Spiritual Explanatory Models of Mental Illness in West Nile, Uganda

2018 ◽  
Vol 50 (2) ◽  
pp. 233-253 ◽  
Author(s):  
Lucia Verginer ◽  
Barbara H. Juen
Keyword(s):  
Mental Illness ◽  
Qualitative Content Analysis ◽  
Participant Observation ◽  
Psychiatric Patients ◽  
Traditional Healers ◽  
Explanatory Models ◽  
Cultural Knowledge ◽  
Research Field ◽  
West Nile ◽  
Holistic View

Integrating indigenous cultural knowledge into conceptualizing mental illness offers highly valuable insights to better contextualize mental health. The meaning given to symptoms determines what is abnormal and requiring treatment. In Uganda, the formal health care system is neither the only nor the most widespread treatment provider. Help is often sought from traditional and religious healers, too. Despite numerous calls for cooperation between the healing systems, this has translated into reality only to a very limited degree. The purpose of this study was to gain insight into local explanatory models of mental illness, to gain an understanding of the different patients’ needs, and to develop a more comprehensive system of care. We used an ethnographic investigation approach, which allowed for a more holistic view of the research field. This was geographically delimited to the West Nile subregion in Northern Uganda. We conducted a total of 56 semistructured interviews with traditional healers ( n = 5), Christian religious healers ( n = 3), psychiatric patients ( n = 16), their attendants ( n = 16), and community members ( n = 16). In addition, we used the method of participant observation. The data collected were analyzed using Qualitative Content Analysis and Grounded Theory methodology. For the purpose of this article, we exclusively extracted the spiritual explanatory models. These were spirit possession and curse. Both were traditional concepts with a religious reinterpretation involving the action of spirits.

Concepts of mental illness and medical pluralism in Harare

1995 ◽  
Vol 25 (3) ◽  
pp. 485-493 ◽  
Author(s):  
V. Patel ◽  
T. Musara ◽  
T. Butau ◽  
P. Maramba ◽  
S. Fuyane
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Traditional Healers ◽  
Explanatory Models ◽  
Psychiatric Nurses ◽  
Medical Pluralism ◽  
Care Providers ◽  
Illness Episode ◽  
Screening Criteria ◽  
Case Vignettes

SYNOPSISThe Focus Group Discussions (FGD) described in this paper are the first step of a study aiming to develop an ‘emic’ case-finding instrument. In keeping with the realities of primary care in Zimbabwe, nine FGD were held with 76 care providers including 30 village community workers, 22 traditional and faith healers (collectively referred to as traditional healers in this paper), 15 relatives of patients and 9 community psychiatric nurses. In addition to the general facets of concepts of mental illness, three ‘etic’ case vignettes were also presented.A change in behaviour or ability to care for oneself emerged as the central definition of mental illness. Both the head and the heart were regarded as playing an important role in the mediation of emotions. The types of mental illness described were intimately related to beliefs about spiritual causation. Angered ancestral spirits, evil spirits and witchcraft were seen as potent causes of mental illness. Families not only bore the burden of caring for the patient and all financial expenses involved, but were also ostracized and isolated. Both biomedical and traditional healers could help mentally ill persons by resolving different issues relating to the same illness episode. All case vignettes were recognized by the care providers in their communities though many felt that the descriptions did not reflect ‘illnesses’ but social problems and that accordingly, the treatment for these was social, rather than medical.The data enabled us to develop screening criteria for mental illness to be used by traditional healers and primary care nurses in the next stage of the study in which patients selected by these care providers on the grounds of suspicion of suffering from mental illness will be interviewed to elicit their explanatory models of illness and phenomenology.

