Nodding syndrome or disease? On the conceptualization of an illness-in-the-making
Nodding syndrome or disease? On the conceptualization of an illness-in-the-making
复制标题
DOI：
10.1080/13557858.2013.780233
复制
发表时间：
2014-01-02
影响因子：
3.1
通讯作者：
Stroeken, Koen
中科院分区：
文献类型：
--
作者：
van Bemmel, Karin;Derluyn, Ilse;Stroeken, Koen
目的 探讨点头综合症 (NS) 的概念化过程，这是一种未知疾病，据报道影响了冲突后乌干达北部、南苏丹和坦桑尼亚的数千名儿童。 设计这项定性研究包括在乌干达北部五个月的实地工作期间对受影响家庭、卫生工作者和政治家进行 40 次深入访谈，并对有关 NS 的现有报告、报纸和学术文献进行了回顾。此外，还在治疗中心以及外展和会议期间进行了观察。重点关注与 NS 相关的关键术语的含义如何产生和协商。人们正在关注不同话语和解释模型的传播。结果话语和解释模型在疾病概念化中发挥着积极作用，无论是医务人员还是受影响的家庭和媒体。在有关 NS 的学术讨论中，生物医学术语的突出使用是引人注目的；建议与盘尾丝虫病和癫痫有关。相比之下，当地话语将国民服役与社会问题联系起来。疾病经历与过去冲突的创伤、贫困和（区域范围内的）忽视造成的挫败感有关。身体症状的文化意义提出了文化对健康影响的问题。结论如果仅关注这种新综合征的生物医学意义，我们将错过如何体验和理解这种疾病的重要方面。在我们未来处理神经科学的过程中，我们将不得不考虑和重新构想文化与神经生物学之间的关系。
ObjectiveTo explore processes of conceptualizing nodding syndrome (NS), an unknown illness which has been reported to affect thousands of children in post-conflict northern Uganda, in South Sudan and in Tanzania.DesignThis qualitative study comprised 40 in-depth interviews with affected families, health workers and politicians during five months of fieldwork in northern Uganda and a review of available reports, newspapers and academic literature on NS. In addition, observations have been made at treatment centers and during outreaches and meetings. Focus is put on how meanings of key terms related to NS are produced and negotiated. Attention is being paid to the circulation of different discourses and explanatory models.ResultsDiscourses and explanatory models play an active role in the conceptualization of illness, as much by medical personnel as by affected families and the media. The prominent use of biomedical terms in the academic discourse on NS is striking; links are suggested with onchocerciasis and epilepsy. In contrast, the local discourse associates NS with social issues. The illness experiences are connected to the trauma of past conflict, to poverty and to (region-bound) frustration over neglect. The cultural significance of physical symptoms raises the question of the impact of culture on health.ConclusionBy only looking at the biomedical significance of this new syndrome, we will miss important aspects of how this illness is being experienced and understood. In our future dealings with NS, we will have to consider and re-conceive the relation between culture and neurobiology.