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肯尼亚内罗毕国际化非正式定居点的传统治疗师与心理健康服务提供情况

Traditional healers and provision of mental health services in cosmopolitan informal settlements in Nairobi, Kenya.

作者信息

Mbwayo A W, Ndetei D M, Mutiso V, Khasakhala L I

机构信息

Africa Mental Health Foundation, Nairobi, Kenya.

出版信息

Afr J Psychiatry (Johannesbg). 2013 Mar;16(2):134-40. doi: 10.4314/ajpsy.v16i2.17.

Abstract

OBJECTIVE

The study aimed to investigate the types of mental illnesses treated by traditional healers, and their methods of identifying and treating mental illnesses in their patients.

METHOD

In urban informal settlements of Kibera, Kangemi and Kawangware in Nairobi, Kenya, we used opportunistic sampling until the required number of traditional healers was reached, trying as much as possible to represent the different communities of Kenya. Focus group discussions were held with traditional healers in each site and later an in-depth interview was conducted with each traditional healer. An in-depth interview with each patient of the traditional healer was conducted and thereafter the MINIPLUS was administered to check the mental illness diagnoses arrived at or missed by the traditional healers. Quantitative analysis was performed using SPSS while focus group discussions and in-depth interviews were analysed for emerging themes.

RESULTS

Traditional healers are consulted for mental disorders by members of the community. They are able to recognize some mental disorders, particularly those relating to psychosis. However, they are limited especially for common mental disorders.

CONCLUSION

There is a need to educate healers on how to recognize different types of mental disorders and make referrals when patients are not responding to their treatments.

摘要

目的

本研究旨在调查传统治疗师所治疗的精神疾病类型,以及他们识别和治疗患者精神疾病的方法。

方法

在肯尼亚内罗毕的基贝拉、坎格米和卡万加雷的城市非正式定居点,我们采用机会抽样法,直至达到所需数量的传统治疗师,尽可能代表肯尼亚的不同社区。在每个地点与传统治疗师进行焦点小组讨论,随后对每位传统治疗师进行深入访谈。对每位传统治疗师的患者进行深入访谈,然后使用MINIPLUS检查传统治疗师做出的或遗漏的精神疾病诊断。使用SPSS进行定量分析,同时对焦点小组讨论和深入访谈进行分析以找出新出现的主题。

结果

社区成员会向传统治疗师咨询精神障碍问题。他们能够识别一些精神障碍,尤其是与精神病相关的障碍。然而,他们存在局限性,特别是对于常见精神障碍。

结论

有必要对治疗师进行教育,使其了解如何识别不同类型的精神障碍,以及在患者对其治疗无反应时如何进行转诊。

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