Aguzzi Annica, Frost Caren J, Singh Tejinder, Benson L Scott, Gren Lisa H
University of Utah, Department of Family & Preventive Medicine, Division of Public Health, 375 Chipeta Way A, Salt Lake City, UT 84108, United States of America.
University of Utah, College of Social Work, 395 1500 East, Salt Lake City, UT 84112, United States of America.
Dialogues Health. 2024 Jun 17;5:100185. doi: 10.1016/j.dialog.2024.100185. eCollection 2024 Dec.
Traditional healing practices are prevalent in rural and mountainous areas of India where Western medicine is not accessible. WHO guidelines recommend integration of traditional and Western medicine to meet rural primary care needs. We explored three dimensions of rural patients' decision-making and satisfaction with their medical care: pregnancy-related concerns, pediatric care for children under five, and acute injuries.
We conducted a qualitative study using a phenomenological approach in India's Spiti Valley between August and October 2023. Sixteen individuals, age 18 years and older, participated in one-on-one interviews. The interviews were transcribed from Hindi into English, reviewed for accuracy by a native speaker, and imported into Dedoose software. Data were analyzed using inductive coding.
Multiparous women aged 35-44 were concerned about pregnancy complications, leading them to choose Western medicine despite access and cost barriers. Pediatric illness requiring urgent care at night was a concern for women with children under five. Those in the injuries group reported having to travel for care beyond basic first aid. Overall, concerns were about limited access to some services locally, as well as costs of travel, medical procedures, and medications when services were obtained beyond the local area.
All participants considered their traditional healer their first point of contact for medical care. A number of Western medical services were not available locally. These findings suggest a need to strengthen access to and integration of Western and traditional medical care in rural settings in India.
在印度的农村和山区，传统治疗方法很普遍，因为那里无法获得西医治疗。世界卫生组织的指导方针建议将传统医学和西医结合起来，以满足农村初级保健需求。我们探讨了农村患者医疗决策和满意度的三个方面：与怀孕相关的问题、五岁以下儿童的儿科护理以及急性损伤。
2023年8月至10月期间，我们在印度的斯皮提山谷采用现象学方法进行了一项定性研究。16名18岁及以上的个体参与了一对一访谈。访谈内容从印地语转录为英语，由以英语为母语的人检查准确性，然后导入Dedoose软件。数据采用归纳编码法进行分析。
35 - 44岁的经产妇担心妊娠并发症，尽管存在获取途径和成本障碍，她们还是选择了西医。五岁以下儿童的母亲担心孩子夜间需要紧急护理的儿科疾病。受伤组的受访者表示，除了基本急救外，还必须前往外地就医。总体而言，人们担心当地一些服务获取途径有限，以及在当地以外地区获得服务时的交通、医疗程序和药物成本。
所有参与者都将他们的传统治疗师视为医疗护理的第一接触点。当地无法提供一些西医服务。这些发现表明，有必要加强印度农村地区西医和传统医学护理的获取途径和整合。
