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Horwitz R, Brener L, Prankumar SK, de Jesus T, Jaworski A, Jadran A, Bryant J. Understanding cultural inclusion in alcohol and other drug services in New South Wales, Australia and assessing the acceptability of a cultural inclusion audit. Drug Alcohol Rev 2024. [PMID: 38825730 DOI: 10.1111/dar.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION Cultural inclusion and competence are understood at the most basic level to be the practice of considering culture so as to provide effective services to people of different cultural backgrounds. In order to work better with clients from diverse backgrounds, alcohol and other drug (AOD) services need to offer a service that is designed to be accessible to all people, where systems in place operate in a way that considers different cultural needs. This research aimed to assess the extent to which non-government AOD services in New South Wales are positioned to support cultural inclusion as well as to evaluate the acceptability of a cultural inclusion audit across four AOD sites. METHODS The research adopted a mixed methods approach comprising of a pre-audit online survey (n = 85) designed to assess AOD services' attitudes and practices towards cultural inclusion, and in-depth interviews that were conducted with nine AOD service staff and four cultural auditors to explore the acceptability of a cultural inclusion audit process. RESULTS Findings from the survey indicate cultural inclusion practices are limited. Interview data highlight that while staff are not fully aware of what appropriate cultural inclusions entails, they are receptive to and want a cultural inclusion program. DISCUSSION AND CONCLUSIONS The study illustrates the benefits of implementing a cultural inclusion audit process aimed at raising awareness of what cultural inclusion entails. Including a cultural inclusion service audit is likely to enhance AOD service provision to culturally and linguistically diverse groups and thereby improve treatment outcomes.
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Affiliation(s)
- Robyn Horwitz
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Tata de Jesus
- The Network of Alcohol and other Drugs Agencies, Sydney, Australia
| | - Alison Jaworski
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Ahmad Jadran
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- School of Social Sciences, UNSW Sydney, Sydney, Australia
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Loyal D, Ricci L, Villegente J, Ayav C, Kivits J, Rat AC. Healthcare providers perception of therapeutic patient education efficacy according to patient and healthcare provider characteristics. Chronic Illn 2023; 19:233-249. [PMID: 34894789 DOI: 10.1177/17423953211058411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Therapeutic patient education improves numerous health and psychological outcomes in patients with chronic diseases. However, little is known about what makes a therapeutic patient education intervention more effective than another one. This study aims to identify in healthcare professionals the perceived determinants of therapeutic patient education efficacy at the individual level. METHODS Semi-structured individual interviews have been conducted with healthcare professionals (HCP, n=28, including 20 nurses) involved in therapeutic patient education programs (n=14) covering various chronic conditions (kidney and cardiovascular diseases, chronic pain, diabetes, etc.). A thematic content analysis following an inductive approach was used (Nvivo.11 software). RESULTS Five themes were retrieved for patient characteristics: understanding and education, personality, readiness and motivation, social environment, and misinformation and beliefs. Four themes were retrieved for healthcare professionals' characteristics: medical knowledge, appropriate attitude and relational skills, pedagogical skills, and training. DISCUSSION Patient personality is rarely discussed in the literature. Patients who are introverted, lack curiosity, or are not compliant might benefit from specific therapeutic patient education practices or formats. All these potential determinants regarding patients and healthcare professionals should be routinely assessed in future studies about therapeutic patient education efficacy to understand precisely what makes an intervention successful.
