Disclosure of Traditional and Complementary Medicine Use and its Associated Factors to Medical Doctors Among the Longhouse Community in Julau, Sarawak

  • Noorzilawati Sahak
  • Jeffery Stephen University Malaysia Sarawak
Keywords: TCM use, disclosure, longhouse community, Sarawak, attitudes


Traditional and Complementary Medicine (TCM) practice is increasing worldwide and Malaysia is no exception. Despite the wide use of TCM by the population, there seems to be an issue of not disclosing TCM use to their medical doctor. The aim was to explore the related factors that influence the disclosure of TCM use to medical doctor among respondents in selected longhouses in Sarawak. A cross-sectional study was conducted on 90 respondents from selected Iban longhouses in Julau, Sarikei District.  Data were collected using face-to-face interview based on questionnaire consisted of sociodemographic characteristics, TCM use and disclosure, health profile, healthcare utilization and attitude towards TCM. To determine the factors related to disclosure of TCM use, independent t-test and Chi-square (χ2) test was used to examine the relationship between various variables and disclosure of TCM use. The mean age of studied participants was 45.20 (±14.92) years and 80% were married. The prevalence of ever used of TCM treatment was 70%. The rate of disclosure of TCM use among respondents was 27%. Univariate analyses yielded three main factors that significant associated with the disclosure of TCM use among respondents which were education level, presence of chronic diseases and type of chronic diseases (heart disease). The rate of disclosure of TCM use in this study is very low consistent with other local and foreign studies. Thus, other relevant factors that are not studied need to be further explored for better understanding in order to have better integration between TCM and current health system.


Abuduli, M., Ezat, S. & Aljunid, S. (2011) Role of traditional and complementary medicine in universal coverage. Malaysian Journal of Public Health Medicine, 11(2), 1-5.

Aina Farhana Zulkipli, Tania Islam, Nur Aishah Mohd Taib, Maznah Dahlui, Nirmala Bhoo-Pathy et al. (2018) Use of complementary and alternative medicine among newly diagnosed breast cancer patients in Malaysia: an early report from the MyBCC study. Integrative cancer therapies, 17(2), 312-321. https://doi.org/10.1177/1534735417745248

Algier, L.A., Hanoglu, Z., Ozden, G., & Kara, F. (2005) The use of complementary and alternative (non-conventional) medicine in cancer patients in Turkey. European Journal of Oncology Nursing, 9(2), 138-146. https://doi.org/10.1016/j.ejon.2005.03.010

Ashikaga, T., Bosompra, K., O’Brien, P., & Nelson, L. (2002). Use of complementary and alternative medicine by breast cancer patients: prevalence, patterns and communication with physicians. Supportive Care in Cancer 10(7), 542– 548. https://doi.org/10.1007/s00520-002-0356-1

Aziz, Z. & Tey, N.P. (2008) Herbal medicines: Prevalence and predictors of use among Malaysian adults. Complement Therapies in Medicine 2009 Jan, 17(1), 44-50. https://doi.org/10.1016/j.ctim.2008.04.008

Barbara, A.M., Byeongsang, O., Esther, L.D., Phyllis, N.B., & Stephen, C. (2012). Cancer patient disclosure and patient‐doctor communication of complementary and alternative medicine use. The Oncologist 17(11), 1475-1481. https://doi.org/10.1634/theoncologist.2012-0223

Bello, N., Winit-Watjana, W., Baqir, W. & Mcgarry, K. (2012) Disclosure and adverse effects of complementary and alternative medicine used by hospitalised patients in the north east of England. Pharmacy Practice, 10(3), 125-135. https://doi.org/10.4321/S1886-36552012000300002

Chang, H.Y., Tiralongo, E., Wallis, M. (2011) Predictors of complementary and alternative medicine use by people with type 2 diabetes. Journal of Advanced Nursing, 68(6), 1256-1266. https://doi.org/10.1111/j.1365-2648.2011.05827.x

