Adapting the concept of explanatory models of illness to the study of youth violence

Patients' Explanatory Models about drug-resistant epilepsy in Argentina. A thematic analysis

OBJECTIVE

The aim of this study is to explore explanatory models (EM) about epilepsy in patients with drug-resistant epilepsy (DRE) in Buenos Aires, Argentina.

DESIGN

A qualitative approach gathered data through semi-structured interviews, oriented to gain an in-depth and contextual understanding of EM about epilepsy of patients with DRE. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis.

RESULTS

75 patients from two public hospitals participated. Emerging codes were grouped into three categories: Biomedical EM, Psychosocial EM, and Traditional EM. Also, factors that trigger or increase the frequency of seizures were reported.

CONCLUSIONS

Patients' EM regarding epilepsy are complex, as biological, psychological, and supernatural aspects intertwine. EM represent a method of understanding the way people explain, recognize, and act in relation to a medical condition. Since patients' beliefs regarding their illness are related to mental disorders, and quality of life, EM could shed light on the real impact of illness in the life of people, and, in turn, guide those intervention strategies to the patients' subjectivity, in order to improve the treatment compliance, reduce distress, and improve health-related quality of life, among other aspects.

Domestic Property Violence: A Distinct and Damaging Form of Parent Abuse

This article reports on the qualitative phase of mixed method research conducted in a medium-size city in New Zealand, which examined 14 parents' experiences of child- and youth-perpetrated domestic property violence (DPV). The research used semi-structured interviews and interpretative phenomenological analysis, enabling parents' perceptions of the causes and impacts of this form of family violence to be explored in depth. Three superordinate themes were identified in the analysis: damage done, the various impacts of DPV; staying safe and sane; and making sense of DPV, parents' perspectives. An ecological meaning-making theory emerged from the data and provided an overarching interpretative framework for considering the themes both separately and together. The findings showed that DPV is a distinct form of parent abuse and one that can have serious impacts of a financial, emotional, and relational nature. The theoretical and practical implications of the findings are discussed along with ideas for further research into this problem.

A lay carer's story about epilepsy in an urban South African context: they call it an illness of falling or an illness of fitting because a person shakes and eventually falls

In South Africa, epilepsy is poorly understood and managed. The different cultural understandings and terms used to explain the condition across the diverse population groups exacerbate this problem. In this article, we describe the findings from a single story about epilepsy which we elicited through a semistructured interview guide in the respondents' natural setting. We used Kleinman and Benson's mini-ethnographic questions to explore the lay carer's explanatory models about epilepsy. Our respondent had different descriptors for epilepsy which include 'an illness of falling', 'an illness of fitting', and 'a thing'. His explanatory models concerning epilepsy were predominantly sociocultural, psychological, economical, and political in nature and were supported by personal examples from his past and present experiences. Key to this man's story is the reality of a strong cultural base of understanding epilepsy, with the added reality of an urbanized world in which people feel alienated from one another and do not necessarily share the same cultural beliefs and practices. Instead of viewing understandings of epilepsy as either 'traditional' or 'western', community-based health promotion interventions must therefore recognize both cultural issues and urban realities and should also incorporate approaches that foster a common ground for patients and carers with very diverse views. The findings of this one interview cannot be generalized but have implications for managing epilepsy in an urban African context.

Explanatory models of obesity of inner-city African-American adolescent males

The purpose of this phenomenological inquiry was to construct an explanatory model of illness in inner-city African-American adolescent males using Kleinman's Explanatory Model of Illness as a framework. Thirteen males were enrolled in this study. In-depth, semi-structured interviews were used to explore adolescents' perspectives regarding the nature, cause, prevention and responses to obesity; their perception of self; and meanings they attach to obesity with particular emphasis on existing attitudes, expectations, and values. Data analysis was achieved through a process of inductive content analysis. Findings, future research and clinical implications are discussed.