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Affiliation(s)
| | - Laetitia Ricci
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France
| | - Julie Villegente
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France.,27078University of Reims Champagne-Ardenne, France
| | - Carole Ayav
- CIC 1433 Clinical Epidemiology, 26920CHRU-Nancy, INSERM, 137665University of Lorraine, France
| | | | - Anne-Christine Rat
- 137665University of Lorraine, APEMAC EA4360, France.,27003University of Caen Normandie, UMR-S 1075 - COMETE, France.,Rheumatology Department, 26962University Hospital Center Caen, France
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van Heteren F, Raaphorst DN, Groeneveld DS, Bussemaker DM. Professionals’ health conceptions of clients with psychosocial problems: an analysis based on an empirical exploration of semi-structured interviews. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023. [DOI: 10.1016/j.ijnsa.2023.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
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Pregnancy Activity Levels and Impediments in the Era of COVID-19 Based on the Health Belief Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063283. [PMID: 35328974 PMCID: PMC8954454 DOI: 10.3390/ijerph19063283] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023]
Abstract
Physical activity (PA) and exercise benefit both the mother and the fetus. Many pregnant women avoid or severely limit PA, leading to complications before and after delivery. This study elucidated the precise effect of each moderator variable on prenatal physical activity (PPA) by examining demographic factors, the PPA-related health belief level (HBL), and the current PPA level. The health belief model (HBM) in conjunction with the international prenatal physical activity questionnaire was used. The HBL in pregnant parous women (PPW) (3.42) was significantly higher than that in nonpregnant nulliparous women (NNW) (3.06). The PPA level in pregnant nulliparous women (PNW) (5.67 metabolic equivalent-hours per week (MET-h/week)) was lower than in the PPW (6.01 MET-h/week). All HBM dimensions (except for perceived barriers) were positively correlated with exercise expenditure in both PNW and PPW. According to the regression tree, participants in PNW aged ≤ 23 years with annual household incomes > CNY 100,001−150,000 had the highest energy expenditure (10.75 MET-h/week), whereas participants in PPW with a perceived benefit score of >4 had the highest energy expenditure (10 MET-h/week). The results demonstrated that the HBL in all groups was acceptable, whereas the PPA level was lower than the recommended PA level. In both PPW and PNW, the HBL was most strongly correlated with exercise expenditure. There is an urgent need to organize public-interest courses to alleviate household expenditure, raise the HBL about PPA in pregnant and NNW, and ensure personal health in the context of COVID-19.
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Mohamed Shaburdin Z, Bourke L, Mitchell O, Newman T. 'It's a cultural thing': excuses used by health professionals on providing inclusive care. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:1-15. [PMID: 34018893 DOI: 10.1080/14461242.2020.1846581] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 11/01/2020] [Indexed: 06/12/2023]
Abstract
Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals - as holders of organisational power - and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support.
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Affiliation(s)
| | - Lisa Bourke
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
| | - Olivia Mitchell
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
| | - Trudie Newman
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
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Leijen I, van Herk H. Health and Culture: The Association between Healthcare Preferences for Non-Acute Conditions, Human Values and Social Norms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312808. [PMID: 34886534 PMCID: PMC8657636 DOI: 10.3390/ijerph182312808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/22/2022]
Abstract
Preference for professional vs. non-professional or informal healthcare for non-acute medical situations influences healthcare use and varies strongly across countries. Important individual and country-level drivers of these preferences may be human values (the fundamental values that individuals hold and guide their behavior) and country-level characteristics such as social tightness (societal pressure for “acceptable” behavior). The aim of this study was to examine the relation of these individual and country-level characteristics with healthcare preferences. We examined European Social Survey data from 23,312 individuals in 16 European countries, using a multi-level, random effect approach, including individual and country-level factors. Healthcare preferences were explained by both human values (i.e., Schwartz values) and societal tightness (i.e., tightness-looseness scores by Gelfand). Stronger conservation increased, whereas self-transcendence and openness to change decreased preference for professional healthcare. In socially tight countries, we found a higher preference for professional healthcare. Furthermore, we found interactions between social tightness and human values. These results suggest that professional healthcare preference is related to both people’s values and societal tightness. This improved understanding is useful for both predicting and channeling healthcare seeking behavior across and within nations.
