Western or Traditional Healers? Understanding Decision Making in the Hmong Population.
Maichou Lor, Phia Xiong, Linda Park and 2 others
PMID 26941160WHAT IT FOUND
Hmong patients chose Western care first for visible injury, severe sudden pain, or unexplained swelling, and traditional healers first for paleness, slow pain, fear, or low energy.
Switching followed perceived treatment failure.
Key findings
01Participants classified illness as spiritual or non-spiritual. Visible signs such as fracture, burn, or swelling pointed to Western care, while pallor pointed to a traditional healer.
02Severe, sudden pain with unknown cause or impending doom led participants to Western doctors first. Ongoing pain without significant severity was often seen as spiritual, and participants sometimes saw a shaman first.
03Participants switched providers when symptoms persisted or treatment seemed ineffective. A Western diagnosis without visible proof such as an x-ray also led some to seek a shaman.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was part of a larger cancer screening project, so it did not follow participants over time to see how decisions changed. All participants had recently visited a primary care provider, so they may have been more oriented to Western medicine than Hmong patients who do not seek care. The sample was small and came from a Midwestern health system, so the findings may not apply to other Hmong communities. Interviews were translated from Hmong to English, so some original meaning may have been lost. The study examined shamans and Western providers only, not other traditional healers, Christian healing, or concurrent use.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that Hmong patients reject Western medicine or are simply non-adherent. They switched providers when symptoms persisted or when a diagnosis lacked visible proof, and they often used both systems at different points.