Patients' and healthcare professionals' perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study.
Patients' and healthcare professionals' perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study.
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DOI：
10.1371/journal.pone.0273286
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
探讨患者、其护理人员、医疗保健提供者、精神和传统治疗师对精神分裂症的看法和经历，以制定基于社区的干预措施，以提高巴基斯坦精神分裂症患者的治疗依从性。这项定性研究涉及四场焦点小组讨论 (FGD)，共有 26 名参与者：患者和护理人员 (n = 5)、初级保健人员 (n = 7)、医疗技术人员 (n = 8) 以及传统和精神治疗师 (n = 6)。参与者是采用有目的抽样方法选择的。 FGD 被录音并转录。对数据集进行了主题分析。确定的主题是（i）精神分裂症不仅仅是一个生物医学问题：参与者认为，社会不平等造成的贫困和自卑感导致了精神分裂症，并导致不坚持服药； (ii) 精神治疗与药物治疗齐头并进：参与者将精神和传统治疗方法视为精神分裂症患者福祉和康复的固有组成部分； (iii) 精神疾病服务：精神卫生不属于基层卫生单位的初级卫生保健范围：与会者认为，初级保健中缺乏服务、培训和必要的药物是社区治疗精神分裂症的主要问题； (iv) 社区干预措施的障碍：初级保健工作人员认为，工作人员面临多重压力、缺乏激励、无法获得药物以及缺乏正式转诊途径，导致初级保健机构无法处理精神分裂症患者。该研究确定了制定和提供社会心理干预措施以支持巴基斯坦精神分裂症患者的一些障碍和促进因素。特别是，我们不同的利益相关者群体强调了精神和传统治疗师参与的重要性。
To explore the perceptions and experiences of schizophrenia from patients, their care givers, health care providers, spiritual and traditional healers to develop a community-based intervention for improving treatment adherence for people with schizophrenia in Pakistan. This qualitative study involved four focus group discussions (FGD) with a total of 26 participants: patients and carers (n = 5), primary care staff (n = 7), medical technicians (n = 8) and traditional and spiritual healers (n = 6). The participants were selected using purposive sampling method. FGDs were audio-recorded and transcribed. A thematic analysis was applied to the data set. The themes identified were (i) Schizophrenia is not merely a biomedical problem: participants believed that poverty and an inferiority complex resulting from social disparity caused schizophrenia and contributed to non-adherence to medications; (ii) Spiritual healing goes hand in hand with the medical treatment: participants regarded spiritual and traditional treatment methods as an inherent part of schizophrenia patients’ well-being and rehabilitation; (iii) Services for mental illness: mental health is not covered under primary health in a basic health unit: participants believed that the lack of services, training and necessary medication in primary care are major issues for treating schizophrenia in community; (iv) Barriers to community-based interventions: primary care staff believed that multiple pressures on staff, lack of incentives, non-availability of medication and lack of formal referral pathways resulted in disintegration of dealing with schizophrenia patients in primary care facilities. The study has identified a number of barriers and facilitators to developing and delivering a psychosocial intervention to support people living with schizophrenia in Pakistan. In particular, the importance of involving spiritual and traditional healers was highlighted by our diverse group of stakeholders.
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