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Bourke L, Mitchell O, Mohamed Shaburdin Z, Malatzky C, Anam M, Farmer J. Building readiness for inclusive practice in mainstream health services: A pre-inclusion framework to deconstruct exclusion. Soc Sci Med 2021; 289:114449. [PMID: 34626883 DOI: 10.1016/j.socscimed.2021.114449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Across the globe, people are not equitably included or respected by health services. This results in some people being 'hardly reached' and having less access to safe and appropriate care. While some health services have adopted specific agendas to increase inclusion, these services can struggle to implement such strategies because the underlying reasons for exclusion have not been addressed. This calls for preparation prior to implementation of inclusion approaches that deconstructs discourses and practices of exclusion. This paper presents a pre-inclusion framework that seeks to deconstruct exclusion in health services. Authors developed this framework from action research in four 'mainstream' regional health services in southeast Australia over five years. Research identified dominant discourses of exclusion among staff in these services. The study also identified common experiences of residents hardly reached by these services. Following, a range of change activities were undertaken within these services to deconstruct exclusion. Researchers also kept journals, reflected on their impact, and identified lessons learned from trying to deconstruct exclusion. Triangulating these analyses, researchers developed an interdisciplinary framework that weaves together Foucauldian theory on power/discourse with continuous quality improvement processes to embed cultural humility and voices of the hardly reached in health care. The framework outlines five foundational concepts (power as productive, deconstruction, use of continuous quality improvement processes, cultural humility and voices of service users), followed by six principles (a journey, expect resistance, whole of service approach, make visible the reasons for change, we are all cultural beings and people centred care) and six actions undertaken within health services (commitment, assessment of exclusion, action plans, structural change, reflective discussions and engagement). Until such approaches to deconstruct exclusion are implemented, inclusive agendas are likely to be ineffective.
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Affiliation(s)
- Lisa Bourke
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia.
| | - Olivia Mitchell
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia.
| | | | - Christina Malatzky
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Kelvin Grove, Brisbane, Qld, 4059, Australia.
| | - Mujibul Anam
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia
| | - Jane Farmer
- Social Innovation Research Institute, Swinburne University of Technology, John Street, Hawthorn, Vic, 3122, Australia.
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Community beliefs toward causes of illness: cross cultural studies in Tolotang and Ammatoa Ethnics in Indonesia. GACETA SANITARIA 2021; 35 Suppl 1:S19-S22. [PMID: 33832617 DOI: 10.1016/j.gaceta.2020.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/04/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aimed to compare community beliefs regarding causes of illness and preventive actions of two minority ethnic groups in Indonesia. METHOD A qualitative design with an ethnographic and phenomenological approach with a total of 18 participants. RESULT The Ammatoa Kajang and Towani Tolotang do believe that many factors determine health status. Both ethnics keep the faith that fail to follow tribe's rules and disobedience to their customs and values inherited from their ancestors will affect their health. The most significant similarity is the way they respect their community leader and traditions. Although both ethnics believe that disease caused by evil spirits, they have a different perspective on disease prevention. While Ammatoa Kajang emphasis more on adherence to Ammatoa's instructions, Towani Tolotang perceives that they should maintain good relations and perform self-control. CONCLUSION There is a need to develop health policies and programs for indigenous community without compromising preserved cultural values.
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Weziak-Bialowolska D, Bialowolski P, VanderWeele TJ, McNeely E. Character Strengths Involving an Orientation to Promote Good Can Help Your Health and Well-Being. Evidence From two Longitudinal Studies. Am J Health Promot 2020; 35:388-398. [PMID: 33047616 PMCID: PMC8010894 DOI: 10.1177/0890117120964083] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose: We examined the impact of an orientation to promote good—one aspect of strengths of character, understood as having consistent thoughts and taking actions that contribute to the good of oneself and others—on flourishing outcomes. Design: We used data from 2 longitudinal observational studies. The primary study used 2 waves of data collected in June 2018 and July 2019. The secondary study used 3 waves of data collected in February 2017, March 2018, and March 2019. Setting: Two culturally different