Ubuntu as a mediator in coping with multimorbidity treatment burden in a disadvantaged rural and urban setting in South Africa.
Ubuntu as a mediator in coping with multimorbidity treatment burden in a disadvantaged rural and urban setting in South Africa.
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Ubuntu 作为南非弱势农村和城市环境中应对多病治疗负担的调解者。
DOI：
10.1016/j.socscimed.2023.116190
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Mbokazi N
中科院分区：
文献类型：
--
作者：
Mbokazi N
背景生活在低收入和中等收入国家（LMICs）的经济不稳定环境中的多重性精神障碍患者经历了试图满足自我管理需求的高工作量。然而，在南非等国，社交网络和支助结构的存在可能会提高病人的能力，特别是当网络受与泛非乌班图哲学有关的文化模式支配时，乌班图哲学通过人性和人的尊严促进团结。我们探讨了Ubuntu在人们自我管理HIV/NCD多发病的能力中发挥的中介作用，这些患者在城市和农村的贫困环境中，在2022年2月至4月期间，我们对30名HIV/NCD多发病患者进行了半结构化访谈。病人在开普敦的古古勒图和东开普省的布伦古拉的公共卫生诊所就诊。我们分析了采访使用框架分析，使用累积复杂性模型（CuCoM）和负担的治疗理论（BoTT）作为框架，通过它来概念化的data.ResultsDespite面临经济困难，人们在南非的multimorrhythm能够科普他们的工作量。他们积极利用和动员家庭关系和外部网络，在经济上、实际上和情感上支持他们，使他们能够更好地自我管理自己的慢性病。在日常生活中，患者往往无意识地接受了Ubuntu及其核心价值观，包括团结，团结和接受医疗工作者的Imbeko（尊重）。这使参与者能够分享他们的治疗工作量，并增加自我管理capability.ConclusionUbuntu是一个重要的调解人生活在南非的多发性硬化症，因为它允许他们浏览他们的治疗工作量，并增加他们的社会资本和结构弹性，这是自我管理能力的关键。将Ubuntu和相关的非洲支持理论纳入当前的治疗负担模型，将有助于更好地了解患者的集体支持，并可以为制定适合非洲慢性病患者需求的特定背景的社会卫生干预措施提供信息。
BackgroundPeople living with multimorbidity in economically precarious circumstances in low- and middle-income countries (LMICs) experience a high workload trying to meet self-management demands. However, in countries such as South Africa, the availability of social networks and support structures may improve patient capacity, especially when networks are governed by cultural patterns linked to the Pan-African philosophy of Ubuntu, which promotes solidarity through humanness and human dignity. We explore the mediating role Ubuntu plays in people's ability to self-manage HIV/NCD multimorbidity in underprivileged settings in urban and rural South Africa.MethodsWe conducted semi-structured interviews with 30 patients living with HIV/NCD multimorbidity between February–April 2022. Patients attended public health clinics in Gugulethu, Cape Town and Bulungula, Eastern Cape. We analysed interviews using framework analysis, using the Cumulative Complexity Model (CuCoM) and Burden of Treatment Theory (BoTT) as frameworks through which to conceptualise the data.ResultsDespite facing economic hardship, people with multimorbidity in South Africa were able to cope with their workload. They actively used and mobilized family relations and external networks that supported them financially, practically, and emotionally, allowing them to better self-manage their chronic conditions. Embedded in their everyday life, patients, often unconsciously, embraced Ubuntu and its core values, including togetherness, solidarity, and receiving Imbeko (respect) from health workers. This enabled participants to share their treatment workload and increase self-management capacity.ConclusionUbuntu is an important mediator for people living with multimorbidity in South Africa, as it allows them to navigate their treatment workload and increase their social capital and structural resilience, which is key to self-management capacity. Incorporating Ubuntu and linked African support theories into current treatment burden models will enable better understandings of patients’ collective support and can inform the development of context-specific social health interventions that fit the needs of people living with chronic conditions in African settings.
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