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Ramasubramanian P, Prose N, Johnson T, Newson C, Charles A, Ratliff O, Kakooza-Mwesige A, Kaddumukasa M, Nakasujja N, Kayanja A, Haglund M, Fuller A, Koltai D. "Walking the Journey Together": Creating a unique learning module in provider-patient communication for the care of epilepsy in Uganda. Epilepsy Behav 2023; 140:109096. [PMID: 36804849 DOI: 10.1016/j.yebeh.2023.109096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/17/2022] [Accepted: 01/14/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVE This report documents the creation of a practical communication skills module about epilepsy care, specifically targeted at first-line care providers who treat patients with epilepsy in Uganda. METHODS Our team conducted semi-structured interviews, utilizing Zoom video conferencing, with Ugandan physicians specializing in epilepsy care. Our interview guide promoted a semi-structured conversational interview that explored aspects related to developing a patient-provider relationship, how epilepsy is described in a culturally appropriate manner, exploration of alternative treatments, the impact of the stigma of epilepsy, and facilitators and barriers to antiepileptic drug treatment adherence. Each interview was then transcribed, and an inductive thematic content analysis approach was utilized to facilitate the development of thematic communication and care subcategories. The resulting PowerPoint presentation included numerous short audio clips of our Ugandan experts suggesting effective ways of communicating with patients and their families. RESULTS Our interviews with experts yielded valuable results to customize the WHO mhGAP v2.0 training program to be culturally relevant and effective in Uganda. The educational content consisted of topic summaries integrated with audio clips taken directly from our interviews with the Ugandan providers. Six themes emerged that would serve as the outline for the communication module we co-created with our Ugandan colleagues: The six major themes of the module included: (1) Greeting the patient, (2) Getting the story, (3) Traditional healers, (4) Stigma of epilepsy, (5) Explaining epilepsy, and (6) Treatment adherence. CONCLUSIONS The communications skills teaching module addresses the most critical aspects of communicating with patients and families living with epilepsy. The format of the presentation, which includes the written and spoken words of experts in epilepsy care, provides a practical approach to the provider-patient interaction, and confronts the stigma associated with this disease. This formatting highlights an effective way for international groups to co-create content in a culturally effective manner.
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Affiliation(s)
| | - Neil Prose
- Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Department of Dermatology and Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
| | - Tyler Johnson
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Colby Newson
- University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | | | - Olivia Ratliff
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Angelina Kakooza-Mwesige
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O. Box 7072, Kampala, Uganda; Department of Pediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda
| | - Martin Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda; Department of Medicine, Mulago National Referral Hospital, Neurology Unit, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Adrian Kayanja
- Mbarara Regional Referral Hospital, Mbarara, Uganda; Mbarara University of Science and Technology, Department of Psychiatry, Faculty of Medicine, Plot 8 - 18 Kabale Road, PO Box 1410, Mbarara, Uganda
| | - Michael Haglund
- Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University School of Medicine, Durham, NC 27710, USA; Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA
| | - Anthony Fuller
- Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University School of Medicine, Durham, NC 27710, USA; Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA
| | - Deborah Koltai
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke University School of Medicine, Department of Neurology, Durham, NC 27704, USA; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC, Box 3119, Trent Drive, Durham, NC 27710, USA
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Lim M, Carollo A, Neoh MJY, Sacchiero M, Azhari A, Balboni G, Marschik P, Nordahl-Hansen A, Dimitriou D, Esposito G. Developmental disabilities in Africa: A scientometric review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104395. [PMID: 36587527 DOI: 10.1016/j.ridd.2022.104395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Developmental disabilities are disproportionately more investigated in higher-income countries. However, global prevalence of developmental disabilities indicate that a large proportion of individuals with disabilities reside in low- and middle-income nations. AIMS The present work therefore aims to conduct a scientometric review to survey available literature on developmental disabilities in low- and middle-income countries belonging to the continent of Africa. METHODS AND PROCEDURES A literature search was conducted on Scopus, where a total of 1720 relevant publications (and an accompanying 66 thousand references) were found, representing research conducted between 1950 to 2022. Then, document co-citation analysis was performed to chart significant co-citation relationships between relevant articles and their cited references. OUTCOMES AND RESULTS The generated network based on document co-citation analysis revealed a total of 14 distinct thematic research clusters and 12 significant documents that have been frequently cited in the literature on developmental disabilities in Africa. CONCLUSIONS AND IMPLICATIONS The scientometric review revealed a trend of broadening research towards systems of care, away from a medical model of disease. It is projected that future research will continue to capitalise on inter-disciplinary strengths to arrive at a more nuanced understanding of developmental disability from all levels - individuals, families, to communities.
