Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights.
Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights.
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DOI：
10.1186/s13033-016-0089-z
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发表时间：
2016
影响因子：
3.6
通讯作者：
Burns JK
中科院分区：
文献类型：
--
作者：
Labys CA;Susser E;Burns JK
对精神病早期干预策略的兴趣日益增长，导致了对理解寻求帮助行为的平行兴趣，特别是在低收入和中等收入国家（LMIC）。然而，很少有LMIC研究检查了非城市，非医院环境中的精神病患者。使用的角度来看，正式和非正式的社区服务提供者，我们的目的是揭示在南非农村社区精神病患者的描述，并阐明他们的求助之旅的潜在复杂性。我们进行了一项定性研究，40个关键的线人访谈和7个重点小组与利益攸关方（传统领袖，传统医士，宗教领袖，保健护士，非政府组织负责人，学校教师，社区护理人员）在农村祖鲁社区（Vulindlela）。使用归纳分析方法对数据进行专题分析。受访者讨论了他们社区中32名可能患有精神病的人，并对他们的症状进行了丰富的描述。一个复杂的求助行为，主要涉及非正式的心理健康服务提供者，出现了。超过一半的报告病例在寻求帮助的过程中没有接触过正规的医疗服务;超过三分之二的人从未去过医院，只有八分之一的人去过精神病医院。我们的研究结果强调了非正式护理提供者在LMIC中的重要作用，以及需要对非医院环境中的精神疾病和当地提供者进行更多研究。社区利益攸关方可以帮助更充分地了解这些问题，从而协助为Vulindlela等南非农村社区制定适当和有效的心理健康干预措施。
Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys. We conducted a qualitative study of 40 key informant interviews and seven focus groups with stakeholders (traditional leaders, traditional healers, religious leaders, health care nurses, heads of non-governmental organizations, schoolteachers, community caregivers) in a rural Zulu community (Vulindlela). Thematic analysis of the data was performed using the inductive analysis approach. Interviewees discussed 32 individuals with probable psychosis in their community and provided rich descriptions of their symptoms. A complex picture of help-seeking behavior, primarily involving informal mental health service providers, emerged. Over half of the reported cases had no contact with formal health services in the course of their help-seeking journey; while more than two-thirds never attended a hospital and only 1 in 8 accessed a psychiatric hospital. Our results highlight the important role of informal care providers in LMICs as well as the need for more research on mental illness and local providers in non-hospital contexts. Community stakeholders can contribute to a fuller understanding of these issues, thereby assisting in the creation of appropriate and effective mental health interventions for rural South African communities like Vulindlela.