Xhosa-Speaking Schizophrenic Patients' Experience of Their Condition: Psychosis and Amafufunyana

1998 ◽  
Vol 28 (2) ◽  
pp. 62-70 ◽  
Author(s):  
Crick Lund ◽  
Leslie Swartz
Keyword(s):  
Psychiatric Patients ◽  
Traditional Healers ◽  
Explanatory Models ◽  
Psychiatric Services ◽  
Face To Face ◽  
False Dichotomy ◽  
Schizophrenic Patients ◽  
Social Constructivist Theory ◽  
Qualitative Methodologies ◽  
Patients Experience

This study investigates the experience of 10 Xhosa-speaking schizophrenic patients attending a community psychiatry clinic in Cape Town. Drawing on social constructivist theory, and its critique of psychiatric constructions of psychopathology and culture, the study explored psychiatric patients' construction of their experience of their condition. In face-to-face open-ended interviews, patients were asked to describe their experience of their condition and its treatment, and their understanding of aetiology. Analysis of the transcribed interviews employed qualitative methodologies. While patients frequently described their condition in terms of ‘amafufunyana’ or ‘nerves’, they reported that their preferred mode of treatment had shifted from consultation with traditional healers to use of psychiatric services. Discussion notes (1) the apparent anomaly between explanatory models and preferred mode of treatment; (2) the complex uses of the term amafufunyana, which include diagnostic, explanatory and aetiological functions; and (3) in the absence of ‘psychological’ language, the presence of ‘medical’ and ‘mystical’ language. It is argued that the separation of amafufunyana and psychosis is a false dichotomy, since patients employ both in a complex web of psychiatric, religious and social constructions. The importance of the consideration of patients' experience for the development of psychiatric services is stressed.

Causal attribution for mental illness in Cuba: A thematic analysis

2019 ◽  
Vol 56 (5) ◽  
pp. 947-972 ◽  
Author(s):  
Laura Nohr ◽  
Theresa Steinhäuser ◽  
Alexis Lorenzo Ruiz ◽  
Juan Emilio Sandoval Ferrer ◽  
Ulrike von Lersner
Keyword(s):  
Mental Illness ◽  
Latin American ◽  
Thematic Analysis ◽  
Help Seeking ◽  
Causal Attributions ◽  
Causal Attribution ◽  
Psychiatric Patients ◽  
Explanatory Models ◽  
Western Hemisphere ◽  
Cultural Economic

Explanatory models (EMs) for illness are highly relevant for patients, and they are also important for clinical diagnoses and treatment. EMs serve to capture patients' personal illness narratives and can help reveal how culture influences these narratives. While much research has aimed to understand EMs in the Western hemisphere, less research has been done on other cultures. Therefore, we investigated local causal attributions for mental illness in Cuba because of its particular history and political system. Although Cuban culture shares many values with Latin American cultures because of Spanish colonization, it is unique because of its socialist political and economic context, which might influence causal attributions. Thus, we developed a qualitative interview outline based on the Clinical Ethnographic Interview and administered interviews to 14 psychiatric patients in Havana. We conducted a thematic analysis to identify repeated patterns of meaning. Six patterns of causal attribution for mental illness were identified: (1) Personal shortcomings, (2) Family influences, (3) Excessive demands, (4) Cultural, economic, and political environment in Cuba, (5) Physical causes, and (6) Symptom-related explanations. In our sample, we found general and Cuba-specific patterns of causal attributions, whereby the Cuba-specific themes mainly locate the causes of mental illness outside the individual. These findings might be related to Cubans' socio-centric personal orientation, the cultural value of familismo and common daily experiences within socialist Cuban society. We discuss how the findings may be related to social stigma and help-seeking behavior.

Deconstructing Persuasiveness of Online Hotel Review Platforms

2020 ◽  
Vol 25 (2) ◽  
pp. 319-333
Author(s):  
Edina Ajanovic ◽  
Beykan Çizel
Keyword(s):  
Cognitive Processing ◽  
Qualitative Content Analysis ◽  
Participant Observation ◽  
Hotel Management ◽  
Social Psychological ◽  
Structure Characteristics ◽  
Peripheral Cues ◽  
Review Management ◽  
Depth Analysis ◽  
Multiple Case

Considering the significant influence of online hotel reviews on both tourism demand and supply side, these may be considered as a successful persuasive tool. Accordingly, it is necessary to investigate the broader context in which reviews are generated and what are the components that contribute to their effectiveness. The main goal of this study was to analyze the communication occurring on hotel review platforms from a social psychological perspective through understanding structure, characteristics, and functions of attitudes expressed in guests' reviews. In addition, it aims to identify how persuasive cues in review responses should be defined. Following this aim, the authors applied multiple case study design and collected data in several stages through document analysis, participant observation, netnography, and interviews with different stakeholders involved in online review management process. Results of the qualitative content analysis showed that, in order to use the full persuasive potential of review platforms, it is necessary for hotel management to define its presence and visibility on these platforms, to conduct in-depth analysis of structure, characteristics, and functions of attitudes expressed in reviews, and to establish a systematic approach towards use of central and peripheral cues in review responses to induce desired cognitive processing of these messages.