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Affiliation(s)
- Mengyu Lim
- Psychology Program, Nanyang Technological University, Singapore 639818, Singapore
| | - Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto 38068, Italy
| | | | - Marzia Sacchiero
- Department of Psychology and Cognitive Science, University of Trento, Rovereto 38068, Italy
| | - Atiqah Azhari
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore 599494, Singapore
| | - Giulia Balboni
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia 06123, Italy
| | - Peter Marschik
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany; Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria; Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet Stockholm, Stockholm, Sweden
| | - Anders Nordahl-Hansen
- Faculty of Teacher Education and Languages, Østfold University College, Halden, Norway
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, England
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto 38068, Italy.
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Zulkifli H, Rashid SMM, Mohamed S, Toran H, Raus NM, Pisol MIM, Suratman MN. Designing the content of religious education learning in creating sustainability among children with learning disabilities: A fuzzy delphi analysis. Front Psychol 2022; 13:1036806. [DOI: 10.3389/fpsyg.2022.1036806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/03/2022] [Indexed: 11/23/2022] Open
Abstract
Teachers found it is hard to figure out what are the best approach and strategies shall be employed to create an effective learning activity that can benefit the children. Children with learning disabilities have distinctive learning difficulties, depending on each individual. Therefore, this requires modification and adaptation in the learning activities to make sure they can learn effectively. Teachers need to make adjustment to the instructions, learning materials, assessments, and activities to accommodate the children with learning disabilities. Therefore, the objective of this research is to develop the content of religious education for children with learning disabilities using fuzzy delphi. This research used method of design and developmental research approach which have three phases. In this research, the researchers focus on the second phase of fuzzy delphi. There were 20 panel experts involved in this research to rank the elements in developing religious education model. Findings showed that, all the elements such as learning style, rights of people with disabilities manners and universal design were above 70% that considered suitable and applicable. It is hoped that this model can assist and guide teachers in teaching religious education for children with learning disabilities.
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Mkabile S, Swartz L. Traditional healers' explanatory models of intellectual disability in Cape Town. Transcult Psychiatry 2022; 59:263-273. [PMID: 35225090 DOI: 10.1177/13634615211055967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While intellectual disability is experienced worldwide, with much greater rates in contexts of poverty, relatively few studies on intellectual disability have been conducted in low- and middle-income countries. High levels of intellectual disability in South Africa exist alongside high levels of poverty, malnutrition and poor or inaccessible healthcare services. The lack of access to services partly explains why many turn to traditional healers. Within this context there is very limited research on the role that traditional healers play in relation to intellectual disability in South Africa. The current study investigated traditional healers' understanding and beliefs about intellectual disabilities and the treatment modalities that they use. An exploratory qualitative research design was used to examine the views and perspectives of traditional healers on intellectual disability. Fifteen traditional healers participated in the study. Key findings show that the naming of and the terminology used to describe and identify intellectual disability are very much similar to what has been observed in African cultures in general where intellectual disability is identified as an abnormality. Some traditional healers located the presentation of intellectual disability within the biomedical sphere while others gave supernatural explanations for how intellectual disability presents in children and for its causes. All traditional healers expressed a willingness to work with the Western formal healthcare system. Findings on traditional healers' views on future collaborations with the formal health system provide opportunities for these two forms of healthcare services to be synergised for the strengthening and improvement of services provided to children with intellectual disability and their families.
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Affiliation(s)
- Siyabulela Mkabile
- Department of Psychology, 26697Stellenbosch University, Stellenbosch, South Africa
| | - Leslie Swartz
- Department of Psychology, 26697Stellenbosch University, Stellenbosch, South Africa
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Historical Portrayal of Children with Disabilities and Exclusionary Practices in Northern Ghana. HUMAN ARENAS 2022. [DOI: 10.1007/s42087-021-00265-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pham TV, Koirala R, Wainberg ML, Kohrt BA. Reassessing the Mental Health Treatment Gap: What Happens if We Include the Impact of Traditional Healing on Mental Illness? Community Ment Health J 2021; 57:777-791. [PMID: 32894398 PMCID: PMC7936992 DOI: 10.1007/s10597-020-00705-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
In this Fresh Focus, we reassess what the mental health treatment gap may mean if we consider the role of traditional healing. Based on systematic reviews, patients can use traditional healers and qualitatively report improvement from general psychological distress and symptom reduction for common mental disorders. Given these clinical implications, some high-income countries have scaled up research into traditional healing practices, while at the same time in low-and middle-income countries, where the use of traditional healers is nearly ubiquitous, considerably less research funding has studied or capitalized on this phenomena. The World Health Organization 2003-2020 Mental Health Action Plan called for government health programs to include traditional and faith healers as treatment resources to combat the low- and middle-income country treatment gap. Reflection on the work which emerged during the course of this Mental Health Action Plan revealed areas for improvement. As we embark on the next Mental Health Action Plan, we offer lessons-learned for exploring potential relationships and collaborations between traditional healing and biomedicine.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Durham, NC, 27705, USA.
