Background:
A better understanding is needed about how people make decisions about help seeking.
Materials:
Focus group and individual interviews with patients, carers, healthcare staff, religious authorities, traditional healers and community members.
Discussion:
Four stages of help seeking were identified: (1) noticing symptoms and initial labelling, (2) collective decision-making, (3) spiritual diagnoses and treatment and (4) psychiatric diagnosis and treatment.
Conclusion:
Spiritual diagnoses have the advantage of being less stigmatising, giving meaning to symptoms, and were seen to offer hope of cure rather than just symptom control. Patients and carers need help to integrate different explanatory models into a meaningful whole.
This article demonstrates the potential of using ethnotaxonomy and nomenclature to assess the vitality status of indigenous languages and traditional knowledge at the ecosystem level. We collaborated with the Vaie people of Sarawak, Malaysia, applying a mixed methodology approach that relies on free-listing to a large extent. We applied the Traditional Knowledge and Language Vitality (TraLaVi) index to assess traditional knowledge and language vitality against five major parameters, specifically: language priority, retrieval of information, knowledge erosion, lexical recognition, and social support for exchange of traditional knowledge. The results show that with a TraLaVi score of 0.84, the Vaie language can be considered “safe”. Individuals practicing the traditional occupation of fishing fared better (mean=0.90) than those of the non-fishermen group (mean=0.77). However, when the language vitality was assessed using the Language Vitality and Endangerment assessment tool of UNESCO, the results indicate that the Vaie language could potentially be in the “unsafe” zone, highlighting the differences between the ecosystem based approach of the TraLaVi and the macro-approach of UNESCO. However, these approaches can be applied in a complementary manner to generate a more accurate portrayal of the language vitality scenario.
In national narratives of 'Malayness', a specific language (Malay) and religion (Islam) have become key aspects of an identity that excludes migrants and those of 'questionable' sexualities. Consequently Filipina migrants working in the nightlife industries in East Malaysia have been subjected to disciplinary discourses of ethnicity and sexuality that underpin these national narratives. Attempts to tighten migration laws and curb nightlife activities have resulted in a racialisation of Filipina migrant sexualities. Using ethnographic methods, this article explains the impacts of dominant state and public discourses of migration, ethnicity and gender, which Filipinas encounter in their everyday lives in their destination country. In the process the article also reveals how Filipinas resist these discourses and hence participate in the formation of their subjectivity.
BackgroundThe systems that help people with mental disorders in Malaysia include hospitals, primary care, traditional and religious systems, schools and colleges, employers, families and other community members.
AimsTo better understand collaboration between and within these systems and create a theoretical framework for system development.
MethodA total of 26 focus groups and 27 individual interviews were undertaken with patients, carers, psychiatric hospital staff, primary care and district hospital staff, religious and traditional healers, community leaders, non-governmental organisation workers, and school and college counsellors. Grounded theory methods were used to analyse the data and create a theory of collaboration.
ResultsThree themes both defined and enabled collaboration: (a) collaborative behaviours; (b) motivation towards a common goal or value; and (c) autonomy. Three other enablers of collaboration were identified: (d) relatedness (for example trusting, understanding and caring about the other); (e) resources (competence, time, physical resources and opportunities); and (f) motivation for collaboration (weighing up the personal costs versus benefits of acting collaboratively).
ConclusionsThe first three themes provided a definition of collaboration in this context: 'two or more parties working together towards a common goal or value, while maintaining autonomy'. The main barriers to collaboration were lack of autonomy, relatedness, motivation and resources, together with the potential cost of acting collaboratively without reciprocation. Finding ways to change these structural, cultural and organisational features is likely to improve collaboration in this system and improve access to care and outcomes for patients.
Declaration of interestNone.
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