一位母亲的选择：关于母亲为患急性腹泻的孩子寻求医疗行为的定性研究
A mother's choice: a qualitative study of mothers' health seeking behaviour for their children with acute diarrhoea.
作者信息
Cunnama Lucy, Honda Ayako
机构信息
Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
出版信息
BMC Health Serv Res. 2016 Nov 21;16(1):669. doi: 10.1186/s12913-016-1911-7.
BACKGROUND
Diarrhoea presents a considerable health risk to young children and is one of the leading causes of infant mortality. Although proven cost-effective interventions exist, South Africa is yet to reach the Sustainable Development Goals set for the elimination of preventable under-five mortality and water-borne diseases. The rural study area in the Eastern Cape of South Africa continues to have a parallel health system comprising traditional and modern healthcare services. It is in this setting that this study aimed to qualitatively examine the beliefs surrounding and perceived quality of healthcare accessed for children's acute diarrhoea.
METHODS
Purposive sampling was used to select participants for nine focus-group-discussions with mothers of children less than 5 years old and 11 key-informant-interviews with community members and traditional and modern practitioners. The focus-group-discussions and interviews were held to explore the reasons why mothers seek certain types of healthcare for children with diarrhoea. Data was analysed using manual thematic coding methods.
RESULTS
It was found that seeking healthcare from traditional practitioners is deeply ingrained in the culture of the society. People's beliefs about the causative agents of diarrhoea are at the heart of seeking care from traditional practitioners, often in order to treat supposed supernatural causes. A combination of care-types is acceptable to the community, but not necessarily to modern practitioners, who are concerned about the inclusion of unknown ingredients and harmful substances in some traditional medicines, which could be toxic to children. These factors highlight the complexity of regulating traditional medicine.
CONCLUSION
South African traditional practitioners can be seen as a valuable human resource, especially as they are culturally accepted in their communities. However due to the variability of practices amongst traditional practitioners and some reluctance on the part of modern practitioners regulation and integration may prove complex.
背景
腹泻对幼儿的健康构成重大风险，是婴儿死亡的主要原因之一。尽管存在经证实具有成本效益的干预措施，但南非尚未实现为消除可预防的五岁以下儿童死亡和水传播疾病所设定的可持续发展目标。南非东开普省的农村研究地区仍然存在一个由传统和现代医疗服务组成的并行卫生系统。本研究旨在在此背景下，对围绕儿童急性腹泻所获得的医疗保健的观念及感知质量进行定性研究。
方法
采用目的抽样法，选取5岁以下儿童的母亲进行9次焦点小组讨论，并与社区成员、传统及现代从业者进行11次关键 informant 访谈。举行焦点小组讨论和访谈，以探究母亲们为腹泻儿童寻求特定类型医疗保健的原因。使用手动主题编码方法对数据进行分析。
结果
发现向传统从业者寻求医疗保健在社会文化中根深蒂固。人们对腹泻病因的看法是向传统从业者寻求治疗的核心，通常是为了治疗假定的超自然病因。社区可以接受多种护理类型的组合，但现代从业者不一定接受，他们担心一些传统药物中含有未知成分和有害物质，可能对儿童有毒。这些因素凸显了规范传统医学的复杂性。
结论
南非的传统从业者可被视为宝贵的人力资源，尤其是因为他们在其社区中得到文化上的认可。然而，由于传统从业者之间的做法存在差异，且现代从业者存在一定的抵触情绪，监管和整合可能会很复杂。
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