e n c e Y.J i-t11 flt2.r·
�-.
c
Soc i a l
th e
c l as s
f:c 2mework
C Cl:r� e E� I·
e tl1 n i c
and
and
de f ine t:he-
to
b aby s .J_ ·t;':::er but n o t:.
]_ i fe ,
a�sa
g r o up ing s
for c ommon v a 1UF! S ,
the
g r o u p T,-vi 1 1
s oc i a l s _i_-tu a t io n r> and ·th i ng s th a:t
_
wi t:h h e a lt.h
and d i s e a s e .
�renk. in s
(13 : 42 0 )
are
L a t in ,
was
t.l.:;.be r cu l o s i s
th a t Neg r o e s
the popu 1 a·t ic.�1 t.h an d i e:
fre quent:
in
L a.t: in s .
Jenk i n s
social
clas ses
a lso
midd le c l a s s e s )
II ,
tendency
numb e r s
to
of
felt
ways
of
far
st c.d ied
d i f f e r ence
b ut. ,
to be
A<1g lo s
rno r e
or
in
U1 e i r p e r c e p t io n
( uppe r
and upp e r
r e;-ao ved f rom t�J.b e r r.:: u io s i. s .
in th. :::.t. r a nk ord.e2:· ,
bel ieve
It
the d i f fe r e nt
IV c l u s t e r e d tog e th � r
an d
in
show e d
th e i r
.i.. nc r e o.s i ng
·th a·t tul)e ?::c�1.t lo s i s a t t ac k s l a r g e r
people .
Fo lkways and
beh av i o r .
a
and An,:J l. o .
e i th e r
'l'n e t.op s o c J. ;:� l. c l a s s
III ,
pe r c ep·t io n s ,
found
and
o f th e d i s e a s e .
Classes
be l ieved
c o n c e rned
;:; t ud i e d ·three
eth n i c g· r o u. p s n am e l y the Negr o ,
fo und
p r ov ide
<:md o·th e r
c u s tom s ,
mannE! :C in wh i ch a n individu a l -vli t:h in
pe r ce i ve
::; i i:: u a t i on
F o lkway s
doing
mo r e s
are
th i ng s ,
also
the
in fluence
ac c u s t.omed
p e r c e pt ion and
and
t ime -hono r e d
the. s o c i a l h ab i ts that b e c om e
23
e s s ary
o f ten pe ::.:· fm:: me d w i -;-.:.rt out th inking- .
c u s t:oms \·�h i ch
a :c e
Hor e s
are
'l'h ey
:c o-.J.t ine .
sccia1
to
and
of
and
Fai lure
in
to tl1e el i f f e r E"� n c c s
i r1
s Q em s
o f h e a l th
l i nk e d
l c:tck
to
s uch
one
th a t
e x amp l e ,
wat.er
to
the
is
due
o ften
to 11e a .l:t11
e·\.t e rl t s
A t r a i ned h e a l th •.-vo :d;: e :--
unde r �:: t and ing
in
a f..; me a n : n.g ful
per-
also
v i ew
the
The i r c u l t u r e
qu i t e
'"' a�.:: o,'. r
c au s e s
d i f fe r ent way
a
t. o thern .
The H i ndu s ,
for
a r e t r c:.d i t i o n a l lv c on d i t ioned t. o pe r c e ive r.i.v s :c
a s ho ly and s o f e r:
please God
conc e r n
1'h e r e
pe r c e ived
g .i \l e n
is
s c i e nt i f i c unde r s t an d i ng .
s ame w a t e r
-j u s t
t.o
r iv e r water b e c au s e h i s
in a s p e c i al ly c o nd i t i on e d way .
them t o v i ei.r.:/ the:
:c e a s o nab l e
and d i s e a s e a J. s o
tJ:. e n1� ct11 i. ng s
in
and
f r om p e r s o n t.o per s on
pub l ic h e a l t.h e f fo r t s
c an p e r c e i v e po l l u t i on
p e o p l e who
J.t
and l ay pe � s on s .
b y p r o fe s s i on a l
is
t. o ano the r ,
i n p e. 1: c ept i on .
c u l ture
to
s ugg e s t t:hat pe r c ep t ion
c ep t i on
from C ll. l t u r e to ClJ. l tu r e
p e r c ept:: ion may d i f f e r
f rom c u 1.t.ur e
d i f f er s .
may v ary
the v a r i at: i on
c o n s e que nt: 1y
in o ther
s ·t r ang e .
thern
and mo r e ;->
;:md n e e -
s ac r e d
as
t.ho ugh p e o p l e
s ub - c u l·t u r e r; rou.p
t r om o n e
S in c e
r e g arded
we l fare even
s o c i e t. i e s m a y th ink
Fo lkw ay s
a:re
and
of
are
to b e
th e i r
th ey dr i.nk
g·cc chw s s
it .
th e h e a l th wo rker
cu l tun � s wh e r e
th e p ar t
of
They d o th i s d e s p i t e
r eg a r d ing known po l lu t i o n
o r d e ath
i l lne s s
f ate .
th ey b a th e i n i t
As
a
r e s u lt ,
p r e v e n t ive
24
or
a
P ined a ,
cultur al
of
r at e
.L
- '-• >-=>
._...
1'� -:-)
r< -P1 <)
... -1- e
-d
:F o s t. e r
..
(10 : 6 7 )
s t udy c onduc ted by Virg i an i a G ut i e r r e z de
a
de s c r ib e s
.., '- (,
CLL
...
;... r "-' "'
nr·"C"'•..:J
-: ....t. ,"l
cur a t i v e
Co l umb i an
f ac to r s
an-thr opo log i s t ,
1n
invo lved
in
i n f an t mo r t a l i ty
th e
t:he
c onc�c:� x.· n ing
pei· cep·t i on
a . rur a l
of
t.::h e h igh
•,:) £ h e �c c o untxy .
area
She po i n ·te d out t h a t wh e n an i l l ch i ld r e cov e :c s ,
p ar en t s
s ay ,
G o d d id
not
p ar e n t s
to
repl ied ,
e x ample
an
t ak e
.r. e c ove :r: e d. w i-thout: med :L c a l
t.h e
d :i.e . "
to
al s o d i e .
care _ "
Foster
pe r c ept i o n
n e w J.y d e v e lop i ng ',vor l d ,.
the
p l a c e whe re
has
lo s t
po i n t e d
p e o p l ?. g o
a l l hope
tl1 at
o ut
G u at en.1 a. l r::�
dr a,t:a l w a s
b a. E ed
e n t ir e
The r e f o r e
.
i n d i v i du a l
t.u r e s
whe r e
the
is
is b e l i ev e d t o b e
used
o ften they
so much
c ited
h e a l th
anoth e r
d i s e ase
and
p e r c e lved
is
as
and no t to g et \ve l l ;
as
me an ing h i s
(10 : 230)
F o s t er
in
t.o h o s p i t a l i z a t. i on
f am i ly
has
also
I nd i an v i l l ag e s
th at b lood.
pe r s on h a s
1
the
extent
o n ly
s amp le
t ak e n
is
non
s o much
·to wh i ch
pe rm an e n t l y we akene d .
b l ood
urge
near
that oppo s i ·tioil to b l o o d �-,' i th-
e ach
th a t
l i fe
it
th e be l i e f
r e g e ne r 2. t ive ,
the
d ie
i nv e s t ig a t i o n
on
(10 : 12 3 )
r e s i s t an c e
f o r h im .
r e 'TeaJ. e d
C i t.y
do c -tor 1
t:.he ho s p j t a. l
to
i s mu ch
:3h e wou ld
i n E gypt .
the p a·t i e n t p e r c e iv e s
because
a
prob lem in
the
th e r e
see
a. tt:ent: ion :;
i n s p i t e o f h av i ng
i n c ro s s - cu l tur a l pe r s pe c t iv e
co n s e que n t ly
When
to
ch i ld
ill
r i ch
med i c a l
of
he
1
i n t e n d him
" Th e
for
rnoney
" See
the
for
i t. is
The r e
f o r m a l ar i a
f o r w itch c r a f t
-
d i r e cted
are
an
l o st ,
cul-
c o n tr o l
ag a i n s t
.2 5
( 1 0 : 2 2 3 ) has
F o ster
the v i c ·t im .
s uch be l ie f arno.:-1g
ind i c ated
th e r e d I n d i an s
s ;.:tc11 b l ood
Nep a l ,
In
.
ev i d ence o f
is b e l ieved t o be u s e d f o r h u� a n s ac r i f i c e to god l i ng s ,
·th e
to please
c o n c e r ne d g o d l i ng·
for
s pe c i f i c
and th a·t s u ch v i c t im wi l l d i e s ome t. .ime s
fu t:. u r e
.
J.n
purpos e ,
the
n e ar
.
per:· c� e i\/e(l
Me ad
n a t. u r al
·th e i r
env i r onment.
.
th e i r he a .l U!.
and
or
water
2nd
d i s e a :::: e
or
do w i t.h
ob j e c t s ,
t:.o J.J.e .
,
as
i l ln e s s
t.he w a t.e r
Water
Me ad
·to
is
s upply
G od ' s
(23 : 228)
abo·.xt wat e r a s a s ou r c e o f
pr e s ent.
::tmonq
'I'h ey
po l lut i o n
cf
it
f e e l ing s
Mex i c o .
New
po s s ib i l i ty
pe o p l e
God w a n t s
that wr:::. r c:
of
people
as
is
var i o u s
o u·t l ined
to
p ctJ�·t o f ·th e env i r onment .
any o t:.h e r
rela tion
Th ey p e r c e ived
disease .
