Understandings of depression among community members and primary healthcare attendees in rural Ethiopia: A qualitative study

2021 ◽  
pp. 136346152110643
Author(s):  
Bethlehem Tekola ◽  
Rosie Mayston ◽  
Tigist Eshetu ◽  
Rahel Birhane ◽  
Barkot Milkias ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Disorders ◽  
Medical Intervention ◽  
Community Members ◽  
Group Discussions ◽  
Individual Interviews ◽  
Rural Ethiopia ◽  
Primary Care Settings ◽  
Prevalence Of Depression ◽  
Community Data

Available evidence in Africa suggests that the prevalence of depression in primary care settings is high but it often goes unrecognized. In this study, we explored how depression is conceptualized and communicated among community members and primary care attendees diagnosed with depression in rural Ethiopia with the view to informing the development of interventions to improve detection. We conducted individual interviews with purposively selected primary care attendees with depression (n = 28; 16 females and 12 males) and focus group discussions (FGDs) with males, females, and priests (n = 21) selected based on their knowledge of their community. Data were analyzed using thematic analysis. None of the community members identified depression as a mental illness. They considered depressive symptoms presented in a vignette as part of a normal reaction to the stresses of life. They considered medical intervention only when the woman's condition in the vignette deteriorated and “affected her mind.” In contrast, participants with depression talked about their condition as illness. Symptoms spontaneously reported by these participants only partially matched symptoms listed in the current diagnostic criteria for depressive disorders. In all participants’ accounts, spiritual explanations and traditional healing were prominent. The severity of symptoms mediates the decision to seek medical help. Improved detection may require an understanding of local conceptualizations in order to negotiate an intervention that is acceptable to affected people.

scholarly journals An asset-based participatory community analysis of natural hazards in Naphuno, Greater Tzaneen Municipality, Limpopo province, South Africa

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Allucia L. Shokane ◽  
Hanna Nel
Keyword(s):  
Natural Hazards ◽  
Community Analysis ◽  
Limpopo Province ◽  
Participatory Action ◽  
Community Members ◽  
Group Discussions ◽  
Daily Lives ◽  
Individual Interviews ◽  
Resilient Communities ◽  
Asset Based Community Development

Natural hazards disrupt the daily lives of people and communities. Consequently, social workers, like any other stakeholders, deal with community predicaments arising from the effects of natural hazards. The social relief distress (SRD) programme of government utilises needs-based, top-down government-driven interventions in communities affected by natural hazards, focused on what communities lack, as opposed to what communities have. This research study involved a community that experienced natural hazards, such as flooding, hail, lightning and windstorms, which destroyed property and livelihoods during the period 2014–2015. Eight experts and 12 affected community members participated in a qualitative participatory action research analysis study between 2016 and 2017. Guided by the asset-based community development (ABCD) approach, the affected community participated in a collaborative manner in the analysis of the consequences of natural hazards within the community. Data were collected through semi-structured individual interviews and focus group discussions, and analysed thematically. The findings confirmed the traumatic effects of natural hazards, such as loss of property, crops and livestock, physical injuries and even death. The main finding established that natural hazards should be managed in a collaborative way between formal experts of natural hazards and community members through ABCD principles and methods in building resilient communities.

Using Community Mapping to Understand Family Planning Behavior

Field Methods ◽  
2014 ◽  
Vol 26 (4) ◽  
pp. 406-420 ◽  
Author(s):  
Darcy White ◽  
Rob Stephenson
Keyword(s):  
Family Planning ◽  
Cultural Influences ◽  
Community Level ◽  
Community Members ◽  
Group Discussions ◽  
Rural Ethiopia ◽  
Community Mapping ◽  
Traditional Approaches ◽  
Mapping Exercise ◽  
Relevant Factors

Traditional approaches to researching family planning in developing countries utilize surveys, focus group discussions, key informant interviews, or some combination thereof. However, these methods are limited in their ability to measure community-level influences on family planning behavior. In this article, we assess the benefits of applying community mapping, a participatory research technique, to understand social and cultural influences on family planning in rural Ethiopia and Kenya. In gender-segregated focus groups, participants collaboratively created a map of their district or zone, which they subsequently used to anchor discussion of local supports, barriers, and targets for change. Qualitative analysis of the transcripts revealed that community mapping is a powerful tool with which to understand community-level factors that influence family planning. By facilitating reflection on and discussion of local assets and issues, the mapping exercise identifies relevant factors from the perspective of community members and defines priority points for intervention.