populations of adults were examined: (1) a large service organization based in the United States and (2) a Mexican apparel company in the supply chain of a major global brand. Subjects: 1,209 U.S. employees and 495 Mexican apparel workers were included in the study. Measures: Self-reports of orientation to promote good, Well-Being Assessment, Flourishing Index, the CDC Health-Related Quality of Life and the Job-Related Affective Well-Being Scale were used. Analysis: An outcome-wide approach and lagged regression analyses were applied. To combine the estimates across samples meta-analytic estimates were computed. Bonferroni correction was used to correct for multiple testing. Robustness of the results to potential unmeasured confounding was examined using E-values. Results: Orientation to promote good was positively associated with subsequently higher levels of life satisfaction and happiness (β = 0.14, 95% CI: 0.09, 0.19), self-assessed mental health (β = 0.11, 95% CI: 0.06, 0.15) and physical health (β = 0.08, 95% CI: 0.04, 0.12), social connectedness (β = 0.102, 95% CI: 0.06, 0.15) and purpose in life (β = 0.07, 95% CI: 0.03, 0.11). It was also associated with decreased anxiety (β = -0.11, 95% CI: -0.17, -0.06), depression (β = -0.07, 95% CI: -0.1, -0.02) and loneliness (β = -0.09, 95% CI: -0.13, -0.04). Possible effects on both positive affect (feeling happy) and negative affect (feeling sad, stressed and lonely) in general and while-at-work were also identified. Conclusions: Policymakers and practitioners should consider orientation to promote good as an important factor for improving population health and human flourishing while also at work.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Human Flourishing Program, Institute for Quantitative Social Science, 1812Harvard University, Cambridge, MA, USA
| | - Piotr Bialowolski
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Department of Epidemiology, 1857Harvard T. H. Chan School of Public Health, Boston MA, USA.,Human Flourishing Program, Institute for Quantitative Social Science, 1812Harvard University, Cambridge, MA, USA
| | - Eileen McNeely
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Lewis D, Francis S, Francis-Strickland K, Castleden H, Apostle R. If only they had accessed the data: Governmental failure to monitor pulp mill impacts on human health in Pictou Landing First Nation. Soc Sci Med 2020; 288:113184. [PMID: 33218887 DOI: 10.1016/j.socscimed.2020.113184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/09/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022]
Abstract
For over fifty years, Pictou Landing First Nation (PLFN), a small Mi'kmaw community on the northern shore of mainland Nova Scotia, Canada, has been told by a Joint Environmental Health Monitoring Committee (JEHMC) mandated to oversee the health of the community that their health has not been impacted by exposure to 85 million litres of pulp mill effluent dumped every day into what was once a culturally significant body of water bordering their community. Yet, based on lived experience, the community knows otherwise, and despite countless dollars spent on government and industry-sponsored research, their concerns have not gone away. Using biopolitical theory, we explore why JEHMC never fully implemented its mandate. We will use a Mi'kmaw environmental 'theoretical' framework to demonstrate that indicators of a relational epistemology and ontology that have been consistently and persistently overlooked in Indigenous environmental health research demands that Indigenous connections to the air, land and water must be taken into consideration to get a full understanding of environmental health impacts. Guided by the principle of Etuaptmumk (Two-Eyed Seeing), which brings together the strengths of both western and Indigenous knowledge, and employing a community-based participatory research approach, we use data that could have been accessed by the JEHMC that might have signaled that human health studies were warranted. Further, we developed an environmental health survey that more appropriately assesses the impacts on the community. Finally, we will discuss how an Indigenous-developed framework can adequately assess the impacts of land displacement and environmental dispossession on the health of Indigenous communities and illustrate how our framework can serve as a guide to others when exploring Indigenous environmental health more broadly.
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Affiliation(s)
- Diana Lewis
- Western University, 1151 Richmond Street, Room 3213, Social Science Centre, London, ON, N6A 5C2, Canada.
| | - Sheila Francis
- Pictou Landing Native Women's Group, Pictou Landing First Nation, 6533 Pictou Landing Rd #6, Trenton, NS B0K 1X0, Canada.
| | - Kim Francis-Strickland
- Pictou Landing Native Women's Group, Pictou Landing First Nation, 6533 Pictou Landing Rd #6, Trenton, NS B0K 1X0, Canada.
| | - Heather Castleden
- Canada Research Chair in Reconciling Relations for Health, Environments, and Communities, Queen's University, Mackintosh-Corry Hall, Room E330, Kingston, ON K7L 3N6, Canada.
| | - Richard Apostle
- Department of Sociology and Social Anthropology, Room 1128, Marion McCain Arts and Social Sciences Building, Halifax, Nova Scotia B3H 4R2, Canada.
