www.blackwellpublishing.com/journals/afm 23 ORIGINAL ARTICLE Asia Pacific Family Medicine 2003; 2: 23–26 Blackwell Science, LtdOxford, UK AFMAsia Pacific Family Medicine1444-1683© 2003 Blackwell Science Asia Pty Ltd 21March 2003 046 Patients with non-acute pain CL Teng et al. 10.1046/j.1444-1683.2002.00046.x Original Article2326BEES SGML Correspondence: Dr Cheong Lieng Teng, AM (Malaysia), M. Fam Med (Malaya), FAFPM, FRACGP, Senior Lecturer, International Medical University, Jalan Rasah, 70300 Seremban, Malaysia. Email: tengcl@imu.edu.my Health beliefs, concerns and expectations of patients presenting with non-acute pain: A preliminary study from a government health clinic in Malaysia Cheong Lieng TENG, Zakiah Mohd JAMIN, Nor Izwah Mohd KAMARUDDIN and Siti Aisyah IDRIS International Medical University, Jalan Rasah, Malaysia Abstract Aim: This study explored the health beliefs, concerns and expectations of primary care patients pre- senting with abdominal pain, headache and chest pain. Methods: Over a 6-week period, 107 adult patients with symptoms of pain were interviewed using a semistructured questionnaire. Results: The presenting symptoms of these patients were: abdominal pain, 41; headache, 35; and chest pain, 31. Females made up 53.3%; the ethnic groups were Malay (35.5%), Chinese (18.7%) and Indian (45.8%); and 71.8% of the patients had primary or secondary education. The patients’ attribu- tions of their symptoms were predominantly non-medical in all three ethnic groups. The non-medical causes mentioned include food, trauma, stress, weather changes and winds (‘angin’). Only two fifths of the patients mentioned disease-specific concerns. Three quarters of these patients expected either medications or wanted the doctor to look for serious causes. Very few patients specifically wanted referral or special tests. Conclusions: The patients in the study had health beliefs and concerns, in view of their non-medical focus, that was at variance with those of the health care providers. However, having decided to consult the health clinic, they were mainly looking for symptomatic relief or evaluation for serious pathology. © 2003 Blackwell Publishing Asia and Wonca Key words: concerns, expectations, health beliefs, pain. Introduction The patient who has decided to consult a physician brings with him his unique view of his illness. This illness experience includes four dimensions: (i) his health beliefs about what is wrong with him (his ex- planatory model or attribution of the symptom); (ii) his concerns or fears (e.g., of a specific disease or com- plications); (iii) the effect of the illness on his daily function; and (iv) his expectations of what should be done. Clinician-researchers at the University of West- ern Ontario cogently argued that physicians should refocus on the patients, in spite of the spectacular advances in the diagnostic and therapeutic modali- ties. 1 Patient-centered medicine, which has as an essential component the exploration of the illness experienced by the patient, is proposed as a solution for the unmet needs of the patients we see today. 1 Pain, with its myriad sociocultural influences on the patient’s behavior 2 is the subject of the present study. In this preliminary exploration of the patient’s per- spectives of his illness, we are particularly interested in finding out the extent of the disease-specific health beliefs and concerns expressed by these patients. Accepted for publication 25 September 2002. ORIGINAL ARTICLE