Chang, M.L.D., Tam, Y.L.A. & Norazah Mohd. Suki (2015). The prevalence of TCM usage in Sabah, Malaysia. 6th International Conference on Business and Economics Research (ICBER 2015) proceeding. Kota Kinabalu, Sabah. 23- 24 March 2015. https://www.academia.edu/25565378/The_Prevalence_of_Traditional_and_Complementary_Medicine_Usage_in_Sabah_Malaysia

Chang Yi. (2014, December 14). Bertangas – Iban traditional herbal spa. The Borneo Post. https://www.theborneopost.com/2014/12/14/bertangas-iban-traditional-herbal-spa/

Chao, M.T., Wade, C., & Kronenberg, F. (2008). Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM. Journal of the National Medical Association, 100(11), 1341–1349. https://doi.org/10.1016/S0027-9684(15)31514-5

Clarke, T.C., Black, L.I., Stussman, B.J., Bames, P.M. & Nahin, R.L. (2015) Trends in the use of complementary health approaches among adults: United States, 2002–2012. National Health Statistics Report No. 79. Hyattsville, MD: National Center for Health Statistics.

Department of Statistics Malaysia, Statistics on Causes of Death, Malaysia 2019. https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=401&bul_id=RUxlSDNkcnRVazJnakNCNVN2VGgrdz09&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09

Foley, H., Steel, A., Cramer, H., Wardle, J., & Adams, J. (2019). Disclosure of complementary medicine use to medical providers: A systematic review and meta-analysis. Scientific Reports, 9(1), 1573. https://doi.org/10.1038/s41598-018-38279-8

Ganasegeran, K., Rajendran, A.K., Al-Dubai, S.A.R. (2014) Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study. PLoS ONE, 9(11): e112124. https://doi.org/10.1371/journal.pone.0112124

Hatje, V. (2016). Pharmaceuticals. In M.J. Kennish (Ed.), Encyclopedia of Estuaries (pp.481-483), Springer. https://doi.org/10.1007/978-94-017-8801-4_141

Health Technology Assessment Section, Medical Development Division, Ministry of Health Malaysia. (2015). Traditional postnatal care in restoring women’s physical and mental health. http://www.moh.gov.my/index.php/database_stores/attach_download/348/267

Hishamshah, M., Ramzan, M., Rashid, A.K., Wan Mustaffa, W.N.H., Haroon, R. & Badaruddin, N.B. (2010) Belief and practices of traditional postpartum care among a rural community in Penang Malaysia. The Internet Journal of Third World Medicine, 9(2), 1-9. https://doi.org/10.5580/49f

Hopman, P., Heins, M.J., Rijken, M. & Schellevis, F.G. (2015). Health care utilisation of patients with multiple chronic diseases in the Netherlands: Differences and underlying factors. European Journal of Internal Medicine, 26(3), 190-196. https://doi.org/10.1016/j.ejim.2015.02.006

Institute for Public Health (IPH). (2015). National health and morbidity survey 2015 (NHMS 2015), Volume IV: Traditional & complementary medicine. http://www.moh.gov.my/moh/resources/NHMS2015-VolumeIV.pdf

Jamshed, S.Q., Khan, M.U., Ahmad, A., Elkalmi, R.M. (2016) Knowledge, perceptions, and attitudes toward complementary and alternative medicines among pharmacy students of a Malaysian Public University. Journal of Pharmacy and Bioallied Sciences, 8(1), 34. https://doi.org/10.4103/0975-7406.171686

Johny, A.K., Cheah, W.L. & Razitasham, S. (2017) Disclosure of Traditional and Complementary Medicine Use and Its Associated Factors to Medical Doctor in Primary Care Clinics in Kuching Division, Sarawak, Malaysia. Evidence-Based Complementary and Alternative Medicine, 2017, 5146478. https://doi.org/10.1155/2017/5146478

Kleijnen, J., Knipschild. P. & ter Riet, G. (1989). Garlic, onions and cardiovascular risk factors. A review of the evidence from human experiments with emphasis on commercially available preparations. British Journal of Clinical Pharmacology, 28(5), 535–544. https://doi.org/10.1111/j.1365-2125.1989.tb03539.x

