Translating mental health diagnostic and symptom terminology to train health workers and engage patients in cross-cultural, non-English speaking populations

Acharya, Bibhav; Basnet, Madhur; Rimal, Pragya; Citrin, David; Hirachan, Soniya; Swar, Sikhar; Thapa, Poshan; Pandit, Jagadamba; Pokharel, Rajeev; Kohrt, Brandon A.

doi:10.1186/s13033-017-0170-2

Cited by 22 publications

(20 citation statements)

References 9 publications

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“…The quality of the data was regularly checked by the site lead by reading the Nepali transcripts whilst listening to the audio files. A standardised Nepali glossary was used to translate mental health terms ( Acharya et al, 2017 ). The Framework Method was used to manage and analyse the data ( Gale et al, 2013 ).…”

Section: Methodsmentioning

confidence: 99%

A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal

Rose-Clarke

Hassan

et al. 2021

Social Science & Medicine

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Most cross-cultural qualitative research on depression has been descriptive, documenting symptoms and explanatory models. There is a lack of qualitative research testing theoretical models of depression. The interpersonal model conceptualises grief, interpersonal disputes, role transitions and social isolation as the context in which depression develops and is the basis of interpersonal therapy (IPT), which is increasingly used in cross-cultural settings to treat depression. We aimed to qualitatively evaluate to what extent the interpersonal model can explain adolescent depression in Nepal. Data were collected between December 2018 and April 2019 and comprised transcripts from 126 participants: 25 semi-structured interviews with depressed adolescents aged 13–18; four focus group discussions with adolescents (N = 38), four with parents/caregivers (N = 39), and two with teachers (N = 17); and seven semi-structured interviews with health and non-governmental organisation workers. We coded data using an analytical framework comprising deductive codes representing key concepts from the interpersonal model of depression and IPT, including principles, techniques and strategies. Participants mainly related depression to interpersonal problem areas of grief, dispute, role transition and social isolation. Interpersonal disputes were common, and for many adolescents this involved parental physical and emotional abuse. Although role transitions were common few adolescents grieved loss of the prior role. Distress related to social isolation was evident despite close physical proximity and extensive social interaction with family and community members. Adolescents described coping strategies that were similar to strategies central to IPT, e.g. identifying helpful and unhelpful relationships and generating options and ways of managing problems. In conclusion, interpersonal problems are relevant to this population and conceptualisations align with core principles of the interpersonal model of depression. The findings highlight the importance of addressing abuse and maltreatment in depression aetiology. They also inform future cultural adaptations of IPT in Nepal and beyond, including the opportunity to integrate local coping strategies.

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Section: Methodsmentioning

confidence: 99%

A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal

Rose-Clarke

Hassan

et al. 2021

Social Science & Medicine

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“…The forms and assessments used during data collection were forward and back-translated from English to Nepali. Culturally-specific Nepali idioms were utilized when applicable [39][40][41]. All quantitative data collection was conducted in Nepali.…”

Section: Outcome Measuresmentioning

confidence: 99%

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

Tergesen

Gurung²,

Dhungana

et al. 2020

Preprint

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This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

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“…Ryder and Chentsova-Dutton (2015) therefore recommend using the broader term “serious distress”, which they define “as the set of clinically significant problems characterized by dysphoria and anxiety rather than on specific diagnostic categories such as major depression, social anxiety disorder” (p. 403). With regard to psychological distress, it is important to consider symptoms that are pathologized or non-pathologized ( Acharya et al, 2017 ) in a given culture, along with idioms of wellness or resilience ( Lewis-Fernández and Kirmayer, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Cultural adaptation of Hap-pas-Hapi, an internet and mobile-based intervention for the treatment of psychological distress among Albanian migrants in Switzerland and Germany

Shala

Morina

Burchert

et al. 2020

Internet Interventions

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Background Internet- and mobile-based mental health interventions have the potential to narrow the treatment gap in ethnic groups. Little evidence exists on the cultural adaptation of such interventions. Cultural adaptation of evidence-based interventions distinguishes between surface and deep structure adaptation. Surface refers to matching materials (e.g., illustrations, language) or methods of treatment delivery to the target population, whereas deep structure adaptation considers cultural concepts of distress (CCD). So far, CCD have only been considered to a limited extent in cultural adaptation of psychological interventions, and there is a lack of well documented adaptation procedures. Aims With a cross-disciplinary and mixed-method approach, following a new conceptual framework for cultural adaptation of scalable psychological interventions, this study aimed to develop both surface and deep structure adaptations of an internet- and mobile-based intervention called Hap-pas-Hapi for the treatment of psychological distress among Albanian migrants in Switzerland and Germany. Methods A qualitative ethnopsychological study was conducted to examine the target group's CCD. Focus group discussions, an online survey, and individual key informant interviews were utilised to evaluate the original intervention, adaptation drafts and the final adapted intervention. A reporting system was developed to support the decision-making process and to report all adaptations in a transparent and replicable way. Results The ongoing involvement of target population key informants provided valuable feedback for the development of a more person-centred intervention, which might enhance treatment acceptance, motivation and adherence. Discussion This study provides empirical and theory-based considerations and suggestions for future implementation that may foster acceptability and effectiveness of culturally adapted evidence-based interventions.

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Translating mental health diagnostic and symptom terminology to train health workers and engage patients in cross-cultural, non-English speaking populations

Cited by 22 publications

References 9 publications

A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal

A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

Cultural adaptation of Hap-pas-Hapi, an internet and mobile-based intervention for the treatment of psychological distress among Albanian migrants in Switzerland and Germany

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