Magico-religious articles such as amulets, strings, and Buddha images are commonly part of treatment or prevention of illness. Other spiritual or magical means of treating illness include blowing on the sick person's body in a prescribed manner and showering or rubbing with lustral water. As noted earlier, many Khmer see no conflict in practicing or using traditional or magic means of treating illness simultaneously with western medicine. Many would further see no conflict in adding Christian prayer to the mix. Major issues in providing quality care are difficulty obtaining accurate and complete assessment, lack of compliance with medications and treatment, and a reluctance to be involved in preventive measures.
Communication is a major issue in assessment and all other phases of care.
Communication barriers may be due to language or to cultural issues. The latter include attempting to use a translator who, for gender, age, social status, or past relationship incompatibilities, may be rejected or not listened to. Assessment is complicated first by a reluctance to complain or express negative feelings. It is common for patients to not report or even to deny symptoms or problems. This may be a cultural issue or may be due to past difficulties in obtaining health care.