G od-- s ent:. and i �.::. h a s n o th ing
or
c b j e c ·t s · ln
S p an i sh- spe ak ing·
igno r e d
or
the r eby
th e
the
ide a o f
c o n t am i n a t io n
qu i ck ly
from
thE:'
f am i l i ar
con·t am i n at in-J
the ir
we l l s .
D iC i c c o
and opinions
urban
are a .
among
th i s
a.nd
of
App l e
o ld e r
'l'hey
adults
found
g r oup ·w a s
th a. t
H e a l th w a s
h e a l th
i nte r f e r e d w i th
t e n an c e
of
d i s comfo r t.
th e
a
the
by
ch e s t who
of
a
l ar g e
t.h e i.r: c o n c ept. o f
only
d a i ly
l\ man
s e c t i on
p e r c e p t ion o f h e a l th
irnp o r t.: ant
i n d e p e nd e n c e .
in
in
i n f lu e n c e d
ac t iv i ty .
an d
s tud i e d r, e a l th n e e d s
( 7 : "1 7 9 , 48 6 )
as
i t bec ame p o o r
a c t iv i ty . a n d m c d.n-·
w i th
s u f fe r s
a
no
v ag u e
and ch r o n i c
i n t e r rup t i on
2C
in his
:.l. a .i ly c1'Ti:: i e .'3
'i.v a s
s e ldom s e e n
me d i c a l atten t i o n urg e n t ly .
4 08
s t. ud i <:� d
f am i l i e s
Corne ly ,
of
c ons i s t ing
;;; :i cJ� ,
as
·th a t
found
t.h e
a lway s
proper
food
p e o p l e per c e ived
::ud 9 8
ach i e v :i.Eg he cd. t.::h .
th at
s t ay 2.ng
h <3 a lthy
r: e l at.ed to g o o:'l. h e <:i l th h ab i t s ,
t ak ing ,
a.s
and g e t t· i ng
l i v ing mod e r ate ly ,
s u f f i c ient s l eep ,
re st
men t i o n e d by mo s t
o f therrt a s d e s i r ab l e be fo r e e at. ing
and prepar ing
to i l e t
or
o th e r
handl ing
and
but was
foods
conn e ct io n w i th
,
o c c a s i on s ,
s o i le d
d i ag n o s i s
and p r omp t
me n t: i oned
a s b e ing
H c:mdw a sl1 i ng ;,v-a s
exer c i s e .
me n t i o n e d
ob j e c t s
t r e at:m2nt.
s uch
o n l y by
as
GS
after
ing ·t:he
Immun i z at: ion ,
.
of
j_ l lne s s we r e ;: ;:,.r e ly
I
'r a lue ·to po s i t. iv e h e a l th .
of
D.
D i s e a s e_
D i f fe r ent peop l e ,
s o c io - c u ltu r a l
d i f f e r e nt ly .
to
i l lne s s
e s pe c i a l ly
c o nd i t i o n ,
p e r c e ive
under
h e a l th
d i f fe r e n t
and
i l ln e s s
The b eh � v i c r o f an i nd i v idu a l in r e spe c t
o r d i s ea s e
i s b a s i c a l ly c o n t r o l led by ·th r e e
f ac t o :r: s ,
thr e at� ,
pe r c e iv e
a c e r t a i n d i s e a s e a s per s o n a l ly t.h r e a te n i ng ,
and
if
they
p r e v e nt i o n ,
and
I
( 6 :. 2 4 )
3 1 0 Neg r c e E.;
vJ"b. i t e s t�o d e ·t e r m .i n e t:h e i r pe r c er:ot i o n o f
They
a l.
!=:!::-_ ·
th c ugh
even
get
know
c au s e ,
the
pr eventi o n .
I f people
a c t u c:, l c au s e and p r o p e r method o f
t.he y m igh t
po s i tive
and
p o s s ib ly t. ake
re s ults .
appr op r i ate
act i o n s
�
I
I
I
27
�_!_ . a L
Young 1
p e r c ep-t ion o f
a lw a. lth
Rosen. s ·tock
i nc l u d i n g h::� l i e f s
f am i ly
w.i th
abo u 'c
r e l at io n s h i p s 1
me an i ng
in
of
s ev e r i ty by
a :r- e a s
as
s uch
o c c up a tion a lon9
and
th e c l in i c .a. l pl:o..b l ems .
the s e
emph a s i z e s
The
d i s e as e ,
m i t i g· at e
h e a l th
t o o ·th
S ur v e y
d e c ay ,
and
t ib i l ity
Center
abo1J.t..
re s u lt
a l th o ugh
l ik e ly t o h appe n ,
a l though
t i v e ly
it
too
is
few p e o p l e
or
,
the
is
showed
is
as
the
c an c e r
as
s ee n
f a i r ly
t o o th de c ay
as
is
a
21
y e ar s
S t and a r d
(19 : 249)
o n pe r ce i v e d
g um d i s e a s e
per c e i v e d
see
adu l t 3 ,
p r o c e d ux e 3 .
s e r i ou s ,
F c)u.r
A str ati f ied ,
emp l oy i ng
th a t
to
t.ube r c u1.. o s i s ,
v e ry
s er iou s
s ev e r e
as
1' uhe r -
s een
no t
as
S lJ.. s c ep-
s e2n
is
a very s e r ious d i s e as e .
r e g a r de d
nor
1, 493
be l i e f s
e f fe ct s
o f d i .s e a s e .
( 1 9 : 2 4 8 -- 2 4 9 )
s amp l. i ns
of
ac t io n s
d i agno s t:. i c
c an c e r ,
n ame ly
s amp l e of
s e :r: i o u s n e s s
and
the b e ne f i c i a l
ob t a i n e d by
o lder w a s
c o n s e que n c e s
con E eqv. en c e s
o:;:'
g um d i s e a s e .
and
l ik e ly t o o c c ur
c u l. o s i s 1
remed i a l ,
p r ob ab i l i ty
and
pe r c e ived..
c o n c e r n ing
cho s e n
were
Re s e ar ch
The
diseas e ,
th r e a t
t op i c s
mu l t i -- s t a g e
ag e
to
p r e v e n t ive ,
th e
1 9 6 3 furthe r
l !.t
t.o f ind ou t th e p e r c e ived
c� oncl.u c t e d
and b e l i e f s
t ak i ng
s urvey c ondu. c ·ted
ideas :
s u rv e y w a s
v u ln e r ab i l i ty
of
c�nc1 p·e :c c e i Ve(t s e�"re r i t: y .
c on s eque n c e s
A n a ·t io n a l he alt.h
of
t.he
f i n a::1 c e s ,
as h i ng ing on two
seen
is
th r e e:.-t
amp l i f i e s
(28 : 297 )
pe:c z> o n ' s
s u g g e st
S ti s c ep t il) i l i ty
per c e ived
b e l ie f s :
{3 2 : J l )
.
as
l ik e ly ,
Re l a--
c o nd i t io n ,
2 t3
As to the b e l i e f s c on c e :cning 'Li:1e prcvent. i on and
bene: f it� s o f e ar ly de t e c t ion ,
5 per c e n t o f d1 c :r:·e spondent. s
s ai d th a t the r e w a s no thing o n e could d o t.o p:r:event
denta l d i s e a s e .
is preven t: able ,
1\.mong t.h o s e who b e l ieved that. 1:h e d i s e ase
·t oo-th--br u sh i ng was w i d e ly b e l ieved to be
a p r e,?en t i ,Je m e a s ur e ,
and m any per s ons
b r u sh ing sho u ld b e done after me a l s .
s p e c i f i e d.
t.h <:t t
F ewer people
be l i eved in the e ff i c acy o f den·t a l v i s i·t s for p r e v en·t: i o n
o f dent a l d i s e as e .
culos is ,
'1
( .L' 9. : ..:.'1 c..J ..L -- L... ::> 2 )
,.
With r espect ·to tuL e r --
1 9 per cent o f ·the r e spondent: s b e l ieved t.h at.
the r e �.va s noth i ng th a t could be done to prevent t.he
di sease .
were
Tho s e "�.i.- ho f e l t th at s omething could be done
a sked t o spe c i fy wh a t m igl1 t. be done .
.Nor e th an
h a l f o f the g r oup �nen t i oned such item s as avo id ing
con t ag i on ,
g e t t i ng r c s t and fr e sh a i r ,
b a l anced d i.et .
and e a t ing
2.
An addi t ion a l 3 4 per c ent ment ioned
t ak ing t e s t. s and ch eckup s .
( 19 : 2 52 )
l'.s t.o the c a nc e r ,
14 per c e nt. o f t:he r e s ponden t s thought n o th ing c ou ld be
the g:':oup r epor t i ng
done to p r event. the d i s e as e .
Of
t.h a t s ometh i ng could be don e ,
the onl.y f r e quen t ly
ment ioned :c e spon s e was to " av o i d smok ing , " rep1� e s enting
2 1 per cent o f the r e spondent s .
5 9 per cen·t o f th e g r o up
t.h at thought prevent ion was po s s ib l e men t i oned t_e s t: s and
che ck s as a p r ev e n t ive .
