Culture, Psychosocial Disorders and Mental Health: an African Perspective
Oliver Mazodze (Bindura University of Science Education, Zimbabwe)
Psychosocial Aspects of Epilepsy in Zimbabwe: The Impact of Culturally Mediated Perceptions
OBJECTIVE: To assess the impact of culturally mediated perceptions of epilepsy among epilepsy patients, their carers and families, communities and health workers, on the mental health of the individuals with the condition.
DESIGN AND SETTING: A cross-sectional study of the impact of culturally mediated perceptions of epilepsy on the mental health of people with epilepsy (PWE), in rural and urban communities in the Mashonaland provinces of Zimbabwe.
PARTICIPANTS: Individuals with epilepsy, their carers and families, health workers, and other members of the communities.
MAIN OUTCOME MEASURES: The level of mental health of the PWE shall be expressed as a function of their psychosocial functional status (PSFS). The PSFS of the PWE shall, in turn, be assessed on the basis of several parameters, some of which may be considered as factors for PSFS, and others may be considered as aspects of PSFS:
- Parameters assessed among all participants:
- knowledge and perceptions of the etiology, diagnosis and management of epilepsy among PWE, their carers and families, health workers and communities
- attitudes of the communities and health workers towards PWE
- Parameters assessed among PWE:
- awareness of PWE on the perceptions and attitudes of the community and health workers towards them
- seizure burden
- seizure control
- behaviour patterns
- neuropsychological performance (IQ measure)
- cognitive outcome/impairment
- adherence to drug therapy and drug compliance
- levels of psychosocial functioning
- quality of life (QoL)
METHODOLOGY: DATA COLLECTION:
- Identification of epilepsy patients:
- Epilepsy patients shall be identified through randomly-selected community pharmacies, hospital epilepsy clinics, and community epilepsy support groups.
- Data collection methods and instruments:
- The main outcome measures for the assessment of the PSFS of PWE shall be obtained through neuropsychological assessments for PWE; and personal interviews and/or structured questionnaires for all participants.
DATA ANALYSIS: It is hypothesised that inaccurate, culturally-mediated perceptions on the etiology and management of epilepsy, or attitudes towards PWE (which shall be termed "negative perceptions"), will result in families/carers not seeking medical assistance for PWE; while correct, scientifically-based knowledge of the etiology, diagnosis and management of epilepsy, and attitudes towards PWE (to be termed "positive perceptions"), would lead to an improvement in the QoL and PSFS of PWE.
Analysis of the captured data would be carried out with a view to verifying this hypothesis, and would include the determination of:
- correlation between seizure burden and culturally-mediated perceptions of epilepsy and PWE (cultural perceptions)
- correlation between cultural perceptions and seizure control
- correlation between cultural perceptions and adherence to drug therapy and drug compliance
- correlation between cultural perceptions and functional status
- correlation between cultural perceptions and QoL
- proportion of PWE that perceive (or do not perceive) themselves to have sufficient cognitive impairment to interfere with social functioning , work performance, or relationships with others