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肯尼亚农村地区向传统治疗师和信仰治疗师寻求服务的抑郁症和自杀倾向患者的生活质量。

Quality of life of depressed and suicidal patients seeking services from traditional and faith healers in rural Kenya.

作者信息

Musyimi Christine W, Mutiso Victoria N, Nayak Sameera S, Ndetei David M, Henderson David C, Bunders Joske

机构信息

Africa Mental Health Foundation, Nairobi, Kenya.

Vrije Universiteit, Amsterdam, Netherlands.

出版信息

Health Qual Life Outcomes. 2017 May 8;15(1):95. doi: 10.1186/s12955-017-0657-1.

Abstract

BACKGROUND

In rural Kenya, traditional and faith healers provide an alternative pathway to health care, including mental health care. However, not much is known about the characteristics of the populations they serve. The purpose of this study was to determine the relationship between depression, suicidal ideation, and socio-demographic variables with Quality of Life (QoL) indicators in a sample seeking mental health services from traditional and faith healers in rural Kenya. Understanding QoL in this sample can help develop mental health policy and training to improve the well-being of this population.

METHOD

This was a cross-sectional epidemiological survey (n = 443) conducted over a period of 3 months among adult patients seeking care from traditional and faith healers in rural Kenya. Data were collected using the Beck Depression Inventory II (BDI-II), Beck Scale for Suicide Ideation (BSS) and WHO Quality of Life Survey- BREF (WHOQOL-BREF), and analyzed using correlation analyses, parametric tests, and regression analyses.

RESULTS

Increasing levels of depression were associated with lower QoL among patients seeking care from traditional and faith healers. BSS scores were significantly negatively correlated with overall, physical, psychological, and environmental QoL, p < .05. There was a statistically significant difference between mean scores for overall QoL between depressed (M = 2.35, SD = 0.76) and non-depressed participants (M = 3.03, SD = 0.67), t(441) = 8.899, p < .001. Overall life satisfaction for depressed participants (M = 2.23, SD = 0.69) was significantly lower than non-depressed participants. Regression analyses indicated that depression, suicidal ideation, and being married predicted lower overall QoL controlling for other variables. Post hoc tests and subgroup analysis by gender revealed significant differences for females only. Depression, and older age predicted lower life satisfaction whereas being self-employed predicted higher life satisfaction, when controlling for other variables.

CONCLUSION

This study sheds light on correlates of QoL in depressed and non-depressed patients in rural Kenya. Evidence suggests that traditional and faith healers treat patients with a variety of QoL issues. Further research should focus on understanding how these issues tie into QoL, and how these healers can target these to improve care.

摘要

背景

在肯尼亚农村,传统治疗师和信仰治疗师提供了一条获得医疗保健(包括心理健康护理)的替代途径。然而,对于他们所服务人群的特征了解甚少。本研究的目的是确定在肯尼亚农村向传统治疗师和信仰治疗师寻求心理健康服务的样本中,抑郁、自杀意念以及社会人口统计学变量与生活质量(QoL)指标之间的关系。了解该样本的生活质量有助于制定心理健康政策和培训,以改善这一人群的福祉。

方法

这是一项横断面流行病学调查(n = 443),在3个月的时间里对肯尼亚农村向传统治疗师和信仰治疗师寻求治疗的成年患者进行。使用贝克抑郁量表第二版(BDI-II)、自杀意念贝克量表(BSS)和世界卫生组织生活质量调查简表(WHOQOL-BREF)收集数据,并使用相关分析、参数检验和回归分析进行分析。

结果

在向传统治疗师和信仰治疗师寻求治疗的患者中,抑郁程度的增加与较低的生活质量相关。BSS得分与总体、身体、心理和环境生活质量显著负相关,p < 0.05。抑郁患者(M = 2.35,SD = 0.76)和非抑郁参与者(M = 3.03,SD = 0.67)的总体生活质量平均得分之间存在统计学显著差异,t(441) = 8.899,p < 0.001。抑郁参与者的总体生活满意度(M = 2.23,SD = 0.69)显著低于非抑郁参与者。回归分析表明,在控制其他变量的情况下,抑郁、自杀意念和已婚状态预示着较低的总体生活质量。事后检验和按性别进行的亚组分析显示仅女性存在显著差异。在控制其他变量时,抑郁和年龄较大预示着较低的生活满意度,而个体经营预示着较高的生活满意度。

结论

本研究揭示了肯尼亚农村抑郁患者和非抑郁患者生活质量的相关因素。有证据表明,传统治疗师和信仰治疗师治疗患有各种生活质量问题的患者。进一步的研究应侧重于了解这些问题如何与生活质量相关联,以及这些治疗师如何针对这些问题改善护理。

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