Browsing by Author "Du Toit, Anina"
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- ItemSeizures: The Perceptions and Frustrations of Healthcare Providers and Traditional Health Practitioners in Namibia(Stellenbosch : Stellenbosch University, 2018-12) Du Toit, Anina; Pretorius, Chrisma; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT: There are currently no official statistics on the incidence or prevalence of psychogenic nonepileptic seizures (PNES) or epileptic seizures (ES) in Namibia. Furthermore, very little is available with respect to diagnostic and treatment guidelines for these disorders. In a developing, resource-poor country such as Namibia, providing services to people with seizures may be fraught with difficulties. In addition, providing healthcare in a multicultural setting may present its own unique challenges and opportunities. This mixed-method research study aimed to explore the perceptions and frustrations of biomedical and traditional health practitioners in managing medically explained (MES) and unexplained seizures (MUS) in Namibia. The objectives were to describe and interpret their conceptualization of seizures, the diagnostic and treatment practices used in the management of seizures and the challenges encountered in managing seizure patients. A concurrent quantitative and quantitative design was used to investigate both the context and the experiences of healthcare providers (HCPs) and traditional health practitioners (THPs) during the diagnosis and treatment of seizures. Quantitative data were collected using two surveys that focused on gathering information on the diagnostic techniques and practices used by HCPs in the management of MES and MUS. Fifty HCPs completed these surveys and data were analysed using descriptive statistics. As part of the qualitative phases of the study, thirty healthcare providers participated in semi-structured interviews regarding PNES and ES. Eleven THPs were interviewed as part of the qualitative phase of the study. Thematic analysis was used to analyse the semi-structured interviews to identify themes and subthemes within the data. The four systems of the ecological systems theory (Bronfenbrenner, 1977; 1979) were used to conceptualize the discussion and integration of the findings. The perceptions and frustrations of HCPs and THPs centred on the areas of diagnosis, treatment, patients and awareness. Findings pointed to a lack of knowledge and awareness regarding seizures, financial constraints that hamper access to specialized services and equipment, lack of collaboration across disciplines and between HPCs and state healthcare facilities, the recognition that the untapped potential of THPs may play a valuable role in bridging the treatment gap for seizures and a need for increased awareness and training opportunities that focus on seizures among both the public and healthcare workers. The unique challenges that a developing country such as Namibia faces were evident in some of the subthemes that highlighted the cultural differences in how seizures are conceptualized and treated. Biomedical practitioners indicated their willingness to engage with THPs in providing culturally inclusive health services for seizure patients. This may be a first step in advocating for the formal recognition of THPs in Namibia. This study is but a first for Namibia and opens the way for future studies to build on the findings reported here. The current study can contribute to the goals of the International League against Epilepsy and the International League against Epilepsy Psychogenic Nonepileptic Seizure Task Force by providing information on the diagnostic techniques and treatment modalities used in Namibia for the management of seizures. Secondly, the findings from the multi-layered investigation could guide policy and future research on seizures in Namibia.