( 19 : 2 5 2 )
The r e s u l t s o f t:he survey p r e s e n t the e v i d e n c e th a t
pe r cept ion o f the s u s ceptib i l ity ,
s ever ity ,
and preven t i o n
29
o f d i s e a s e by the peop l e m ay
th a t
an
One mi�rht. c on c l ud-2
v ary .
in o r d e r to ll r i ng about:. ch anq e
prog r am vvould
educ at:.ion a l.
wou ld
i n c r e a s e b e l.i_ _ e f s
bene f i t s
of
preventive
i.n
need
in h e u. lt.h beh a v _i _,:) r ,
to
be
t:he
·to h e a 1t.h beh a-,; _i o r ,
o f p e r c ep t i o n
to
a ch o l,:; r a
ep idemic
d i s t u rbed
the
of
the
i n a Chine s e
Th e
proper s an iL=:t:t:y
c o u l d be pr even t e d .
the i r
e f fm-_- t s
the i r
0\'lD
vve r e
The
coun t e r -me as ur e s .
d i s e as e \vas
o n ly be
devices
an im a l
t o ward
The
th e i r
t ak e n
people
·.J\'lrl
s a c r i fices ,
the
i nh ab it a n t s h ad
oc,,m
·the i r
s p 1. :t· i ·t s
1
<:-l nd
and b r e ach
f o r:
gods
'-1 S e o £
o f f the d i s e a s e
e f fo r t but
peop l e be l i eved th at
�-ii s c ond;_1 c t
ple ase
s o u r c ::::
th e
an d ·th a t wit.h
and
t.r ag edy
about by g od - s e n t
to
the
ar:,d d e e p ly
g r e at
'l'h e
the c au s e s o f th e ep i d er::l i. c
we r e
me e t ing s I
in
b r o ught
th e
ave r ag e
r e c a l l ed by g od s .
c o d e we r e
Ac t io n s
l arge ly '"c:t s -t: e d .
for
o£
thE:� e p i d em i c o f ·the d i s e a s e
t ak e n
They worked w i th
e xp J ar� a t i on
many
th at.
..
fe c a 1 cont:ami n a.tio n ,
me :::l. s >:<r e s
Cho l e r
loc c.c l h e a l th wo rk e r s k n ew tha t.
c <m s e o f t.h e e p i d em i c ',va s b a c te r i a l
of t.h e i n fe c t: i o n 'ila s
t.own :
s truck
town o f Yunn an prov ::. n c e
eve ryone .
:r: e l at. io n s h i p
info:cma.t. ion
ut i l i z ing
a common and d r e a.ded d i s e a s e in Ch ina ,
inhab i t anJc s
and
t ake n .
Hsu
r E� l at iv e
s e-ve r i ty ,
�> u �; c ept ib i l i ty ,
ac t io n s
·th a t:.
deve lope:d
ch arms ,
could
o f mo r a l
people. .
the
such
the
as
pr aye r
an d o·th e r
s p ir i t s .
o f Yunn an pr o v i n c e
as
they we r e
r e ar ed
c u l t u r a l m i l i e u r e t a i ned the i r tr ad i t i o n c-1 1
t.l1 e y 'de r e
·though
O t.h e r
r e s e ar ch
among
v ar i o u s
As
r e g a r c1 s
th e
pe op l e
due
"co
w ind ,
sb mvs
th e
c au s e
B aug
o f the
Th i s
the i r own way of
o th e r
among
th e Mag ar s ,
to
·trw i r
the i r
( 1 2 : 30 )
one
ov:n way
vTh en s om e o n e
a
a
ch i ld
s p r i ng ,
the
th i s
ln
c au s e
is
c one s
th e
s i ck ,
a
b ath ,
home ,
to
the
ch i ld wi t.h
n ame
and
I
i ts
the
of
wi l l
to
for
the
di s e a. s e .
t.h e
in
f o und
Nepal ,
'.vho
he
is
i l l they
spec i f i c
g o ci -·
e x c e pt i o n a l powe r .
f a th r2 r
and put·. s
g oe s
on
to
the
c .l e an
c l oth ing .
a le a f p l a t e and
a l on g •,v i th a copper p i c e .
mak C\ S
promi s e .
" p le a s e
do
co n t e n t s
a
tr m.:b l e
puj a
for
a r e h i dd e n
pu j a h a s b e e n
th e
a l s o h ave
the
God 'vvho
The
f ath er
be c om e s
to uche s
the le a f p l a t e and s a.y s , ·t ak i ng
o f t.h e g o d l in.'} he w i .s h e s t o c a} 1 o n
th e
·the
fo r he l p ,
and d i z z in e s s .
s i ck ne s s . · H i tcho c k
of
f am i ly
Mag ar
( vror s h i p )
put s s ome r j_ c e in i t ,
The cc in s ·t arK1 s f o r S h i v a ,
a wi tne s s
a c i r c l e thr ::. ugh
t.h e f o l lo-.,v ing m anner :
in
the
or
cLi s ,?. af: e v:h i ch i s r e l a·ted
the
r epu·t o.t i o n
t c:tk e s
When he
cur ing
of
pu. j a
l ing w:i.t"b.
feve:;: ;
·th e e th n i c g r oup s
of
of
i l lu s t r a te s
a
produ c ing
preven·t i ng
or
a.s
e ar th ,
out o f
p e o p l e m i gh t
·th e s e
--
e l em e n-t s
h e ad c.che s ,
1
s i ckne s s
m ay g e t
of in
th at
e aid
o f p e r c E:p t ion o f d i s e as e m ay be
f o rms
p r om i s e
e lemen t s
i n s t e a,:"'
th at
per c e p t i on
If
The
tr e a:t ing
Still
h av e
f ou r b a s i c
b e l ch i ng
fac t i n d i c a t e s
( 2 7 : 16 8 )
p e x: c e iv e
t.h a t f i r e dom i n a t e s ,
p r o du c i ng
di s <::� a s e .
·the
s ub - c cl lJcur a l g r oups .
Paul
Thai l and
Ch c\11 1
w i n d s may b l ow upv1a rd
the body 1
and
o f di sease ,
and wat e r .
so
p r opo r t i on
of
s im i l ar m i s concept. io n ab ou t: d i s e a s e
imb 2< l an c e
f i re ,
th r e at
pe op l e , c u l tu r e s 1
the
of
o f th e
a.w ar<3
p r om i s e .
done
th i s
you . "
away
ch i ld r o mo:r. e ,
Th e p l a·te and
s omewh e r e
unt. i l
and s e r v e s a s a r em i nder
3 J.
f --··- - -!U�:t;�a,;-�];-l49; ·h��-�;;i:t��l
s urveys c o n d u ct.ed ·to evz, luate
pub l i c
the
of
people
3 , 000
s tuden t s ,
s uch
as
and
wi th
They·
o f bo th
r epo r ted
is
was
c ent T...v e r e
f au l ty
re s t
or
( 1 7 : 14 9 - 1 50 )
as
s t ud i e s
th a ·t 46
per
c o u ld be
nutr it ion ,
an
th a t
Th e
p r e s en -t e d
th e y
o th e r
The
i n 1 9 3 9 and
the conc l ud ing
r e l ated to
tube r cu lo s i s .
cent o :: th e r e t:; po ndeni: s ·thought
40 per
ill f e e t ion
cent
( in f e c ted
ind i c a t.ec1 s cnJ.r c e s ) ,
be l i eved
cow 1 s m i lk ,
a:Ki
36
per
it was pr im a:r:· i ly c au s e d by
F o rty-- th r e e
pe r c e nt
imp o r t an t f o r r e covery
th a t ·tub e r c u l i n
c ur ing
an d hou s ewive s .
i nh e r i t:e d ,
p r im a r i l y
conv i nc ed
i s mo s t.
s t at e d
a ? ar i e ty o f
Pub l i c He a lth S er v i c e
i n f e c t e d p e r s o n s we r e
and
o f a s amp l e
a s amp l e of 1 0 0 , 0 0 0 p e o p l e .
·tube r c u lo s i s
t.h at
v.r a s .
s choo l and c o l l e g e
g r ade
b u s i n e s sm e n ,
of
One s urvey
c o n s i s t ed
It
r e pr e s e. nt. ing
adu l t s
cond u c ·ted by
K i l an d. e r
result
19 3 6 .
i n c lud ing
te acher s ,
s urvey w a s
1940
-'c.he h c a l t."h knovrledg e
i n d i f f e r en t f ie l d s o f he alth .
conducted by h ims e l f in
·1
�;;t,;;ri
;,t,s: -;;�--t�;:�- --
in j e c t. ion w a s
and
ind i c a t ed
v e r:y
sm a l l
th at
a m e an s o f prevent i nq
tube r c u lo s i s .
r e su l t s
of
th e
surveys s ugg e s t th a·t
I
l
numb e r s I
pe r c eFt i o r�
I
---- �·- ·-�----------�--- - ------- ' � - -.----·-� ---·-�� "�"-��---�,-�,..-----------�-�----�----·��-,�---------�-- ·- --� ��---.-·�-----��--""''-�---- "" ------ �·---
1.
L ack o f know l e dg e
i t.
know ,
2.
and h e lp l e s sne s s ,
j us t h appen s ,
Re fe r e n c e to
l owe r e d r e si st a n c e or
of i n f e c t i o n , e . s:f .
n u t.r it :L on ,
we c:l_k ne s s ,
u n c l e an
f a ti.gue ,
c r owd s .
Ah lmv a l i a p r e s e n ·t.ed
2 2. 2
o f d L f fer· en·t
pe r s ons
o c c up at i o n ,
from
plJb l i c mi s in format i o n
h e a l ·th
e xh ib i t ion
1 96 5 .
The
at
que s t. i ons
p e o p l e p e r c e ived
are
p r even t ion
t::h e
i ind ing s
on
u rb an
are a s
in
I nd i a
disease
t.h e Kuruk s h e t.r a F a i r
d i s e as e
2s
in
sma l lpox
about
sex ,
of
a•:Jf� ,
to
st. udy
dur ing·
·th e
Novemb e :r: ,
and how tb e
to i t s c au s e and
re l a ·tec1.
g :t v e n be l. o�l'l :
Wh a t
L'3
On ly
t.h e c au s e o f s m a l lpo x ?
