Gureje O, Acha R A, Odejide O A
Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Trop Geogr Med. 1995;47(3):125-9.
Pathways patients take to psychiatric care will reflect the nature of the services available and the popular beliefs about mental illness. Studying the pathways may help in the identification of sources of delay in the receipt of care and suggest possible improvements. By studying the pathways of 159 patients to a tertiary psychiatric service in Nigeria, we show that traditional and religious healers are consulted at some stage by many patients with mental illness. Such healers are the first carers to a large proportion of the patients. These patients are not different from those who consult orthodox medical practitioners either in demographic features, presenting complaints, or nearness to service. Patients who consult traditional healers first tended to arrive at a tertiary psychiatric service much later than those who consult other carers. Our observations suggest that attempts to incorporate traditional medical care into the health care system must seek to improve their referral skill.
患者寻求精神科护理的途径将反映出可用服务的性质以及对精神疾病的普遍看法。研究这些途径可能有助于识别接受护理过程中的延误来源，并提出可能的改进措施。通过研究159名尼日利亚患者前往三级精神科服务机构的途径，我们发现许多患有精神疾病的患者在某个阶段会咨询传统治疗师和宗教治疗师。这些治疗师是很大一部分患者的首位护理者。这些患者在人口统计学特征、就诊主诉或与服务机构的距离方面与咨询正统医生的患者并无不同。首先咨询传统治疗师的患者比咨询其他护理者的患者晚得多才到达三级精神科服务机构。我们的观察结果表明，将传统医疗护理纳入医疗保健系统的尝试必须设法提高其转诊技能。