Management of Painful Physical Symptoms Associated With Depression and Mood Disorders

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S19) ◽  
pp. 1-16 ◽  
Author(s):  
Thomas N. Wise ◽  
Lesley M. Arnold ◽  
Vladimir Maletic ◽  
David L. Ginsberg
Keyword(s):  
Primary Care ◽  
Neuropathic Pain ◽  
Mood Disorders ◽  
Primary Care Physicians ◽  
Depressive Disorders ◽  
Pain Perception ◽  
Antidepressant Treatment ◽  
Physical Symptoms ◽  
Emotional Symptoms ◽  
Primary Care Settings

AbstractDepression is a common, recurring illness that continues to be underdiagnosed and undertreated in both psychiatric and primary care settings. It is increasingly being recognized that painful physical symptoms, which commonly exist comorbid with depressive disorders, play a role in complicating diagnosis of depression. Patients tend to discuss physical pain with primary care physicians and emotional pain with psychiatrists, often oblivious to the fact that both may be aspects of one disorder. Those who present with somatic complaints are three times less likely to be accurately diagnosed than patients with psychosocial complaints. However, thorough evaluation of mood and anxiety disorders in primary care is sparse due to the limited time primary care physicians can spend with each patient. Better recognition and treatment of both physical and emotional symptoms associated with mood disorders may increase a patient's chance of achieving remission, which is the optimum therapeutic goal.Abnormalities of serotonin and noradrenaline are strongly associated with depression and are thought to play a role in pain perception. Brain-derived neurotrophic factor, which is increased with antidepressant treatment, appears to influence regulation of mood and perception of pain. Clinical evidence indicates that dual-acting agents may have an advantage in modulating pain over those agents that increase either serotonin or noradrenaline alone. The novel dual-acting agents, such as venlafaxine and duloxetine, are better tolerated than tricyclic antidepressants and monoamine oxidase inhibitors. These agents have demonstrated efficacy in depression and in diabetic neuropathic pain independently. Therefore, unless otherwise stated, all inferences to studies of pain in this monograph refer to neuropathic pain in nondepressed patients.

Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers

Dementia ◽  
2015 ◽  
Vol 16 (6) ◽  
pp. 780-796 ◽  
Author(s):  
Grace O’Sullivan ◽  
Clare Hocking ◽  
Kathryn McPherson
Keyword(s):  
Service Providers ◽  
Care Staff ◽  
Team Approach ◽  
Specific Training ◽  
Group Discussions ◽  
Community Based ◽  
Individual Interviews ◽  
Community Data ◽  
Contractual Obligations ◽  
Perceived Outcomes

Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and “real stories” grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.

scholarly journals A REPORT ABOUT INTIMATE PARTNER VIOLENCE IN SOUTHERN AND WESTERN RWANDA

2018 ◽  
Vol 9 (3) ◽  
pp. 68
Author(s):  
Immaculée Mukashema
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Legal Status ◽  
Physical Violence ◽  
Intimate Partner ◽  
Community Leaders ◽  
Community Members ◽  
Group Discussions ◽  
Individual Interviews ◽  
Psychological Harassment

The present paper reports on intimate partner violence (IPV) in 3 districts of Southern Province and Western Province in Rwanda. Qualitative data were obtained via 3 focus group discussions conducted at the headquarters of each district, and 10 individual interviews with key informants, community leaders who worked in the districts. The types of IPV discussed were physical, economic, sexual, and psychological harassment. Community leaders stated that the women in their communities had no hesitation in reporting economic abuse and physical violence, but noted that the women needed support from other people to report sexual violence, and generally did not report psychological harassment, perhaps because they accepted it as the norm. They also noted that men generally did not report IPV and that the main victims of IPV in all its forms were children and women. The community leaders suggested a number of measures to reduce IPV: empowering females so that they are financially independent; educating and sensitizing family members about their responsibilities and community leaders about laws and human rights; educating all community members about gender equality and IPV, including premarital instruction; increasing access to services; putting in place a law that protects free unions by giving them legal status after a period of cohabitation; setting up a specific institution to deal with IPV; improving both support to the victims and follow-up of reported cases, along with instituting punitive responses to deter potential new perpetrators.

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