A Biomedical Educational Intervention to Change Explanatory Models of Psychosis among Community Health Workers in South India

By Joel, D.; Sathyaseelan, M. et al. | Indian Journal of Psychiatry, July-September 2006 | Go to article overview

A Biomedical Educational Intervention to Change Explanatory Models of Psychosis among Community Health Workers in South India


Joel, D., Sathyaseelan, M., Jayakaran, R., Vijayakumar, C., Muthurathnam, S., Jacob, K., Indian Journal of Psychiatry


Byline: D. Joel, M. Sathyaseelan, R. Jayakaran, C. Vijayakumar, S. Muthurathnam, K. Jacob

Background: Community health workers in developing countries commonly hold indigenous beliefs about mental illness which differ markedly from biomedical models. Aim: To test the effect of a biomedical intervention on explanatory models (EMs) of community health workers. Methods: Indigenous beliefs about chronic psychosis were elicited from community health workers. The Short Explanatory Model Interview formed the basis of the interview. Half the workers were taught about the biomedical model after discussing their EMs of chronic psychosis. The others did not receive education. The beliefs of all community health workers were reassessed 2 weeks after the initial assessment. Results: A variety of indigenous beliefs, which contradicted the biomedical model, were elicited at the baseline evaluation. Seeking biomedical help at follow up was significantly related to receiving education about the biomedical aspects of chronic psychosis (OR 17.2; 95% CI: 18.75, 15.65; p< 0.001). This remained statistically significant (OR 9.7; 95% CI: 82.28, 1.14; p< 0.04) after using logistic regression to adjust for baseline variables. Conclusion: The high prevalence of non-medical beliefs among community health workers suggests the need to elicit and discuss beliefs before imparting knowledge about biomedical models of mental disorders. Biomedical educational intervention can change EMs of mental illness among health workers.

Introduction

Local culture and beliefs influence many aspects of human behaviour such as idioms of distress, help-seeking, treatment compliance, patient satisfaction and coping. Perspectives of mental illness, also called explanatory models (EMs), play an important role in health-related behaviours and in patient- health worker interaction.[1],[2],[3],[4],[5] Diverse explanations are offered to explain mental illness including social circumstances, relationship difficulties, witchcraft or sorcery, or a broken taboo.[5] Eliciting local EMs in routine clinical psychiatric practice gives a better understanding of the subjective experience of illness,[1],[2],[3],[4],[5] attitude towards and compliance with treatment, and thus promote therapeutic adherence and improve clinical outcomes.

Despite the past few years having witnessed an increase in literature regarding local beliefs about causes of schizophrenia,[6],[7],[8],[9],[10] there is paucity of studies evaluating local EMs and the efficacy of intervention to change EMs.[11] Consequently, there is a need to understand not only the local perspectives but also to evaluate the efficacy of inter-ventions based on biomedical models of schizophrenia.

Understanding local perspectives is crucial for establishing culturally sensitive healthcare for a community. Community health workers are part of the World Health Organization's plan to integrate mental health component into primary healthcare in developing countries.[12],[13],[14],[15] However, many community health workers hold indigenous beliefs about mental illness which differ markedly from the biomedical models emphasized by mental health professionals.[16] Most education programmes have not evaluated local perspectives and the role of training in changing indigenous beliefs held by health workers. This study attempted to evaluate a structured intervention programme used to educate health workers about the biomedical aspects of psychosis in changing indigenous beliefs.

Methods

The setting

The Rural Unit for Health and Social Affairs (RUHSA), a community health programme of the Christian Medical College Hospital, Vellore, India, serves the K.V. Kuppam Block in the Vellore district in the state of Tamil Nadu. The block has an area of 180 sq. km. The programme operates in all 84 villages in the area. The total population served is about 120,000. The majority of the population speaks Tamil, is involved in agriculture and animal husbandry and belongs to the lower socioeconomic strata. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

A Biomedical Educational Intervention to Change Explanatory Models of Psychosis among Community Health Workers in South India
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.