2 9 per
c e n t. knew th a t
rest
wh i l e
the
bad
diet
or
God ' s
How
c an s m a l lpo x be preven t e d ?
at. tr ibuted
2.nnoy anc e o f the G odde s s D evi ,
40
to
per
cen t
c aus e d
g e rms
d i se ase ,
Abo u t
i n t e r v i ewi n'J
leve l ,
c ommun i c ab l e
asked
e.g.
s ewag e .
f r om
edv. c a t i o n a l
and
rur a l
germs ,
good ,
II
c r owds
Re fe:r: ence to c o n t am i n a t i on o r i n fe c t ion ,
flies ,
don ' t
f a t.e .
w i t.hout men t ic n
poor
e .g .
it
the
to
t o b ad a i :::: ,
s courg e .
s a id
th at:
the
d i se a s e
c o u ld
a l l or c o u l d be p r evented
by wo :r: sh ip:[) i.ng the G o dd e s s o x: by e a·t ing good
food , wh i l e 60 per c e n t. k n ew th a t i t could be
no t b e
preven t e d
p r e v e n t e d by
Nh at
be
30
is
cured
p€: r
at
v a c c inat i on .
the ·t r e atme nt for sm a l l p ox and c an i Jc
or
not?
cen t thought
t:.r e ated b y pr ay ins:r
the
temp l e
(1 : 12- 13)
or by
th at
sm a l lpox
to God ,
could be
by o f fe r :i. ng s t o
f o lk me d i c i ne
t r e a tm.ent .
.. •
33
rrh e
r e s u lt s
of
d i f f e r e n t ly p e o p l e
kn ow l e dg e ,
also
the
p e r c e iv e
c u ltu r e ,
{ 3 .· 2. _r.:) �7 )
E aum::r a r t.ner
o f V"t1h ite
adu l t ::3 condv.cted in
r e l a.·t ive
t.o
th e
th at 91 per c8nt.
e f f i c acy
of
at t i. t.ude
th at
to
get
is
and
o f the
t.yplw id
s c.mp i e
" if you
fever .
did
found
r ·t was
in Jch e
n o t: b e l i ev e
g·o ing t o g e ·t
are
(8 : 26)
·th e
i. t. ,
f at a l i s t i c
g o ing
are
you
k e ep
s ugg e s t e d
·th i s
h a pp e n s
i f th i s
t.h at
th e
and hen c e
individual
t.o
D ' On o f r i o
f a i lur e
to
fatal i s t ic ,
and
th e
et .
�l·
and
(8 : 29)
c an
:
has
help
t
furt.h e r
ag a ins·t
p r e c a ut i o n s
indi,.r idua. l
t. ake
I
me ,
to
fee l s
no
p r e c au.-t :::.. o n s ;
th e
but d o e s n o t know wh at p r e -
t ak e s
thr e a t ,
fee l s
no
( 29 : 9 9 )
o f pe r so n a l r e ad i ne s s
att i. -tud e s ,
t ak e
i n d i.v i d=.1 a. l
th e r e fore
Ro s e n stock ,
f a c to r s
no n e e d to
fe e l s thr e at. ,
t ak e ;
to me ,
t 8 rG.e .
the
he wi l l
c an ' t. h .:::,pp e n
Th i s
f r om h appen5.. ng
d i s e a s e rr.. ay be be c au_ s e :
c au t i o n s
tha·t wh e n an ind i -
f a.ced ,,T i th th.e th r e a t frorr, a d i s e a s e ,
to
th r e a t ,
s ug g· e s t. e d
has
o n e o f thr e e w ay s :
in
I want
a
aq a. i n [; t
it. "
vidual
it
194 1 to de termine be l i.c.:: f s
t..:.h e se vacc i n e s anc. expre s s ed
D ' Ono f r i o
r e ac t
n ;::�t i. o nwidc survey
a.
e f f i c a cy o f v ac c i n 2. t i o n
sma l lpox ,
d iphther i a ,
a n d t r ad i t ion .
d i s c u s s ed
\
L ack o f s c i ent i f i c
d i s e ase .
a�d in c o r r e ct inte rpr e ta t i o n
s uper s i t i t i o n s ,
in f luen c e b e l i e f s ,
further emp'h a s i z e how
s t udy
bu·t
p r e c aut. i o n ar:y
S U<Jg· e s t th at
i n c l u d i ng
b e l i e f s o f i n d iv i du a l s
t.h e
a f f e c ·t
is
ac t. i on s .
the
mo t iv e s ,
th e i r
I
I
I
1
I
I
I
j
wi_ l l ing n e s s
to
the ir h e a lt:h .
I
s e ek
c o n ne c t i o n •.vi th po l i omye l i t is
v a c c i n a·t i o n · c an b e
of
the d i s e as e ;
g e t ti ng
e f f e c t i v ene s s
i n d iv i d u a l
t. o
a
feel
s ee
real
t ak e
t:.h a t
s ome
g iv e n
c o u1: s e
o r p o t en t i a l h e a l ·th p rob l em ,
·th r e atened by the h e a l·th pr ob l err.l ,
one
or
mo r e
the
made
s e r i ou sr,e s s
of
ac ti on
�:__
t.
of
the
1
a ..._
.
opr:cn
ac t. i o n
h e r.m s t
__
only
b u t he nn1 s ·t
also
t.o h im ,
.
-
pe:c c ep t io n
of
th r e a·t ,
peop l e
r e l a t iv e
n o t.
( l tl� : l 6 3 ...')") d. 1 s cu. s s e d
s tated b y Ro s e n s t o ck .
c au s e ,
and
wh i ch h e
o c c ur r e n c e
They
t•h. e
r e s e ar ch
.
a l ong· th e
s tu d i e d
pr eve:;:1t i o n
the
o f pol i o
o f D ade coun·ty and h o'"' po l i o v ac c i ne w a s
pr eve n t l ,e
·the
me a s ur e .
p e r c e iv e d
a ;;;
·th e
v a.c c i n a t i o n p r og r am
�..
ac c ept a n c e
r at e
c ep t i o n
th r e at ,
of
of
for
p r ob ler:; .
as
poli o
in o r de r
l ike l ihood o f
l in e
th e
c o n s E:quen c s s
F lo :r: i d a S t a·te He a lth D e p ar tme n t
under
bas ic
cour s e
e it1!. e r r ed u c e th e
Joh n s on ,
by
t.h e
o f t.'l e s a f e 1:y a nd
c onc ept
exp l a i ne d
(28 : 2 97 )
to
b e l i e·v e s w o u ld
or
his
r e g ard s
·the d i s e a s e ;
t.o
tl1e v ac c in e .
of
Ro s e n s to ck
an
s u s c ep t i b l e
wi th wh i ch he
s e r i ou sne s s
the ext ,:::nt: t o
i d e nt i f i e d �
•l'lh i ch he be l i e v e s h e m ay be
1 the
I
In
·
·three componen t s o f a . pe r s on ' s r e ad u1e s s
v ac c i n a t i o n ,
to
vo lun t <:n:·y act ion. ,,Ji d;. r eg ard t.o
t� a.ke
of
the
v a cc i �e
c au s e ,
in
1960
They
and
c ondu c t e d
s tu d i e d
the
in r e l at i o n to the p e r -
and p r e v e nt. ion
of
the
d i s e as e .
The s t u dy w a s d o n e b y m e a n s o f i n te r v i ew o f the p e o p l e
ye a r s
of
ag e .
Th e
d i s cu s s io n
o f the s tudy
35
···-····· ·····-··· ····----�·---�--········ ··--···-- ····.. -··--···-- ...............................
Expec-tins;r
inc i d e n c e
·t-h at
a per s o n
s p s �: c ept. ion of the l o c a l
1
should g i ve
of polio
a
..
( 14 :
were be tter
in formed a s
d i s e a. s e ·itJe r e mo s ·t
in fcrrned
poo r ly
to
16)
�,va s
T.h at
fo und
o f ths
t ak. e v ac c i ne �:: ,
to
no t.
C oun ty h ad
D <:;, d e
th e::
to
l ik e ly
U:mded
It.
co
as};-_ e d.
inte:r·\r i e·v:;(3 r S
'' About how mar1y
que s t i on :
t ah:e
Y.Iher e as
( 14 : 17 )
v a c c i ne �> .
the
que s t i on >;.'J a s
11Do you t h i nk th e ch anc e s
a sked :
o f people you r
ag e gett. ing po l i o a r e gr e a �c e r ·th ;:.:,_n ,
·th an ,
a1x�ut
th e
Abou·t
t.wo-- th i rd s o f th e r e spon.dent. s
or
( 14 : 18 )
adu l t
chanc e s
of
s ame
as
I'he
i n c r e a s e d g r adu 3. 1 ly 'd i th
b i l i ty but
. 05
the
t.J-tey are
probab i l i ty o f
p e r c ept i on
a s s o c i a t i o n vv 21. s
leve l. o :E s ·t at i s t i c a l
app e a r s
It
was
a
the
D ade
f e> c tor
..
l ike l ihood
of
..
v ac c in e
i n c r e ar.; e d
s t r ong
p e r c e iv e d
t.h s
s tt s c ep t i --
t ak ing
enough
s ig n i f i c an c e .
t.h at
tho ug·h t
s u s c e p t i -·
r e a c1--:,
�co
( 14 : 1 8 )
s u s c ept. ib :L l i ty
l
t ak ing o f v a c c ine i n
s tudy .
expe c t. ing
s e v e r ity o f
.
.
a s s o c i a t e d wi th
C o un ty
Ag a in ,
p r ob ab l e
not
le s s
for ch i ld r e n "? "
g e t t i ng po l io ls s s th an t.he
ch i ldren .
b i l i ty o f
the
the::�
a
r ang e ,
th e
I
coH�_p z:n· a t :i.ve r c;:t. ing o f
h i. s own p e r c e ived s u s c epLi.b i l i t.y ·t�b.r:!.
the
·-1
that a p<:� r s on '
a d i s e as e wou l d be
th a t h E! wo u l d.
t ak e
s
pe�c c ept. i on
a s s oc i a·te d -.,v i. th
as
to
th e
a c t i on to p r o t e c t h ims e l f
I
I
J
--- j
!