Lao, L., Bergman, S., Langenberg, P., Wong, R.H. & Berman, B. (1995) Efficacy of chinese acupuncture on postoperative oral surgery pain. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 79(4), 423-8. https://doi.org/10.1016/S1079-2104(05)80121-0

Lee, G.B.W., Charn, T.C., Chewa, Z.H. & Ng, T.P. (2004). Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Family Practice, 21(6), 654-660. https://doi.org/10.1093/fampra/cmh613

Liu, C., Yang, Y., Gange, S.J., Weber, K., Sharp, G.B., Wilson, T.E., Levine, A., Robison, E., Goparaju, L., Gandhi, M. and Merenstein, D. (2009). Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women. AIDS Patient Care and STDs, 23(11), 965-971. https://doi.org/10.1089/apc.2009.0134

Malaysian Medical Council, Ministry of Health, Malaysia (2001) National policy on traditional/complementary medicine, Malaysia. https://www.mps.org.my/html/National%20Policy%20on%20Tra%20Med%20Malaysia.pdf

Medagama, A.B. & Bandara, R. (2014). The use of complementary and alternative medicines (CAMs) in the treatment of diabetes mellitus: Is continue or effective? Nutrition Journal, 13, 102. https://doi.org/10.1186/1475-2891-13-102

Merriam, S. & Muhamad, M. (2013). Roles traditional healers play in cancer treatment in Malaysia: implications for health promotion and education. Asian Pacific Journal of Cancer Prevention, 14(6), 3593-3601. https://doi.org/10.7314/APJCP.2013.14.6.3593

Mohd Razali, S. & Muhammad Najib, M.A. (2000). Help-seeking pathways among Malay psychiatric patients. International Journal of Social Psychiatry, 46(4), 281-289. https://doi.org/10.1177/002076400004600405

Mohd Zaki, N.A., Rasidi, M.N., Awaluddin, S.M., Tee, G.H., Ismail, H., Mohamad Nor, N.S. (2018) Prevalence and characteristic of dietary supplement users in Malaysia: data from the Malaysian Adult Nutrition Survey (MANS) 2014. Global Journal of Health Science, 10(12), 127-135. https://doi.org/10.5539/gjhs.v10n12p127

Mwaka, A.D., Tusabe, G., Orach, C.G., & Vohra, S. (2018) Turning a blind eye and a deaf ear to TCM practice does not make it go away: A qualitative study exploring perceptions and attitudes of stakeholders towards the integration of TCM into medical school curriculum in Uganda. BMC Medical Education, 18(1), 310. https://doi.org/10.1186/s12909-018-1419-4

National Center for Health Statistics. (2007). National Health Interview Survey (NHIS): 2007 data release [online]. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2007/althealt_freq.pdf

Nordin, M.S. and Zakaria, N.H. (2016). Plants used for medicines by the indigenous Malay of Pahang, Malaysia. Medicinal Plants-International Journal of Phytomedicines and Related Industries, 8(2), 137-145. https://doi.org/10.5958/0975-6892.2016.00017.4

Othman, C.N., Farooqui, M., Che Lamina, R.A. & Din, N. (2012). Malay traditional massage therapy (MTMT) seeking behaviours among Malays for their chronic diseases-case study. Procedia-Social and Behavioural Sciences, 50, 591-601. https://doi.org/10.1016/j.sbspro.2012.08.062

Ohemu, T.L., Sariem, C.N., Dafam, D.G., Ohemu, B.O., Okwori, V.A., Olotu, P.N. & Jerome, C. (2017). Knowledge, attitude and practice of traditional medicine among people of Jos North local government area of Plateau state, Nigeria. International Journal of Pharmacognosy and Phytochemical Research, 9(10), 1353–1358.

Orme-Johnson, D.W. & Herron, R.E. (1997) An innovative approach to reducing medical care utilisation and expenditures. American Journal of Managed Care, 3(1), 135–44.

