Conceptual framework to provide culturally congruent care to epilepsy patients in selected rural communities in South Africa

Abstract

Background: Epilepsy is a neurological disorder affecting millions of people in Africa. Among other reported findings, many people living with epilepsy (PLWE) believe that the condition is caused by spiritual factors. Previous studies have revealed that majority of PLWE are not receiving adequate care and treatment because of diverse cultural beliefs associated with epilepsy. Consequently, they consult either faith-based healers or traditional healers. Others, however, acknowledge the medical causes of epilepsy and seek developed medical treatment. Aim: To develop a culturally congruent care conceptual framework to provide comprehensive and holistic epilepsy care. Setting: This study was conducted in the selected rural communities of Limpopo and Mpumalanga provinces. Methods: A qualitative multi-method research approach was employed and sub-divided into three phases. Phase 1: All 15 articles were reviewed and appraised using the Critical Appraisal Skills Programme (CASP) rating tool. Phase 2 involved two stages of empirical study in which an exploratory-descriptive study design was used. The study population comprised of 20 traditional healers, 15 faith-based healers, 20 professional nurses and 22 PLWE. Data were collected using in-depth individual interviews and analysed through eight Tesch’s steps of data analysis. Following data analysis, Phase 3 entailed synthesising the systematic and empirical findings into a conceptual framework. Results: Three themes that emerged from the findings were cultural epilepsy interventions, faith-based epilepsy intervention and medically developed epilepsy interventions. Conclusion: Incorporation of cultural beliefs, values and practices into the medically developed management of epilepsy is crucial for providing culturally congruent care that is preferred by majority of PLWE. Contribution: Healthcare providers may tailor care interventions that are culturally appropriate and acceptable hence promoting early diagnosis and treatment adherence leading to improved quality of life.