" Whe n
adu lt: s - g e ·t p o l io ,
or
do you
a mi lder ,
th ink t.hey - u s '.B l ly h ave
� m o r e · s evere c a s e
th ey get it. ? "
ch .i J. d :c e n
( 14 : 1. 9 )
th e.
e qu a l ly seve re
as
d i s e as e
to
mor e
t ak e
t.he
adu l t s
in
as
1J_ s ed
I t. was s xpe ct e d that
also
tho s e who h ad bu i 1. t up
a fe ar o f t.he d i. s e a ::� e ove.r
t: ime ·wou ld
in m in d ,
t:h i s
With
l a s t f e',v y e ar s ,
might g e t po l i o ? "
wo r r i ed
you
mor e
The
po J :i_ o
was
fe ar ,
c ar e ;
i n ab i l i ty
t o wor k
i ty o f c r ipp l i ;:1g ;
it
d e ath .
\'hiS
o f po l i o
o :r-
( 14 : 23
expe c ted
wou ld
!:he
s a i d t.h ey h ad
aske d ;
v a r i e ty
a
care
lor:cg·
th a·t you you::- s e l f
" j ust. the f <3 ar o f gett i ng " ;
v ag ue
11W i Ul i n
pe r s o n s -.,;rho
·;t;- a ::::- c•
a
th e-en the unv:o r :c :i.ed .
a sk e d :
e v e r \llj-o r r i ed
The r e
you mo s t ? "
a v i c 1.: im
'/ a.c c i n e
( 14 : 2 2 )
about g e t t ing
Ag a. i n
t ak e
�
th e que s t �Lon \vac-.;
h av e
for
the
o f r e s p on s e s :
cost
o f medi c a l
f a n.1 i ljl ;
p o s s ib i 1 -
)
that. p e r son a l ly knm.Jing
i n c r e a.,s e
f e a.r
of
th e
d i se a se
and th u s e n c o o. r aq e th e t ak in:r o f prsventive me a s ure s .
qu e s t i o n vla s
So ,
the
who
had p o l i o ?
"
I
pe r c ,2 ived t.h r e at:.
or 's ub j e c t. i ve fe ar w a s
of
I
-I
v a c c ine .
a.]_ ·t E: r 11. at:. j_ ·\l8 vv ay o f
per iod
l
asked :
( 14 : 23- 2 4 )
" H av e
It w a s
yo u kn o\'rn anyone
found
th a t
about
I
3 [3
I t �.vas
·the
h i gh
a l s o tho1._;g·h t.
e f f e c t iv e
v a c c ine via s
a c c ept anc e
ln
po l io \.V O'Ll. ld h ave
prevent:ing
8 2 per
r a·t:e .
·tho s e vd1.;:,1 b e l i e v e d th a·t
th ai..:
cen·t o f
�.vho took v ac c i n c.t. i o n i n d i c ated t.h e i r
r e sp on d e nts
the
fai th in ·the
v ac c i n e
But 6 0 pe:c c e nt o f ·the r e spondent s who h ad n o t. -t�ak en
v a c c ine
also
i nc1 i c at.E�d that. fait.h
to
suf f i c ient
not
pr ogr am .
The
v a c c i ne
sex ,
r e s e ar ch wo rke r s h ave
a c c ept. an c e
e·thn i c
educ a"c ion ,
c l as s ,
s oc ial
( 1 4 : .3 2 - 4- cJ )
It
r e s po n d en t s
W ?. s
th at mo s t.
c as e s
of
the
the r e
l
in
t'he
'-l acc l n at. i.on
i:r1
d i f f e :r: e nc e s
to v ar i ab l e s
r e l ig ious group ,
as
such
soc ial
f am i ly compo s i t io n ,
etc .
no·t u� e s ame .
c arne
expe c t at io n s
was
above
th e
s tu dy
Jco be
i n d i c a t ed
true t.hough in
no s t. at i s t i c al s ig n i f i c a.nce .
the r e l at i o n sh ip be twe e n t ak ing v ac c j_ n_ e
pe r c e i v e d w o r ry ,
J
.......
and prevent:i.cn o f po l i o by a l l t.he
data a n a l y s i s o f
The
l
g- r o up ,
.
was al s o f ound th a t: the p e r c ept i on o f
c au s e ,
Howev e r ,
a c co_;-: ding
par t. i c ip at i on ,
the th r eat ,
s ome
.r a·te
fo und
_,_
th e v a c c :i.ne w a s
ln
p a r t i c ip a t i on
a s s ur e
the
( 1 4 . ') 8 )'
·the i r be l ie f in the v ac c ine .
s t ated
·1
was
not c l e a r .
I t was
and
fo1:md ·th a·t
fe ar
o r wo rry o f i l lne s s d i d n o t d i f fe r ent i a l ly i n f l u e n c e
pr e v e nt. ive
h e a lth b eh av i o r .
A p o i n t.
of
c ommen t
could
be m a d e in th i s r e spe d s in c e t h e i n t e r v i ewer s o r
r:e s e ar ch
an
wo rk e r s
did
not
:::: :t�-:o:c l�:��n�-
p r ob e
-
:he�
-
d e e p ly
::ked
enough to r e a ch
=
j u s t a one d ime n s i o
J
39
que s t:. lon
with
arH:t
the knovJ l edge
r e sponden t s v1ho
An
a s pe c t .
s aid
a n swer
th ey we r e \\ror r i ed
� ' Pos s ib i l i ty
they \\7:r: o te
propo s e d
qu e s t� i on
c o u l d be
th e a sk i ng
e x amp le w a s
" �\Th at. wor :r· i e d you mo s t ? "
polio �
s u ch
the o th e r C: imen s i on wh i ch h a s to do
om i. t t� e d
and
about. g e tt ing
a l te:r: n a t iv e
t.he
o f c r ipp l ing . "
s p l i t:
into
·two
d imen s ions ,
as :
( a) .
How d o e s
c r ipp l e d by po l i o ?
a p e r s o n b e c ome
··· - -- -· �Knowl edg e
(b )
Are
•
y o u wo r r i e d
about b e i n g
The
r e s ponden t s
who
are
s uppo s e d
r e spondent s
-vvho
do
s upp o s ed
to b e
n o ·t h a ve
v a c c i Yl at:. i on pror::�-r am do e s
the s e
t.wo
p o s s ib l e
One
g e ne r a l
S ome
at wh at
of
the
r at i o n a l
di f f e r e n t .
The
and
r e -·
resul t
o£
no t d i s ti ng u i sh be t\ve e n
They
qu e s t ion
about
s ympt.oma·t i c
that
the
a s ke d .
the
fac t
So ,
p r e s er:t.ed
a s k ing
is
t.he
s u ch know l e dg e are
a l s o be
qu e s t ion
po l io
abo�·t
cormnent m iqht
th e
r e spond e n t s
by po l i o ?
g r ou p s .
of
th e n atur e
m i s sed
mo r e
·to be emo t io n a l o r i r r at i on al .
s p e c t i v e b e-h av i o r m ight b e c om e
the
c r i pp l e d
h ave the know J e d g e
o f po l i o
nature
d imen s i o n .
d ime n s i o n .
- - - - - F e ar
·the
The
m ight
they
not k n mv o r
or wh a t Sjlmpt cms
th ey
r e cogn i z e
tot a l ly
the
d i s e ase .
·they m igh t be
c- o n f u s erl
it
the
about
c ar r i e s .
di s ease
To
th e r e
be
sur
sh o u l d
�
l
�
�
I
" " "j
40
d a:t a mo r e
the
E.
a c c u r a.t. e ly .
Con c lu s i o n
_________,
One
c an
cau se
have
of
t.h e
di sease ,
to
The
th e i:J: ·
for ego ing
ind i v i du a l s
belie f .
abo ut
They do
them
ln
c o l o r e d :by
an
s ig n i f i c a::d::.
prog r am s .
h e a lth
for
He
of
the
of
ac t: i on .
g u ided
ln
p e r c e i v e"
t.hey
n o t.
a
per c e ive
the
o f pe: x: c epl: i on tJ\ ey
disease
v1 i l l b e ar
c o n s t. an t J .y
s ome
emph a s i z e d
th e i r a c t i o n s b y the i r
a r e b a s e d o n t r ad it ion a l.
c u lture and
nec e s s ar i ly· n e x: c e i.ve the '.v o r ld
o.c c u r a te. manr , e r be c a :.: .:o c
the i :r:
d i f fe r e n c e
how
a n d wh a t k ind
d i scus s ions
aJ: e
.
Thi s
th r e at ,
cour s e s
pe r c ept io n s wh i ch
is
a
about. the p r ev e n t i on
r e l at. i on
that
as
d i s e as e
p a r t i c u l ar
th at. how peop l ·3
c on c lude
own
the i r
p e r c e pt i on
in<li v id u a l or g r oup me an ing s .
in p e r c e p t i on
lS,
t.h e h e a l th wo.cke r
of
who
c o ur s e ,
qu i t e
p l an s h e a l t.h
must know how peo p l e p e r c e i v e d i s e a s e o r
p r ob l ·.::. m s
in
order
to
prope r ly
plan
a n y pr o g r am .
I
I
I
··· · ·
I
J
CHP�:PTER I I I
'l'I-IE S URVEY l.NSI'RU::·H ';NT
P.. .
.