- Duke Global Health Institute, 310 Trent Drive, Durham, NC, 27710, USA.
- Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, 44616, Nepal.
| | - Rishav Koirala
- University of Oslo, Problemveien 7, 0315, Oslo, Norway
- Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, 44616, Nepal
- Brain and Neuroscience Center Nepal, Krishna Dhara Marg, Kathmandu, 44600, Nepal
| | - Milton L Wainberg
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA
| | - Brandon A Kohrt
- Duke Global Health Institute, 310 Trent Drive, Durham, NC, 27710, USA
- Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, 44616, Nepal
- George Washington University School of Medicine and Health Sciences, 2120 L Street, NW, Suite 600, Washington, DC, 20037, USA
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Abstract
PURPOSE OF REVIEW This review highlights what current research says about how local beliefs and norms can facilitate expansion of mental healthcare to meet the large unmet need for services in Africa. RECENT FINDINGS In contemporary Africa, religious beliefs exert important influences on mental health as well as the way people with mental illnesses are viewed and cared for. Mental healthcare practices based on traditional and other religious beliefs, and offered by complementary and alternative health providers (CAPs), reflect the people's culture and are often preferentially sought by a majority of the population. Despite important differences in the worldviews of CAPs and biomedical mental healthcare practitioners in regard to causal explanations, there are nevertheless overlaps in the approaches of both sectors to the management of mental health conditions. These overlaps may provide a platform for collaboration and facilitate the scaling-up of evidence-based mental health services to underserved African populations, especially those residing in ever-expanding urban centres. SUMMARY Faith-based mental healthcare is an important but informal component of the mental health system in much of Africa. Collaboration between its practitioners and biomedical practice may help to bridge the large treatment gap for mental health conditions on the continent.
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Mkabile S, Swartz L. Caregivers' and parents' explanatory models of intellectual disability in Khayelitsha, Cape Town, South Africa. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1026-1037. [PMID: 32232922 DOI: 10.1111/jar.12725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 02/08/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Post-apartheid, understanding and management of intellectual disability remain poor in South Africa, complicated by various contextual and cultural explanations used to describe and conceptualize this condition. METHOD We conducted 20 semi-structured interviews with primary caregivers and parents of children with intellectual disability residing in Khayelitsha, a low-income setting in Cape Town, South Africa. We used Kleinman's Explanatory Models (EMs) of illness to explore terms used to describe and conceptualize this condition. RESULTS Carers' explanatory models included biomedical causes, injuries during pregnancy or birth, as well as spiritual causes. It was reported that there were significant difficulties in accessing services and support, and difficulties with coping in the context of extreme poverty and deprivation. CONCLUSIONS Current findings highlight a need for collaboration between the biomedical and alternative healthcare systems in educating carers and parents regarding intellectual disability.
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Affiliation(s)
- Siyabulela Mkabile
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.,Department of Psychiatry and Mental Health, Division of Intellectual Disabilities, University of Cape Town, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Opoku MP, Nketsia W, Banye MA, Mprah WK, Dogbe JA, Badu E. Caregiving experiences and expectations of parents with in-school children with intellectual disability in Ghana. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 96:103524. [PMID: 31739195 DOI: 10.1016/j.ridd.2019.103524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The literature suggests that there are challenges faced by parents of children with intellectual disabilities (ID), which have resulted in calls for support services to be made available to parents and their children with ID. Although regular schools in Ghana are unable to admit students with ID, it is believed that special schools have the necessary facilities to support parents and their children with ID. However, little has been documented on the experiences and expectations of parents whose children with ID are enrolled in a special school. METHOD In this qualitative study, one-on-one semi-structured interviews were conducted with purposively recruited parents (n = 20) from the second most populous city in Ghana to explore their caregiving experiences and expectations regarding the education of their school-going children with ID. RESULTS Although the parents acknowledged that access to education has some benefits, such as the protection of their children with ID from negative societal attitudes and a reduction of their caregiving burden, they had low expectations for their children's education. Furthermore, the parents encountered considerable challenges in catering for their children with ID, such as financial problems and limited access to caregiving skills. CONCLUSION There is a need to intensify efforts at public education in relation to disability acceptance as well as to develop formidable social support systems.
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Affiliation(s)
| | - Williams Nketsia
- School of Education, Western Sydney University, Kingwood, Australia
| | - Mabel A Banye
- Department of Community Health, Centre for Disability Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom K Mprah
- Department of Community Health, Centre for Disability Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joslin A Dogbe
- Department of Community Health, Centre for Disability Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Badu
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
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