“Hay que Cantar con Ternura”: Baladas Románticas as a Site for Translingual Youth Convivencia

2021 ◽  
pp. 238133772110246
Author(s):  
Cati V. de los Ríos ◽  
Yared Portillo
Keyword(s):  
Music Education ◽  
Participant Observation ◽  
Cultural Knowledge ◽  
Mexican Origin ◽  
Bilingual Students ◽  
Video Recordings ◽  
Music Making ◽  
Schooling Experiences ◽  
K 12 ◽  
A Site

For many Mexican-origin bi/multilingual children, Mexican music education begins early in their home. Music is inextricably linked with the sociocultural context in which it is produced, consumed, and taught and the interrelationship between music, society, and culture. Using ethnographic methods, this article examines a small group of bilingual and emergent bilingual Mexican-origin students who regularly congregated in their English teacher’s classroom at lunchtime to recite and perform romance ballads, or what we refer to as baladas románticas, on a weekly basis. We use participant observation, plática-inspired interviews, focus groups, and video recordings to present ethnographic knowledge about how, for these young people, music was a way of being and a deliberate act to build community. Our findings describe the ways the bilingual students found themselves at the margins of their K–12 schooling experiences and, in turn, agentically fostered their own space for translingual expression and solace. This manifested in two primary ways: (a) how they collectively fostered their own form of convivencia (humanizing coexistence) anchored in their ancestral and cultural knowledge through their music-making and (b) how their music-making allowed them to release translingual and transmodal play and creativity that might have otherwise been suppressed at school. We end with a call for literacy researchers and educators to continue to recognize and honor students’ lived translingual experiences, identities, and musical gifts as resources for learning.

Social stigma in severe mental illness in Tunisia: Clinical and socio-demographic correlates

2017 ◽  
Vol 41 (S1) ◽  
pp. S577-S577 ◽  
Author(s):  
U. Ouali ◽  
R. Jomli ◽  
R. Nefzi ◽  
H. Ouertani ◽  
F. Nacef
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cultural Context ◽  
Social Inclusion ◽  
Psychiatric Patients ◽  
Social Stigma ◽  
Cross Sectional Study ◽  
Local Context ◽  
Cross Sectional ◽  
Competing Interest

IntroductionMental patients generally internalize some of the negative conceptions about how most people view them: they might be considered incompetent or untrustworthy or believe that people would not want to hire, or marry someone with mental illness. A lot of research on stigma has been conducted in western countries; however, little is still known on the situation in Arab-Muslim societies.ObjectivesTo evaluate social stigma as viewed by patients suffering from severe mental illness (SMI)MethodsThis is a cross-sectional study on clinically stabilized patients with schizophrenia and Bipolar Disorder (BD) according to DSM IV, who were interviewed in our out-patients clinic with the help of a semi-structured questionnaire, containing 8 opinions on the social inclusion and stigmatization of psychiatric patients, with special reference to the local cultural context (e.g.: “It is better to hide mental illness in order to preserve the reputation of my family”)ResultsWe included 104 patients, 51% with schizophrenia and 49% with BD. Mean age was 38.4 years (18–74 years); 59.6% were males. Overall social stigma scores were high. Social stigma in patients was correlated with gender, age, place of residence and diagnosis. Patients with BD showed significantly less social stigma than patients with schizophrenia.ConclusionOur results show the need for a better understanding of this phenomenon in patients with SMI, but also within Tunisian society, in order to elaborate anti stigma strategies adapted to the local context.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals HIV, syphilis, and hepatitis B and C prevalence among patients with mental illness: a review of the literature