I n t:rod.u c l i en
'The
fo l lo-,-;.in<J
co n s i de r ed
to u s e ,
as
a
t e s te d
s h o u l d not. be
it
Be fore
·the g r o '-'P
on
c an be
vvh e re
o .r:
he n s io n o f
put
i t. s use
Th e pu rp o s e o f th i s ho: s t inq vvc; u l d b e
e l imin ate
t ime t:he
i.n s t r umer.t
f in a l pr oduct .
i t mu s t be
i n t ended .
sur'rey
is
to
·min im i z e prob le..-n s r e l ated ·to the c ornp r e -
th e
targ e t
,. J.. .
L
group .
..L
s ug g e s ted th <::rt e ach
.
l
,c..
tar:�r e t. qroup i s ch a n�r c d 1
th e te s t. i ng p r c c edu:r.· <::,
be r e p e a·t:: e d .
'I'h e
to
perception o f th r e a t ,
the
When
ch o J. e r a .
be
we l l
to
the
B e fo r e
d e t.e rmined
-�.he
tJ-1e
if
s u r v ey
the
f o rm a t
an s\ve r: ing
a.n swe :r: ing
cho s en .
so
order
an
p:;::-evE-'mt io.c. o f
used ,
th a·t t:.J:v:·
of
it
t:he que s t io n s .
an svJ e r by
inte r v i ewe r .
a. f fe c t.ed by
the
m i g �1 t.
r e sp:.:.ndent.
i s F L1 t t.o u s e ,
.
que s t ion s w i l l b s
to t.h e
q ue s t ion s
r e s pon d ent w i l l
of
for
and
ac tu a l ly
i r: s i:.r ::tment
form o r by
D i r e c ·t i o n
is
in f l u en c e d by th e
in the
the
c au s e ,
i n s t r umen t
r ::rndom i z e
'l:,'o uld no t be
be
qP e s t. i.on s h a.ve bc::� e n g r c up e d accor d i ncJ
f o l lo\.J ing
it mus t
f i l l i ng
The
forma t
d e c i s io n .
vv-ou ld t:.lwn be p r o v ided ac c o rd i ng
Two
f a c to r s
41
U1 at w i l l
in f l u e n c e
fD1�(�''"d:E:17eiciJ?!r-,er:� c-:;�:-t:-Th:e___ s1iJ.::·;;;:E�Y ---:tc;rr:i1·- -�<1r_e
l
I
___
of
·t arg e t p:.::> p ul at. i or:
t.h e
Th'6--Tite1�-acy�--rafe
and ·th e av r.d. L�b i l it:y o f
j i nt e r v i e,;Jer ::; . .
I
iB .
I
I
Il A .
I
11.
Age
Re 1 ig ion
S ex
·-------
_____
-----
O c cupa. t:. i cn.
E du c a t ion
PE'RCEPT ION O F THREAT
Hovr many peop l e
do you th i nk
s u f fe r ed
from c:ho J_ e r: a.
in your c ommun i t.y l a. s t y e a r ?
12.
I
Do
3.
.rvlany .
you
know
fei:J .
·ha.s
anybody
ye s ,
f r on cho l e r a
1.
F r i e nd
3.
B o·th .
1'0 Ur
2.
No .
2 .
Re l a t ive
wh o ?
To -vv-h a t e x t E:n t
ln
s u f fe :c sd
the p a.s t: ye ar ?
]_ . Y e s ..
If
13.
Ve r y
du r: i ng
I
I
1.
do you
C� C ii.lE11.1t-l l. ty
th i nk
th i s
1.
Ve ry po s s ib l e .
3.
No t p o s s il) J. e .
cho l e :c a m igh t
o c c ur
ye ar ?
2 .
P o s s ible .
__ _ _ _ _
4.
5.
of
you r
fr i e n d s
yo u m ight
a. l s o
get
If
any
Wh a t
choler a ,
i t. '?
l.
Ver y po s E� ib .l e .
3.
Not po s s ib l e .
2.
are c ommo n to
s yrnptoms
do y o u th i nk
the
P o s s ib l e .
person
s i ck "ivi·th
cho l e r a?
1.
Vom i t i ng .
2.
Lo s s
3.
D i ar rh E: a .
4.
T•;Ji tch ing·
6.
P a in
5 . Co ugh .
7.
6.
If
of
in
temper atur e .
o f mu s c l e .
Ute
ch e s t .
'I h i r: s t .
'
a man h a s h ad
cho ler a
onc e ,
h e wi l l
never
get
it
ag a i n .
l.
7.
Do
you
2 .
T rue .
·th i nk
ch o l e r a i s
s t. i l l
False .
a p r ob l em in your
c ornmun i ty?
1.
8.
2 . No .
Ye s .
Wh a t d o you
t h i nk Ure po s s ib i l i ty o f you r
cho le r a so m e t i m e
i n the
l.
Ve ry p o s s ib le .
3.
No t. p o s s ib l e .
f u tu r e ?
2.
P o s s ib l e .
a c qu i r ing
9.
110 .
II
Al� e you _ ·v1o r r ied th aJc yo u ;:n igtrt tJ e -t ch o le r a. ?
H ave yc>u
1.
ll .
ever
whe n ?
Wh a t
you
Gre a-t e r .
3.
Le s s .
Mark the
I
th ink
1.
·2.
No .
( no t e
ge tt. ing
ag e g ro up
No .
cho l e r a '?
Ye s ..
I f yes ,
do
h ad
2.
the
ch an c e s
cho l e r a
as
(s)
l.
Cho l e :c a
2 .
O n l y poor
3.
Cho le r a niay
About
y o u th i nk
c anno t ·h app e n
people
o c cur
get
\vi t.h ch i ld r e n ·?
c omp a r ed
2.
s t a.i::.erne n·t
o f people o f your
are
is
in
th e ;:-; ame .
( are ) c o r r e c t .
ad u l t s .
cho l e r a .
both i n
adu l-t s
and
ch i ldr e n .
13 .
V.lh a t k in d o f p e r s on do you
of
g e t t ing
---
1.
th ink
has
a
gr e a te r
ch ance
cho l e r a ?
One who
do e s
no t
v a c c i n a t ion .
t ak e
cho l e r a
2.
One who
3.
One
who
does
n ot
t ak e
4.
One wh o
doe s
no t
smok e .
-.__.:-1,o
e s not h ave
an
a
or
ad e qu ate
T AB C
d ie t .
d a i ly b ath .
I
I
I
J
P o r c E d v e d s e------·----.¥v e r i t:Y'
-------·�------··
·
Do you
cho ler a i s d ang e r o u s ?
th ink
1.
Ye s .
I f ye s ,
\vhy ?
2.
1.
I t. may
cause
de a th .
2.
I t. may
c au s e
i l lne s s
3.
I t may '.ve ake n h e a l th p e rm an e n t. ly .
4.
I t mav
-'
Wh at v.;o u ld you
c au s e
d am ag e
do
you
if
�6.
�7 .
vJh a t
though t
t r e atme nt
2.
S ee
other pr a c t i t i one r .
3.
Wai t
see
and
4 .
Wait
unt i l
5.
Make
p r ay e r
do
you
th ink
in
your
1
.
.
3.
you h ad cho l e r a ?
i t would c.;o
if
it
is
to
are
immed i a te ly .
away wi thout
s e r ious .
God .
the
symptor:1s
th ink
o :E
d ie d o f
c ommun i ty ?
2.
f ew .
d ay s .
o rg· ans .
f j-:-orr phy s i c i an
do y o u
H any .
Ve r y
s ev e r a l
to body
G e ·t
How m any p e o p l e
y e ar
for
1.
t r e atment .
I
No .
Few .
c ho l e r a ?
cho le r a
last
1! 6
D o y o n pe r s o n a l ly know
wi th i n
If
19 .
t.".b. e
pas t t.h r e e ye ar s ?
1.
Ye s .
yes ,
11Jh o ?
Mark
1.
Re l a t i ve .
3.
B o t.h .
the
1.
Cho l e r a
2.
Cho l e r a may
3.
Tho ugh
Wha t
o th e J::
is
not
2.
No .
2.
Fr i e nd .
is
t::. u e .
d an g e r ou s
c au s e
d e ath
to
if
l i fe .
t r e a te d
not
t im e .
cho l e r a
20 .
you ·th ink
s t a tement
in
d i e d o f cho l e .I: a
anybody who
it may
is
t h i ng s
·t ake
a
not
are
mo1.· e
c cn:mmn i ty th an cho l e r a ?
a.
l ong
d e ad ly
t ime
to
d i s ease .
r e c ove r ,
thr e <::.. ten ing to your
( l i s t. n o m o r e than th r e e )
l.
2 .
3.
Mark th e s t ateme n t
1.
2 .
(s)
w i th wh i ch
you
a gr e e .
I d o no t b e l ieve cho l e r a o r 'T AB C v a c c i n a t i o n
wi l l h e lp p r e v e nt cho le r a .
Cho le r a
or
p r e v e n t ing
b e c au s e
the
TAB C
v ac c i n a t i o n h e lp s
cho l er a ,
but
I
d on ' t
in
t �< e
it
I am n o t wo r r i e d about g e tt i ng
d i s e as e .
. •
3.
I am ·wo r r i e d abou t g e tt:: i n:c; cho l er <'t , s o
war1t. t o t ak e cho l e r a or Tl'l.BC v ac c i n at. i o n
·to p r e v er::. t the d i s e a s e .
4 .
Cho le r a
I
i t c an b e
a m i ld d i s e a s e 1
is
d e f in i t e ly c ur e d
if
o c cur s .
it
PERCEP'E I ON OF CAUSE
l.
th a t
W ab: ' r
come s
f r om p i p e
l in e
1 . Ye s .
2.
th at
Water
g r ound
is
2.
c ome s
s afe
f r om
to
the we l l
Mark
·th e
dr i nk .
to
No .
th a t
deep
lS
the:
in
dr i nk .
l . Yes .
3.
s afe
is
2.
s t a·temen t
(s)
you
th i nk
1.
