A communal holistic therapeutic approach for psychosocial health management among Southern African indigenous communities

Abstract

Background: Mental health remains on the backseat of the global healthcare system. With more than a third of people suffering from mental health having no access to mental health services. Consequently, this research realizes that communality and Ubuntu are considered the epitomes of living systems in African indigenous communities. Therefore, the aim was to develop, confirm, and validate a Middle-range Theory of psychosocial health management among indigenous Southern African communities. Methods: An explorative sequential mixed methods design was conducted. For the qualitative strand (Phase One), a qualitative approach was used where classical Grounded Theory was employed as a design. Makgotla were used as data collection method, and theoretical sampling was used for participant selection. In Phase Two, a qualitative approach followed where a critical, integrative literature review was conducted. Purposive sampling was employed for the literature collection. Finally, for the quantitative strand, a quantitative approach was used where content validity index (CVI), content validity ratio (CVR), and Kappa statistic were used to confirm and validate the emerging theory. Purposive sampling was used, where experts were selected for the confirmation and validation of the emerging theory. Findings: This research presents an emerging Middle-range theory referred to as the ‘Inclusive Holistic Communal Psychosocial Health Management Approach.’ This approach is informed by the shared cultural belief system, co-living system, and communal therapeutic techniques. Fundamental to the emerging Middle-range theory are the five cultural axioms found in this research to be of evidential value to culturally congruent and needs-aligned psychosocial health management. Embedded in the belief that life is a holistic-circlic continuous process independent of living, wherein the point of equilibrium (good health) is the sense of balance between life and living. Furthermore, it has been found that the emerging Middle-range theory expressed through the 40-item instrument is content valid and comprehensive as all the items were found to be relevant and acceptable with I-CVI values greater than 0.79 and Kappa values above 0.74.