Haifa University, Technion - Israel Institute of Technology.
Parnassia Psychiatric Institute.
Transcult Psychiatry. 2022 Jun;59(3):249-262. doi: 10.1177/13634615211036398. Epub 2021 Sep 9.
Brua is an Afro-Caribbean religion and healing tradition predominantly practised on the ABC islands of the former Netherlands Antilles. It is grounded in oral tradition and shrouded in strict social taboos. Existing literature suggests that the majority of people on and from the islands are familiar with Brua and that it plays a substantial role in shaping their illness conception and idioms of distress. A lack of knowledge of Brua may therefore lead biomedically trained health professionals to misdiagnose these patients. This article discusses how religious beliefs related to Brua influence the illness concepts and idioms of distress of psychiatric patients originating from the ABC Islands, based on semi-structured interviews with former islanders receiving treatment at a psychiatric institute in the Netherlands. We found that of the 29 interviewees, 93.1% knew what Brua involved, 72.4% believed in it, 48.2% had first-hand experience with Brua practices, and 34.5% attributed their mental illness to Brua with greater or lesser certainty. However, only one patient had previously discussed her belief in Brua with her psychiatrist and only when asked to do so. The role of psychoactive substances in the context of Brua practices was negligible. Thus, the present study indicates that the majority of psychiatric patients from the ABC islands are familiar with Brua, but feel reluctant to discuss their concerns in this area with mental health professionals. Recommendations for clinical practice and further research are provided, including the need for a culture-sensitive approach and integrative care.
布鲁阿是一种非裔加勒比宗教和治疗传统，主要在荷属安的列斯群岛的 ABC 岛上实践。它以口头传统为基础，笼罩在严格的社会禁忌之中。现有文献表明，岛上和来自这些岛屿的大多数人都熟悉布鲁阿，它在塑造他们的疾病观念和痛苦习语方面起着重要作用。因此，缺乏对布鲁阿的了解可能导致接受生物医学培训的卫生专业人员误诊这些患者。本文讨论了与布鲁阿相关的宗教信仰如何影响来自 ABC 群岛的精神科患者的疾病观念和痛苦习语，这是基于对在荷兰一家精神病院接受治疗的前岛民进行的半结构化访谈。我们发现，在 29 名受访者中，93.1%的人知道布鲁阿涉及什么，72.4%的人相信它，48.2%的人有过布鲁阿实践的第一手经验，34.5%的人或多或少地将他们的精神疾病归因于布鲁阿。然而，只有一名患者曾在之前与她的精神科医生讨论过她对布鲁阿的信仰，而且只是在被要求这样做时才讨论。在布鲁阿实践的背景下，精神活性物质的作用可以忽略不计。因此，本研究表明，来自 ABC 群岛的大多数精神科患者都熟悉布鲁阿，但他们不愿意与心理健康专业人员讨论他们在这方面的担忧。为临床实践和进一步研究提供了建议，包括需要采取文化敏感的方法和综合护理。
