Conceptualizing and contextualizing functioning in people with severe mental disorders in rural Ethiopia: a qualitative study.
Conceptualizing and contextualizing functioning in people with severe mental disorders in rural Ethiopia: a qualitative study.
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埃塞俄比亚农村严重精神障碍患者的概念化和情境化功能：一项定性研究。
DOI：
10.1186/s12888-015-0418-9
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发表时间：
2015-03-04
期刊：
影响因子：
4.4
通讯作者：
Hanlon C
中科院分区：
文献类型：
--
作者：
Habtamu K;Alem A;Hanlon C
与高收入国家相比，低收入和中等收入国家的严重精神障碍（SMD）患者的功能结果据称更好;然而，跨文化功能措施可能无法充分捕获农村，非西方环境中的相关功能活动。本研究旨在深入了解埃塞俄比亚农村环境中的日常功能以及与SMD相关的功能障碍。在埃塞俄比亚南部的Butajira地区进行了一项定性研究。对SMD患者（n = 6）、宗教治疗师（n = 2）和精神科护士（n = 2）进行了深入访谈。与SMD患者的护理人员（n = 37）和项目外展工作者（n = 5）进行了四次焦点小组讨论。采用了专题分析方法。与会者强调，SMD患者的功能障碍不仅是由于与疾病相关的症状，而且还由于贫困，社会排斥和缺乏社会支持。在这个农村社区，生产性工作、参与家庭生活、维持自我照顾和履行社会义务的能力是最受重视的功能领域。详细阐述了各种各样的耕作任务，并指出其难度各不相同。虽然许多有症状的SMD患者据报道能够进行简单的耕作任务，但这与有效的耕作不同。性别差异在工作和家庭生活领域最为明显。据报告，功能受损对SMD患者、其照顾者和家庭中的年轻一代的生存有着至关重要的直接影响，并对他们一生的机会有着长期影响。该研究表明，除了通过基于社区的康复计划进行医疗治疗外，还需要解决社会排斥和贫困问题。功能角色的性别化和工作活动的复杂性，在这个自给自足的农业社区提供支持的论点，当地的情境化措施的功能与SMD的人。
The functional outcome of people with severe mental disorders (SMD) is purported to be better in low- and middle-income countries compared to high-income countries; however, cross-cultural measures of functioning may not capture adequately the relevant functional activities in rural, non-Western settings. This study aimed to gain in-depth understanding of day-to-day functioning in a rural Ethiopian setting and the functional impairments associated with SMD. A qualitative study was carried out in the Butajira area, south Ethiopia. In-depth interviews were conducted with people with SMD (n = 6), religious healers (n = 2) and psychiatric nurses (n = 2). Four focus group discussions were carried out with caregivers of people with SMD (n = 37) and one with project outreach workers (n = 5). A thematic analysis approach was used. Participants emphasized that functional impairment in people with SMD arose not only because of the symptoms associated with the illness, but also due to poverty, social exclusion and lack of social support. Within this rural community, the ability to work productively, engage in family life, maintain self-care and fulfill social obligations were the most highly valued domains of functioning. A wide range of farming tasks were elaborated in detail and noted to be of varying levels of difficulty. Although many people with symptomatic SMD were reported to be able to carry out simple farming tasks, this was distinguished from effective farming. Gender differences were most apparent in the domains of work and family life. Impaired functioning was reported to have a critical immediate impact on survival and longer-term impacts on the lifetime opportunities of people with SMD, their caregivers and the younger generation within the family. The study indicates that tackling social exclusion and poverty is needed alongside medical treatment through contextual community based rehabilitation programs. The gendering of functional roles and the complexity of work activities in this subsistence farming community lend support to arguments for locally contextualized measures of functioning in people with SMD.
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DOI：
10.1192/bjp.bp.112.118018
发表时间：
2013-04
期刊：
The British journal of psychiatry : the journal of mental science
影响因子：
--
作者：
De Silva MJ;Cooper S;Li HL;Lund C;Patel V
通讯作者：
Patel V
影响因子：
4.4
作者：
Bolton, P;Wilk, CM;Ndogoni, L
通讯作者：
Ndogoni, L
影响因子：
6.6
作者：
Jaaskelainen, Erika;Juola, Pauliina;Miettunen, Jouko
通讯作者：
Miettunen, Jouko
影响因子：
4.5
作者：
Getahun, Workineh;Gedif, Teferi;Tesfaye, Fikru
通讯作者：
Tesfaye, Fikru
影响因子：
6.6
作者：
Honkonen, T;Saarinen, S;Salokangas, RKR
通讯作者：
Salokangas, RKR