Saxe, G.A., Madlensky, L., Kealey, S., Wu, D.P.H., Freeman, K.L., & Pierce, J.P. (2008). Disclosure to physicians of CAM use by breast cancer patients: findings from the women’s healthy eating and living study. Integrated Cancer Therapies, 7(3), 122-129. https://doi.org/10.1177/1534735408323081

Sirois, F., Riess, H. and Upchurch, D. (2017). Implicit Reasons for Disclosure of the Use of Complementary Health Approaches (CHA): A Consumer Commitment Perspective. Annals of Behavioral Medicine, 51(5), 764–774. https://doi.org/10.1007/s12160-017-9900-6

Siti, Z.M., Tahir, A., Ida Farah, A., Ami Fazlin, S.M., Sondi, S., Azman, A.H., Maimunah, A.H., Haniza, M.A., Siti Haslinda, M.D., Zulkarnain, A.K., Zakiah, I. and Wan Zaleha, W.C. (2009). Use of traditional and complementary medicine in Malaysia: A baseline study. Complementary Therapies in Medicine, 17(5), 292-299. https://doi.org/10.1016/j.ctim.2009.04.002

Sridhar, S.B., Shariff, A., Al Halabi, N., Sarmini, R., Harb, L.A. (2017). Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine. J Pharm Bioallied Sci., 9(1), 48-55. https://doi.org/10.4103/jpbs.JPBS_337_16

Szabadi, E. (2006). Book review of St. John’s Wort and its active principles in depression and anxiety, by Walter E. Müller (Ed.). British Journal of Clinical Pharmacology, 62(3), 377-378. https://doi.org/10.1111/j.1365-2125.2006.02692.x

Traditional and Complementary Medicine Division, Ministry of Health Malaysia. (2009). Traditional and complementary medicine practice guidelines on Malay massage. http://tcm.moh.gov.my/en/upload/garispanduan/amalan/MALAYTRADITIONAL.pdf

Traditional and Complementary Medicine Division, Ministry of Health Malaysia. (2011). A handbook of traditional and complementary medicine programme in Malaysia. https://docplayer.net/20026471-A-handbook-of-traditional-and-complementary-medicine-programme-in-malaysia.html

Wan Farzana Fasya, W.H., Devita. V.D., Nurul Ain, A., Noor Amanina, S., Suriani, I. & Rosliza, A.M. (2017). The use of traditional Malay massage and traditional Malay herbs in Malaysia: a review. International Journal of Public Health and Clinical Sciences, 4(5), 24-37.

World Health Organization (WHO). (2002). WHO traditional medicine strategy 2002-2005. https://apps.who.int/medicinedocs/en/d/Js2297e/5.3.html

Wu, M.S., Chen, K.H., Chen, I.F., Huang, S.K., Tzeng, P.C., Yeh, M.L., Lee, F.P., Lin, J.G., Chen, C.F. (2016) The efficacy of acupuncture in postoperative pain management: A systematic review and meta-analysis. PLoS One, 11(3), e0150367. https://doi.org/10.1371/journal.pone.0150367

Zhang, B., Xu, H., Wang, J., Liu, B., & Sun, G. (2017) A narrative review of non-operative treatment, especially traditional Chinese medicine therapy, for lumbar intervertebral disc herniation. BioScience Trends, 11(4), 406-417. https://doi.org/10.5582/bst.2017.01199

Zhang, Q. (2015). Traditional and Complementary Medicine in Primary Health Care. In A. Medcalf, S. Bhattacharya, H. Momen, et al.(Eds.), Health For All: The Journey of Universal Health Coverage. Orient Blackswan. https://www.ncbi.nlm.nih.gov/books/NBK316267/?report=reader

How to Cite
Sahak, N., & Stephen, J. (2022). Disclosure of Traditional and Complementary Medicine Use and its Associated Factors to Medical Doctors Among the Longhouse Community in Julau, Sarawak. Trends in Undergraduate Research, 5(1), b21-35. https://doi.org/10.33736/tur.2688.2022
Medicine and Health Sciences