Lecturer in Psychiatric Nursing, College of Nursing, Christian Medical College, Vellore 632004.
Indian J Psychiatry. 2006 Jul;48(3):138-42. doi: 10.4103/0019-5545.31575.
Community health workers in developing countries commonly hold indigenous beliefs about mental illness which differ markedly from biomedical models.
To test the effect of a biomedical intervention on explanatory models (EMs) of community health workers.
Indigenous beliefs about chronic psychosis were elicited from community health workers. The Short Explanatory Model Interview formed the basis of the interview. Half the workers were taught about the biomedical model after discussing their EMs of chronic psychosis. The others did not receive education. The beliefs of all community health workers were reassessed 2 weeks after the initial assessment.
A variety of indigenous beliefs, which contradicted the biomedical model, were elicited at the baseline evaluation. Seeking biomedical help at follow up was significantly related to receiving education about the biomedical aspects of chronic psychosis (OR 17.2; 95% CI: 18.75, 15.65; p<0.001). This remained statistically significant (OR 9.7; 95% CI: 82.28, 1.14; p<0.04) after using logistic regression to adjust for baseline variables.
The high prevalence of non-medical beliefs among community health workers suggests the need to elicit and discuss beliefs before imparting knowledge about biomedical models of mental disorders. Biomedical educational intervention can change EMs of mental illness among health workers.
发展中国家的社区卫生工作者通常对精神疾病持有本土信仰，这些信仰与生物医学模式有很大的不同。
测试生物医学干预对社区卫生工作者的解释模型（EM）的影响。
从社区卫生工作者那里引出对慢性精神病的本土信仰。简短的解释性模型访谈构成了访谈的基础。一半的工作人员在讨论了他们对慢性精神病的 EM 后，接受了生物医学模式的教育。其他人则没有接受教育。所有社区卫生工作者的信念在初始评估后两周重新评估。
在基线评估中引出了各种与生物医学模型相矛盾的本土信仰。在随访中寻求生物医学帮助与接受慢性精神病生物医学方面的教育显著相关（OR 17.2；95%CI：18.75，15.65；p<0.001）。在使用逻辑回归调整基线变量后，这仍然具有统计学意义（OR 9.7；95%CI：82.28，1.14；p<0.04）。
社区卫生工作者中存在大量非医疗信仰，这表明在传授精神障碍的生物医学模型知识之前，需要引出和讨论信仰。生物医学教育干预可以改变卫生工作者对精神疾病的 EM。