2008 ◽  
Vol 24 (suppl 4) ◽  
pp. s607-s620 ◽  
Author(s):  
Lorenza Nogueira Campos ◽  
Mark Drew Crosland Guimarães ◽  
Ricardo Andrade Carmo ◽  
Ana Paula Souto Melo ◽  
Helian Nunes de Oliveira ◽  
...  
Keyword(s):  
Mental Illness ◽  
Hepatitis B ◽  
Psychiatric Patients ◽  
Developed Countries ◽  
Chronic Mental Illness ◽  
Review Of The Literature ◽  
Sexually Transmitted ◽  
Lack Of Information ◽  
Representative Samples ◽  
Developing And Developed Countries

A limited number of studies worldwide have investigated the prevalence of HIV, syphilis, and hepatitis B and C infection among psychiatric patients. However, prevalence of these infections in the population with chronic mental illness has not been clearly established. Most of the published papers are from developed countries and have derived from relatively small and non-representative samples. We performed a systematic review of the published literature to identify studies on these infectious diseases within psychiatric populations in Brazil and other developing countries. Overall, prevalence rates varied from 0% to 29% for HIV; 1.6% to 66% for HBV; 0.4% to 38% for HCV; and 1.1% to 7.6% for syphilis. Several risk factors were identified and discussed, although sampling limitations restrict the generalization of study findings. This review highlights the lack of information on the prevalence of sexually transmitted diseases and their associated factors among persons with chronic mental illness and identifies gaps in the knowledge base in both developing and developed countries.

Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness

2021 ◽  
pp. 136346152110583
Author(s):  
Evgeny Knaifel
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cultural Competence ◽  
Severe Mental Illness ◽  
Former Soviet Union ◽  
Health Knowledge ◽  
Qualitative Content Analysis ◽  
Family Psychoeducation ◽  
Family Coping ◽  
Immigrant Mothers

The successful integration of cultural competence with evidence-based practices in mental health services is still limited for particular cultural populations. The current study explored culturally adapted family psychoeducation intervention for immigrants from the former Soviet Union (FSU) in Israel who care for a family member with severe mental illness (SMI). Semi-structured in-depth interviews were conducted with 18 immigrant mothers about their experience of taking part in Russian-speaking multi-family psychoeducation groups (MFPGs). Qualitative content analysis revealed five salient processes and changes that participants attributed to their engagement in the intervention: 1) from a language barrier to utilization of and satisfaction with services; 2) from a lack of information to acquiring new mental health knowledge; 3) from harboring a family secret to exposure and sharing; 4) from social isolation to cultural belonging and support; 5) from families blurring boundaries to physical and emotional separation. The results showed that these changes—linguistic, cognitive, emotional, socio-cultural and relational—improved family coping and recovery. Implications for cultural adaptation of family psychoeducation for Russian-speaking immigrants are discussed.

Team based communication and the healthcare communication space

2018 ◽  
Vol 32 (6) ◽  
pp. 825-840 ◽  
Author(s):  
Janet Alexandra Cornett ◽  
Craig Kuziemsky
Keyword(s):  
Common Ground ◽  
Group Communication ◽  
Qualitative Content Analysis ◽  
Participant Observation ◽  
Content Type ◽  
Individual Level ◽  
Study Approach ◽  
Communication Space ◽  
Support Team ◽  
Healthcare Communication

Purpose While previous studies have described structural, process and social aspects of the healthcare communication space there is no overall model of it. Such a model is an essential first step to improving the operationalization and management of healthcare communication. The paper aims to discuss these issues. Design/methodology/approach This paper used a case study approach to study team-based communication on a palliative care unit. Non-participant observation, interviews and documents were analyzed using qualitative content analysis. Findings The analysis developed an overall model of the healthcare communication space that consists of five stages: purpose, practices and workflows, structures, implementation, and the development of common ground to support team-based communication. The authors’ findings emphasized that implicit communication remains a predominant means of communication and workflow issues at the individual level are a frequent cause of unnecessary group communication tasks. Originality/value To improve team-based communication we first need to develop protocols that support team communication needs such as loop closing of group communication tasks in order to minimize unnecessary individual communication tasks. We also need to develop common ground at the protocol, document and terminology levels as part of supporting team-based communication.

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