O c cur r: e n c e o f cho J. e r a
2.
Cho l e r a i s
p e o p l e :[or
a
is
No .
( ar: e )
is
::1
c or: r: e c t. .
n a tur a l phenome n a .
God- g iv e n p un i shment to the
m i s c o nd r:.cb: : an d b r e .::t ch o f
t.h e i r
mor a l c ode s .
Poor
3.
lS
nutr i t i o n
a tt a c1<" .
C h o l er a i s
4.
5.
Impr oper
a d i s e ase
d i sp o s a l
o f pu r e wa·t e r
c o nt r i bute
4.
Mark
·th e
1.
s t a t eme n t
Flies
c an
2.
3.
Flies
may
c au s e d by
ev i l
spirit .
o f h 1..;m an w a s t e s and l a ck
are the f a c t.or s -ch a t.
s upp ly
to ch o l e r a c a s e s .
(s)
y ou
are h arm f u l
c au s e
t.he m a i n c aus e o f ch o l e r a
th ink
to
is
( ar e )
t r ue .
peop l e be c au s e
they
cho le r a .
c arry
cho l e r a g e rm s
so
they
c an b e
h arm f u l t o p e o p l e .
F l ie s
h ave
J::.h.o.l.e.l:'.a
..._ ....� �-···· ...... .. .... �---....>< .........
n o t h i ng
........ ..... ....... ...... ........ .
to
d o w i th
the
s pr e ad
of
5.
Water
is
a God-g i v e n
g i ft
s o it do e s not c arry
d l s e r: s e g erms .
l.
6.
2.
Yes .
R iver wat e r
i s h o ly ,
th e r e f or e ,
No .
it
not c au s e
doe s
cho ler a "
1.
7 .
I t i s man ' s
l.
2.
Ye s .
fate
to
get
cho le r a .
Ye s .
2.
PERCEPT' ION
1 .
No .
Mai·k wh a t. you
OF
No .
PREVEN'l' ION
t.h ink 'v'To uld b e
the
aprn:·opr i a.i::e
me thod
o f pre\lent irlg c"l1.o le r a .
2.
l.
B y d r ink ing
2.
B y Y/(�.r sh ipp i_:rig God .
3.
By e at i ng n ut r i t i o u s
4 .
By h av ing d a i l y
I f a p e r s on
th i nk
food s .
exe r c i s e .
in your comraun ity h ad cho l e r a -v.rh at do yo u
o th e r s
d i s e a s e ?·
pur e w a t e r .
s1""10 u. l d
{.M:ark
th e
do
in
order
p r e f2r r e d
S tart
t.ak i ng
cho l e r a o r
2.
It
is
e n tJ ugh
if
3 .
·to
get
the
ac t i on )
1.
they
not
TJ'ill C v a c c i n a t io n .
don ' t
go
·to
see
t.h e
p a t i e nt .
S t ar t wor sh i pp i ng
or
g iv ing
s ac r i f i c e
to
God .
3.
Mark t.he
1.
2.
s t<xi.::. e rne n t: you
If
a
th ink
per s o n wi t.h
+.:rue .
J_ s
cho l e r a d i e s ,
the
di sease
g oe s aw ay w i ·th h im , s o t:he r e i s n o d ang e r
o f ·the d i s e a s e b e ing ·t r an smit. ted t o o t.h e :r· s .
Even
if
a p at i en. t wi th
d i s e as e m i ght: be
his
c loth e s
ch o l e r a d ie s
tr ansm i t ted
and o th e 1�
·to
pe r s o n a l
the
o·th e r s
if
art. i c l e s
a r e not d i s p o s e d o f prop e r l y o r w a sh e d
we l l w i th
4.
5.
s o ap
and ho·t w a t e r .
cho l e r a c an b e
S o m e p e op l e
fee l
thro ugh
th e
s tool
and vorn .:L t
wh at:
do
you th ink
abou t · i ·t ?
l.
Agr e e .
3.
Don • t k now .
If
a
of
th e
·th a t
____
f r i end o f you r s
1 .
2 .
3 .
f o l l ow i no:;
suf fered
S ug g e s t
and
D i s agr e e .
f r om cho l e r a how m any
s ·t e p s wo u ld you
tha·t he b e
p r e f e r r e d home
Go
ch o le r a p at ient ,
2.
S ugge s t th at h i s f am i ly
h o s n i t a 1 f o r t r e a tment .
your
see
t ake .
·t o
t ak e h im
i s o l at e d
t r e a·tm e n t by
if
·th ey
a phys i c i an .
th e p a t i e n t b e c au s e
it
is
duty .
4.
Go and s e e
bette r .
5.
It. i s g o od to
t r e a tment: but
·to h i s
6.
a
of
t r an s m it. ted
S ugg e s t
th e
f am i ly .
p a t ien t
th a t he
may
feel
t ak e h im to a h o s p it a l for
I d on • ·t want to s ay anyth ing
th a t h i s
s ac r i f i c e
so
f am i ly p r om i s e
and wor sh ip
to
God .
s ome
50
6.
7.
8.
�fu at i s your
s 6urc o o f dr ink ing
wate r ?
1.
We l l .
2 . River
3 .
P oo l .
4.
'I'ube ,,,e l l .
5.
c r e ek .
6.
L ak e
7.
P ip� l i ne r e s ervoir .
Why do
r? ome p e op l e bo :i. l vla tE': r before d r i nk ing
dur ing
cho l e r a
1.
'I'o
2.
T o mak e
3.
They
4.
It
Wh i ch
th e
e p i d em i c ?
of
kill
so f t .
the
t a s te .
the i r h ab it. .
is
of
it
l ik e
f o l l ov:ing h v.b i t s
the
·time
ch o l er a g e r m .
a
chc l e :r ct
do
you
f o l low dur i ng
e p i de m i c ?
' +l
·-
2.
3.
9.
Why
at
I
add
I
j u s t.
to
potash
dr ink
in
the
·the
.
w ater b e fo r e d r i nk ing
,,l a t e r w i tho ut.
d o .Lng
it .
any th i n•:r
it .
do
s ome
people
the
t ime
of
a
add
p o t a sh
ch o le r a
to ·the i r dr :i.. nk in9 ,,,ra·t e r
epidemi c ?
51
·why doe s
the
gov e rnment
or
V·l at e r
s upp ly
company
add
ch lor ine to the wate r ?
11 .
Are
·th e r e
are
mo r e
s ome.
o th e r
impor t ant.
ne8d s
t.o
o f your s
you than
th at. you
t.:h :Lnk
·the need o f pl:e?e n t inq
cho l e r a ?
2 .
If
ye s ,
1.
2.
3.
I
112 .
I
wha·t
are
the y ';'
(L i s t.
No .
no mo r e
t.h an
thr e e )
---·-·---..--------·
-·-----··--·--·-· ---- ·-----··----- ---
------ ------ ·-----
Wh a·t
do y o u th ink a r e the mo s t impor -t ant problems
your
c ommun i ty·::·
( L i s t no mo r e
th an
thr e e )
1.
2.
3.
---..- -..--.----
in
52
3.
The
f o 1 1 (;\<T ing-
i de a s
Do
or
impor t ant
1.
'J� ake
·
cho l e r a
b e fo r e
1.
2 .
3.
4.
l.
6.
1.
you
f e e l.
oM
t:h a t they ar:e
vacc ination
o f human w a s t e s
ln
s upp ly
____
th a t p e o p l e
Not
imp o r t cm t .
a proper
---·- 2 .
Impor t an t .
e v e r y ye ar
s e a s on .
---·- 2 .
Impor t an t .
S ug ge s ·t.
---·
___
TABC
Imp o r t. ant .
cook e d
5.
or
M a i nt a i n pure w at e r
___
-
impor t ant. ?
t.l"w ep idemic
D i sp o s al
l.
not
� uaae
s ted a s wavs o f
�
have b e e n
Not:
t a s r u. on .
irnpor t ant� .
s y s tem .
2 .
e at o n ly
No t
imp o r t ant
fr e sh
.
and we l l
f oo d s .
Impor·t an t .
S ugge s t
--
th a t p e o p l e
· 2 .
Not
imp o r t.ant .
r e duc e h ar d - t o - d i g e s t
foo d s .
1.
2 .
li11.por t ant .
S ugg e s t
t h a t p e op l e
avo i d
Not
impor t an t .
ove r e at ing .
Impor t a.J."lt: .
2.
No t
impo r t e>.n t .
Cho l e r a
is
so
ar.y
a c t ion
p r ev e n t
the
1.
l.
a G od - s en t d i s e a s e
Ye s .
di se a s e
wi l l be
ag a i n s t
2 .
No .
t ak e n
·to
the w i l l o f God .
r.
---�---��---· ·---·······
--····· ····--------�--�··--··-··-
11 5 .
Do vou be l i eve
m ight:. lw lp
116.
I
1I17 .
l.
Do
.
..�-
" ..........,... .
.
.
...... ·---- ..... . .... .....
t:.h at i s o l a t i o n o f ·th e ch o le r a p a ·t i e n t
2.
Ye s .
1.
.. .......-.
in d e c r e a s i ng t.h e spr e ad o f ·t.he d i s e a s e ?
f l i e s he lp
V.."hy do
....... --.�--------···�· ..... ..... � .......�-·-- -··" ....... .
ln
s p r e ad ing
2.
h e a l th
wo r k e r s
or
�'ABC v ac c in a t i o n ?
If
a
No .
ask. Uw pe o p l e to t ake cho l. e :r a
I
I
18 .
t ime s
fr i e nd
,
o f y ou r s vom i t s
"'·<'h a t wo u l d yo u
and h a s
s ugge s t
d i ar rhe a
th at h,�
or h i s
s ever a l
f am i ly
do ?
