Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study

Background:The involvement of people with psychosocial disabilities in decision-making is a fundamental component of a person-centred and recovery-oriented model of care, but there has been little investigation of this approach in low- and middle-income countries. The aim of this study was to explo...

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Main Authors: Souraya, Sally, Hanlon, Charlotte, Asher, Laura
Format: Article
Language:English
Published: BMC 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/53713/
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author Souraya, Sally
Hanlon, Charlotte
Asher, Laura
author_facet Souraya, Sally
Hanlon, Charlotte
Asher, Laura
author_sort Souraya, Sally
building Nottingham Research Data Repository
collection Online Access
description Background:The involvement of people with psychosocial disabilities in decision-making is a fundamental component of a person-centred and recovery-oriented model of care, but there has been little investigation of this approach in low- and middle-income countries. The aim of this study was to explore the involvement of people with schizophrenia in decision-making relating to their care in rural Ethiopia. Methods: A qualitative study was conducted in rural Ethiopia as part of the Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE) project, involving two focus group discussions (n=10) with community-based rehabilitation workers, and 18 in-depth interviews with people with schizophrenia, caregivers, health officers, supervisors and a community-based rehabilitation worker. Thematic analysis was used to examine major themes related to involvement in decision-making in this specific setting. Results:Involvement of people with schizophrenia in decision-making in this rural Ethiopian setting was limited and coercive practices were evident. People with schizophrenia tended to be consulted about their care only when they were considered clinically ‘recovered’. Caregivers typically had a prominent role in decision-making, but they also acquiesced to the views of health care professionals. People with schizophrenia and caregivers were often unable to execute their desired choice due to inaccessible and unaffordable treatment. Conclusions: Community-based rehabilitation, as a model of care, may give opportunities for involvement of people with schizophrenia in decision-making. In order to increase involvement of people with schizophrenia in rural Ethiopia there needs to be greater empowerment of service users, wider availability of treatment choices and a facilitating policy environment. Further studies are needed to explore concepts of person-centred care and recovery across cultural settings.
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spelling nottingham-537132018-10-08T04:30:14Z https://eprints.nottingham.ac.uk/53713/ Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study Souraya, Sally Hanlon, Charlotte Asher, Laura Background:The involvement of people with psychosocial disabilities in decision-making is a fundamental component of a person-centred and recovery-oriented model of care, but there has been little investigation of this approach in low- and middle-income countries. The aim of this study was to explore the involvement of people with schizophrenia in decision-making relating to their care in rural Ethiopia. Methods: A qualitative study was conducted in rural Ethiopia as part of the Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE) project, involving two focus group discussions (n=10) with community-based rehabilitation workers, and 18 in-depth interviews with people with schizophrenia, caregivers, health officers, supervisors and a community-based rehabilitation worker. Thematic analysis was used to examine major themes related to involvement in decision-making in this specific setting. Results:Involvement of people with schizophrenia in decision-making in this rural Ethiopian setting was limited and coercive practices were evident. People with schizophrenia tended to be consulted about their care only when they were considered clinically ‘recovered’. Caregivers typically had a prominent role in decision-making, but they also acquiesced to the views of health care professionals. People with schizophrenia and caregivers were often unable to execute their desired choice due to inaccessible and unaffordable treatment. Conclusions: Community-based rehabilitation, as a model of care, may give opportunities for involvement of people with schizophrenia in decision-making. In order to increase involvement of people with schizophrenia in rural Ethiopia there needs to be greater empowerment of service users, wider availability of treatment choices and a facilitating policy environment. Further studies are needed to explore concepts of person-centred care and recovery across cultural settings. BMC 2018-08-02 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/53713/1/Souraya%202018%20Globalization%20and%20Health.pdf Souraya, Sally, Hanlon, Charlotte and Asher, Laura (2018) Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study. Globalization and Health . ISSN 1744-8603 (In Press) Decision-making; Patient participation; Community-based rehabilitation; Convention on the Rights of Persons with disabilities; Schizophrenia; Psychosocial disabilities; Mental health; Community mental health services; Human rights; Ethiopia; Developing countries
spellingShingle Decision-making; Patient participation; Community-based rehabilitation; Convention on the Rights of Persons with disabilities; Schizophrenia; Psychosocial disabilities; Mental health; Community mental health services; Human rights; Ethiopia; Developing countries
Souraya, Sally
Hanlon, Charlotte
Asher, Laura
Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title_full Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title_fullStr Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title_full_unstemmed Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title_short Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
title_sort involvement of people with schizophrenia in decision-making in rural ethiopia: a qualitative study
topic Decision-making; Patient participation; Community-based rehabilitation; Convention on the Rights of Persons with disabilities; Schizophrenia; Psychosocial disabilities; Mental health; Community mental health services; Human rights; Ethiopia; Developing countries
url https://eprints.nottingham.ac.uk/53713/