Patient narratives of illnesses requiring abdominal surgery in Cambodia: Heroic/stoic, and dealing with 'the ball of meat'

• Published in: Global public health Vol. 15; no. 5; pp. 763 - 775
• Main Authors: Page, Wendy, Murray, Linda, Phun, Khann, Turner, Richard
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03-05-2020; Taylor & Francis Ltd
• Subjects: Abdomen; Abdominal pain; Abdominal surgery; anaesthetic; Ancient Greek philosophy; Cambodia; Content analysis; Cost control; Health care expenditures; Health services utilization; Help seeking behavior; Illnesses; Intervention; Interviews; Meat; Medical treatment; Narratives; Patients; Recovery time; Rehabilitation; Stoicism; Surgery; treatment-seeking behaviour; Cambodia; treatment-seeking behaviour; Cambodia; anaesthetic; surgery
• DOI: 10.1080/17441692.2019.1636113
• EISSN: 1744-1706
• ISSN: 1744-1692

This study describes the illness narratives that inform treatment-seeking behaviours for acute abdominal conditions in Cambodia, and thereby explores factors impeding the timely delivery of surgical intervention. Semi-structured qualitative interviews were undertaken with patients who had undergone abdominal surgery at Siem Reap Provincial Hospital between 2011 and 2014. Interviews collected basic demographic information and also patient narratives based on Groleau's McGill Illness Narrative Interview (MINI). Interviews were contemporaneously translated from Khmer to English and recorded for transcription. A content analysis of interview transcripts based on narrative enquiry was undertaken. Ninety-seven patients participated in the study and five themes emerged from the data. These were: Explanatory models about the causes of abdominal pain and effects of surgery; Pre-surgery stoicism and illness management; Fear of poor outcomes and death; Burden of treatment costs and anticipated recovery time; and, Enhancing community trust in surgery. Our findings add the patient voice to the limited evidence about access to surgery, and socio-cultural and financial barriers affecting treatment-seeking behaviours in Cambodia. By understanding the collective narratives surrounding experiences of abdominal surgery, efforts to improve surgical services in Cambodia may be better informed of the reasons patients delay treatment.