I f y o ur
do yo u
k e ep
I
�
�
ne ig�hb o r i ng
a
cho l e r a e p i d em i c
th ink th a t s ometh ing c an b e d o n e in o r d e r to
th e
di se a s e
1.
Ye s .
I f ye s ,
wh at
-
c omm1.1.11 i ty h 2. s
f r om
c om i ng
intc your c ommun ity?
2.
c an
be
done ?
No .
I
1
l
I
No .
cho l e r a ?
Ye s .
,
.. . .
54
0.
Hark
the
( s ) yo u
s t a teme n t
1 . Cho ler a
Ch o l e r a
3.
A Man h a s
4.
It
is
a man ' s
5.
It
is
a n a·tu r: a l
c anno t be
( c:;_ :r: e ) tr ue .
e r ad i c at e d .
s u f fe r
to
in h i s
o c c ur
J. s
p r eve n ·t ab l e -.
2.
once
th ink
f � om
cho l e r a
at
f at e
to
f r om cho l e r a .
su ffer
proce s s
for:
in i:h e c ommun ity o n c e
ye ar s .
ch olera to
i n a ye ar
s e ve r a l
6.
Man
c an p r e v e n t
7 . Ch o l e r a
le ast
l i fe .
c anno t
ch o l e r a
be
i f he
preve nt:ed .
tr i e s .
or
c.: ,_.,
....; _;
c.
of
An a l y s i s
d at a g a·th e r e d by m e a n s
'Ihe
m a t i on
such
c ou l d be
s u r v e y·
a�
Data
U1 e
---- -·----.,.__ � �--------=
·
-------··
age ,
of
th e h e a l th i n f o r -
a c c ord i ng
an a ly z ed
re l ig i on , o c c upat ion ,
sex ,
The p e r c ept i on _ o f thr e at ,
c a� s e ,
·to
a nd
v ar i ab l e s
educ ation .
and p r ev e n t i on o f
ch o l e r a m igh t b e depend e nt "l< pon e ach o f the v ar i ab le s .
T"h e r e m ay be
thr e e br o ad c a t e g o 1� i e s o f p e op l e
r u r a l c ornrnun i t i e s o f Nep a l :
the
trajitional ,
in
c on s er v a t i v e
a n d p r og r e s "-; .:i_ve .
people
The
qu i t e
r ig i d
it be c om e s
beh av i o r
to
1n
t r ad i t ion a l
in the i r b e l i e f s
d i f f icu l t
a
s c i e nt i f i c
d ir a c t ion .
s e em
o f l i v i ng
and ways
ch a n g e ·t:he i r
to
g r o up
at t i tu d e s
to be
Thus ,
.
and
·Th i s m ight. be
due
r e l i g io u s be l ie f s .
The
cri tical
to
the
ln
people
in
ac cept
ide as
s u ch
we l l be iiLg .
The
new
propo s e d
and
ch :::m g e s 'H0 1...d d be
Age
and
ch a�1g e s
They
if
appr o p r i a·te
e d u c ai.:. i.on m igl1 t
be
the y
to be
s e em
feel
to the i r
in f Lt en c i n�;
i n ·t:.�'l i s g T oup .
1 - fac tor s
I
i d e as
and
c o n s e rv at ive g r oup tend
th i nk i n g and J Uc�s en;.e r::. ·f: .
th .;::, i.r
�J.ew
U1 e
in
ide a s
be h igh ly
th em ,
is
fall
into
people
in
the
and propo s e d
s u s c ep t ib l e
progre s s .
th i s
pr ogr e s s ive
ch ang e s
to
c a tegory .
r e a d i ly .
chang e s
G e ne r a l l y ,
group
S lGce
young
t end
Tl1ey
to
s e en1 to
any chang e ,
p e op l e
a c c� e pt�
tend to
for
56
r· --···
•·n · -·····��-·-�----·-··�--�·---·�-�---·-·--�-·-·-"···�--- n· •-··· ·· ········ · ·
---- - - -
�� ng -'tiiE:� - ,o;:rl.a.-J�Ysi s
Foiio�I
to a s s ig n pe .:c s ons
p o s s ib l e
d e s c r .ibed .
s ep a r a t e
t.he n b e
b e i ng·
and
(�I -tE�� -cra.Fa
to one o f
--·····--------·--
Tf -nl.I.9T1F_b_e__ _
t.l1 e thr e e g- r oup s
The . 2.dvant. ag e o f s o do ing wo uld be i.:h a t.
s p e c i f i c h e a l th
d e v e l op e d
d i f fe r e nt.
appr o ach .
.... . ...... .... .....---�-·-··----............. ... ............ ..... ..... .�
for
ed u c a t ion prog r am s
e ach of t'h e gro-up s .
r e qu i r e s
could
'The g r oup s
a d i f fe r e nt h e a l th ed•.;.c a·t ion
'!�
·----- - - -
-- -
�-
.. " 1
i
CHAP'rER IV
S U�JIV.\.RY 1\J:m
Human per c ep t i o n
of
s i gh t
h e a r i ng ,
,
c o n c e pt s ,
v a l ue s ,
m e a n i ng s mu s t
uat i o n
is
and
perc eption
upon h i s
a J. s o upon h i s
pe r s on a l
a dd e d
and
by h i s
the r e f o r e
is
to
Cho l e r a
c ountr i e s
s u.ch
Th i s
p e r c ept i o n
and p sycho l og i c
k g r ound .
r·t
need s ,
is
d i f fe r e:n t for e ach p e r s on .
l.n
r e s pe c t
t. ak e
th at
wi l l
the
to
is
also
thr e at.
a f fected
pe r c ep i: i. o n
a f f e c -t b eh z.v i o r ,
i n to
is
a maj or
hea lth
as
Nep a l .
H ov;eve r ,
it
c o n s i der a. t i on .
prob l em in deve l o p i ng
A nt1rribc-;!� o f r e s e o. r che r s
pr a c t i c e ,
o f he a l th a c t io n m 2.y be d·L.ce
'
p e "L c ep f� J.
on .
to
it .
s i t-
any
m a n y me a s ·u.r e s th a t
t ak e :1 ·to s o lv e th e prob lem ar e no t pu t into
could b e
s ar y
to
and
In o r d e r to p l ar. h e a. l th e d u c a.·t ion
act. iv i t i e s
n e c e s s ar y
reacts
t.h-2 p r omo t i o n o f he a l th
or
or
Man
s o c i o - c u l t ur a l b ac
p e ."!:' c ep-t i on .
p r og r ams
.
Ideas ,
r e l a t i o n sh ip s ,
phy s i o l og i c
Hmv a p e -r: s on beh ave s
o f d i s e as e
of
t.h e me r e
a n d touch .
t as t e ,
to how he pe r c e iv e s
a c c o rd i ng
depende nt.
ext end s b eyond
sme l l ,
a l s o be
CONCL US JON
I f s ucb
J. s
d e t e r m i n e wh at
ope r at ive
in
the
S l.1 J g e s ·t
th a t
l ac k
s e em
nece s -
·
tc s e v e r a l c omponent s o f
c ase ,
c omponen t s
it. wo u l d
o f P'� r c ept i o n
a par t i c u l ar p opu l at i on g r oup .
are
Th e n
an
58
e d u c a.t. ion a l p r og .r. am
P a- t i c, �l -l ar
..:...
�
.
......
fare�
o. f
· ·-'-
-
Th i s
s ur v ey
s tudy
i n s trument
c ou ld be
thr e at ,
c au s e ,
g ath e r e d b y
i n f luence
p r og r am s .
in
n � r c en�_. i c1 r. !
."'- t;::: _
J-
..
r ep r e s en t s
for
o f h e a l ·th pe r c ept. i on
deve loped
t.h e
an
.
an
attempt
t o deve l op
d e t. e rm i n ing v a r i o u s
in
r.· e l a. t i o n
and pr event i o n .
such
to a f fe c t a
t.o
The
d e t e r m in a t i o n
c omponent s
cho l e r a
a n a lys i s
in s t r umen t. vvo uld be
of he al·th
a
s uch
as
of
data
a g u id ing
e d uc a t io n
B IBL IOGRAPEY
2.
Al lpor t ,
F l. oyd
3.
B a urng ar t.ne r , L2on a. .
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1 G .: 2 3 -- 2 8 ( J ar. . ·- F 9b . , 1 9 E 3 ) .
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9.
Ehr l i ch ,
Bew�,
C a �ol N .
David A l an .
92 : 4 3
( Ju ly ,
1 . Gordon , J'or m E .
( ed . ) .
1967 ) .
Co:n t r o l o f C ontrnun .i. c ::tb l e
D i s e a s e s i n Man .
Ne\-l-�-lc·:r·k.-;---;:rhe·--�!1.1ner i c a.n-Pub l i c
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and I n•Tin M . R.o s c:, n s t:ock .
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24 .
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F l o r i d a S ·t a t e B o a.r d o f H e a l th ,
6,
1964 .
27 .
0.
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P au l , B e n j am i n D .
( ed . ) .
Nevl Yo�:k :
fgmmc�_;:-d. t.y_ .
1955 .
28 .
Ro s e n s to ck ,
S ugg e s t s
I .
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l n Mo t iv at: i o n
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11\iV.hy P e op le F a i l t.o S e ek
P o l iomye l i t i s Vac c i n a t ion , 1 1 P upl.:i c He al·th R�o r -t s ,
C a r :c ig e r .
B arb a r a K .
7 4.: 9 8 - 1 0 3
( F eb . ,
1959) .
F l oyd L .
_?�_�ho loqy__ 2lD.9,_� i_f e .
S co t "c , F or e sm::.-,n and C omp a n y , 1 9 6 7 .
30 .
R u ch ,
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S o c i e ·ty o f Pub l i c He a l th E duc a to r s ,
Inc . ,