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Malatzky C, Glenister K. Talking about overweight and obesity in rural Australian general practice. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:599-608. [PMID: 30311287 DOI: 10.1111/hsc.12672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 07/25/2018] [Accepted: 09/10/2018] [Indexed: 06/08/2023]
Abstract
As many patients' sole point of contact with the health care system, primary health care physicians (general practitioners [GPs] in Australia) are often positioned as key players in responding to rates of overweight and obesity in dominant public discourse. However, research from Western industrialised countries suggests that GPs may not be prepared for, or confident in, having conversations about overweight and obesity with patients. Little attention has been given to this topic in Australia, particularly in the context of rural health. The aim of this study was to understand how GPs in two rural settings in Victoria, Australia talk about overweight and obesity with patients. Working from a multidisciplinary perspective, a qualitative study design was adopted, and semi-structured interviews were conducted with seven GPs and seven GP patients living in two rural communities between January and April, 2016. Data was coded manually and thematic analysis was used to explore the data. The findings of this study support the argument that, in contrast to dominant messages within public health discourses, GPs may not be best placed to act as the primary actors in responding to overweight and obesity as they are constructed in epidemiological terms. In fact, the perspectives of GP study participants suggest that to do so would compromise important dimensions of general medical practice that make it simultaneously a human practice. Instead, more balanced, holistic approaches to discussing and responding to overweight and obesity with patients could be taken up in local, interdisciplinary collaborations between different health professionals and patients, which utilise broader social supports. Focussing on long-term, incremental programs that consider the whole person within their particular socio-cultural environment would be a productive means of working with the complexities of overweight and obesity. However, structural level changes are required to ensure such initiatives are sustainable in rural practice.
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Affiliation(s)
- Christina Malatzky
- Culture and Rural Health, Department of Rural Health, Melbourne Medical School, The University of Melbourne, Shepparton, VIC, Australia
| | - Kristen Glenister
- Rural Chronic Ill Health, Department of Rural Health, Melbourne Medical School, The University of Melbourne, Wangaratta, VIC, Australia
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Abstract
Integrating indigenous cultural knowledge into conceptualizing mental illness offers fruitful avenues to better contextualize mental health. What is abnormal and indicative of psychological distress varies in the meaning given to symptoms and the actual identification of disorders. This is no less true in Ovambo culture in Namibia, Southern Africa. The Namibian government, however, has noted that little is known about the mental health needs throughout the country. Although some researchers have identified symptoms of psychological distress in Namibian men and women, cultural tradition and belief systems are typically missing. The purpose of this study was to use ethnographic data to develop an understanding of what Ovambo men and women living in a rural area of Northern Namibia believe about mental illness. Informal discussions and formal interviews served as data. Participants ( N = 14) were all Ovambo men or women who were sampled after ongoing engagement in a rural community in northern Namibia. Data from field observations and interviews were analyzed using grounded theory open coding, resulting in two key categories: (a) Eemwengu (madness) and Omunanamwengu (the mad one) and (b) Where Madness Comes From: Explanations of Mental Illness. The first category offers insight into a culturally embedded way of identifying mental illness in Ovambo culture. The second category includes several subcategories oriented to the etiology of mental illness in Ovambo culture. Etiological beliefs about mental illness, eemwengu as a culturally embedded construct, and social control in the beliefs about psychological distress in Ovambo culture are discussed.
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Knettel BA. Exploring Diverse Mental Illness Attributions in a Multinational Sample: A Mixed-Methods Survey of Scholars in International Psychology. ACTA ACUST UNITED AC 2016. [DOI: 10.1037/ipp0000048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Attributions, or beliefs about the causes of mental illness, have been associated with thoughts, emotions, and actions related to mental health problems and treatment. Research has shown that people hold a wide variety of beliefs about the causes of mental illness, including components that are social, genetic, spiritual, fatalistic, or simply a result of chance. The current study surveyed 158 English-speaking scholars in psychology from 65 different countries, who reported beliefs they had observed among members of the public related to attributions of mental illness. Following the research design of Landrine and Klonoff (1994) , questionnaires included free-form qualitative questions and a list of quantitative ratings of the importance of various attributions in a specific country. The scholars’ responses supported models developed with more geographically homogeneous samples, with supernatural causes, social stress, and lifestyle among the most common attributions of illness in a variety of nations. A multivariate analysis of variance (MANOVA) of the 7 derived factors revealed significant differences in attributions among regions of the world, and particularly with respect to attributions to supernatural causes, social/stress, physical health, and substance use. Although further validation of the model is recommended, an international attribution framework may lead to valuable research examining help seeking for mental health concerns, mental illness stigma, and other variables in diverse geographical and cultural contexts.
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