Musyimi Christine W, Mutiso Victoria N, Nandoya Erick S, Ndetei David M
University of Nairobi and Founding Director Africa Mental Health Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, Nairobi, Kenya.
University of Nairobi, Nairobi, Kenya.
J Ethnobiol Ethnomed. 2016 Jan 7;12:4. doi: 10.1186/s13002-015-0075-6.
Qualitative evidence on dialogue formation and collaboration is very scanty in Kenya. This study thus aimed at the formation of dialogue and establishment of collaboration among the informal (faith and traditional healers) and formal health workers (clinicians) in enhancing community-based mental health in rural Kenya.
Qualitative approach was used to identify barriers and solutions for dialogue formation by conducting nine Focus Group Discussions each consisting of 8-10 participants. Information on age, gender and role in health care setting as well as practitioners' (henceforth used to mean informal (faith and traditional healers) and formal health workers) perceptions on dialogue was collected to evaluate dialogue formation. Qualitative and quantitative data analysis was performed using thematic content analysis and Statistical Package Social Sciences (SPSS) software respectively.
We identified four dominant themes such as; (i) basic understanding about mental illnesses, (ii) interaction and treatment skills of the respondents to mentally ill persons, (iii) referral gaps and mistrust among the practitioners and (iv) dialogue formation among the practitioners. Although participants were conversant with the definition of mental illness and had interacted with a mentally ill person in their routine practice, they had basic information on the causes and types of mental illness. Traditional and faith healers felt demeaned by the clinicians who disregarded their mode of treatment stereotyping them as "dirty". After various discussions, majority of practitioners showed interest in collaborating with each other and stated that they had joined the dialogue in order interact with people committed to improving the lives of patients.
Dialogue formation between the formal and the informal health workers is crucial in establishing trust and respect between both practitioners and in improving mental health care in Kenya. This approach could be scaled up among all the registered traditional and faith healers in Kenya.
在肯尼亚，关于对话形成与合作的定性证据非常匮乏。因此，本研究旨在促成肯尼亚农村地区非正式（宗教和传统治疗师）和正式卫生工作者（临床医生）之间的对话并建立合作，以加强基于社区的心理健康服务。
采用定性方法，通过开展9次焦点小组讨论来确定对话形成的障碍和解决方案，每次讨论由8至10名参与者组成。收集了有关年龄、性别、在医疗环境中的角色以及从业者（以下用于指代非正式（宗教和传统治疗师）和正式卫生工作者）对对话的看法等信息，以评估对话的形成情况。分别使用主题内容分析法和社会科学统计软件包（SPSS）对定性和定量数据分析。
我们确定了四个主要主题，即：（i）对精神疾病的基本认识；（ii）受访者对精神疾病患者的互动和治疗技能；（iii）从业者之间的转诊差距和不信任；（iv）从业者之间的对话形成。尽管参与者熟悉精神疾病的定义，且在日常工作中与精神疾病患者有过互动，但他们对精神疾病的病因和类型只有基本了解。传统治疗师和宗教治疗师感到被临床医生贬低，临床医生无视他们的治疗方式，将他们刻板地视为“不卫生”。经过各种讨论，大多数从业者表示有兴趣相互合作，并表示他们参与对话是为了与致力于改善患者生活的人交流。
正式和非正式卫生工作者之间形成对话对于在双方从业者之间建立信任和尊重以及改善肯尼亚的精神卫生保健至关重要。这种方法可以在肯尼亚所有注册的传统治疗师和宗教治疗师中推广。
