The explanatory model is used as a substitute for the full explanation of the thing in question. To be sure, the causes of nonadherence are complex. The following are the main elements of an explanatory model of illness. Mona haugum department of community medicine institute of health and society the faculty of medicine university of oslo may 2011 supervisor. Appreciate the use of explanatory models in clinical practice. Forms of sexual intimacy in the context of localised prostate cancer treatment. The first aim is to compare and contrast three different conceptualexplanatory models for thinking about mental illness with an eye towards identifying the assumptions upon which each model is. The definition of the term explanatory model of illness underscores the nonuniversal nature of the manner in which illness is defined and experienced bringing to bear the thesis that illness is a socially constructed experience and not solely the result of purely biological factors. Discordance between explanatory models may lead to difficulties in communication and poor disease outcomes.
Andreas binnerthe explanatory model free download as powerpoint presentation. Cultural adaptation of scalable psychological interventions. Understanding these explanatory models is therefore essential for. A casebased approach to training health professionals, wileyblackwell, oxford, uk. The health belief model as an explanatory framework in. Illness explanatory models in contemporary research. Explanatory models of adult patients with type 2 diabetes. The qualitative data from this study provides a foundation and framework for the design of targeted health promotion messages for a rapidly growing south asian. Article information, pdf download for explanatory model interview catalogue. Apr 21, 2009 the present study aimed to investigate the effect of patient and interviewer characteristics on the assessment of ems among dutch mental health patients of turkish and moroccan origins. Various adaptations of the emic framework have produced semistructured interviews based on an operational formulation of an illness explanatory model that systematically clarifies the experience of illness from the point of view of the people who are directly affected.
In view of these findings it should be possible to develop more specific and better models to explain the links between unemployment and illhealth. I also define the subset of methodologies and research trends toward which my comments are directed. Anthropologist arthur kleinman suggested that by exploring the explanatory model of illness we can better. Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable explanatory laws are ill.
An explanatory model is a useful description of why and how a thing works or an explanation of why a phenomenon is the way it is. Eliciting the patients explanatory model of illness through a set of targeted questions shown below is an important tool for facilitating crosscultural communication, ensuring patient understanding. The biggest barrier to treatment of common mental disorders in primary care settings is low recognition among health care providers. This essay addresses two fundamental questions about explanatory models for psychiatric disorders. The patient explanatory model the health care blog.
The semi was employed to study the explanatory models of subjects with common mental disorders among whites. Research shows that a patients explanatory model is not simply going to disappear because the patient has had a. Explanatory model of illness causality energy medicine. Its focus is on increasing understanding of individual experiences of illness with an aim to bridge the gap between clinical knowledge and an individuals realities. A more appropriate scientific model for psychiatry emphasizes the understanding of mechanisms, an approach that fits naturally with a multicausal framework and provides a realistic paradigm for scientific progress, that is, understanding mechanisms through decomposition and reassembly. The social support, as well as the control models, were also fairly good. Initially developed by kleinman 1980, 1987 for use in clinical health settings, an explanatory model reveals how a person makes sense of an illness and their experience of it.
Exploring the use of explanatory models in nursing. I provide a brief overview of the explanatory model interview catalogue emic, which is the. Within this framework, explanatory models feature as cultural explanations of illness domain 2. Limitations and dangers in a global context philip thomas,1 patrick bracken2 and salma yasmeen3 correspondence to. I show how progress can be made using the approach of decomposition and reassembly despite the complexity and nonadditive nature of the etiological processes involved.
Based on the definition of the world health organization, more than a lack of clinical mental illness, mental health is a sense of happiness that allows individuals to recognize their abilities, adapt to the natural tensions of life, and be efficient and productive resources for their communities 1. Such a movefrom laws to mechanisms as the fundamental explanatory goal of our scienceproduces a more coherent and practical conceptual framework. Developing and validating a tablet version of an illness. Use of kleinmans 1980 concept of explanatory models ems is explored first, by describing the concept as it was developed by kleinman. Exploring the use of explanatory models in nursing research. Illness perceptions and explanatory models of viral. An important contribution of the present studies is to analyze how. Pdf the development of the short explanatory model interview. Jul 17, 2015 in this weeks readings and lectures we learned about explanatory models and how they are different for different people. With the concept of explanatory models of illness as a framework, we examined the notions of different categories of traditional and faith healers about mental disorders. Pdf illness explanatory models in contemporary research. The treatments and practices of these traditional and alternative healers will be influenced by their ideas about the causes and effects of mental disorders.
Explanatory models of schizophrenia powerfully affect community perceptions of whether people who suffer from this illness retain their fundamental moral status or humanity. So paramount is this orientation that the professional training of. We learned that different people may have different views of what illness is and that doesnt make them wrong, people especially those from different cultural backgrounds often have very different ways of. People interpret and react to health and illness events within a cultural system. In this model the explanatory factors may be inherent to the conceptual and institutional framework to which policy makers adhere, or they may be real world factors such as badlydefined performance indicators or cyclical economic problems. Explanatory model of helpseeking and coping mechanisms among. On the other hand, biomedicine is primarily interested in the recognition and treatment of disease curing. Individual interviews were conducted with key informant n6, and depressed female patients n6. Mental health is a primary and principal component of health.
We modified the explanatory model framework to accommodate forms of knowledge applicable to communicable infections such as transmission factors and preventive methods. The western medical model is mechanistic in nature. Figure 1 illustrates the conceptual model for this study derived from the csm. The present study aimed to investigate the effect of patient and interviewer characteristics on the assessment of ems among dutch mental health patients of turkish and moroccan origins. A major obstacle in the assessment of ems is the respondents occasional tendency to conceal or misreport their beliefs in an interview situation. We learned that different people may have different views of what illness is and that doesnt make them wrong, people especially those from different cultural backgrounds often have very different ways of understanding illness, its consequences, and how best to treat. Even though varying names such as illness perception model, selfregularity model, parallel process model, explanatory model are used, all are derived from the common sense model csm. Research shows that a patients explanatory model is not simply going to disappear because the patient has had a clinical encounter. A more appropriate scientific model for psychiatry emphasizes the understanding of mechanisms, an approach that fits naturally with a multicausal framework and provides a realistic paradigm for scientific progress, that is, understanding mechanisms through decomposition. However, the explanatory models framework of etiology, time and mode of onset of symptoms, pathophysiology, course of sickness, and treatment is built on categories characteristic of biomedical.
A hypothetical case vignette was also used in focus group discussions and individual interviews with lay people three focus groups including 25. The explanatory model interview catalogue emic refers to a collection of locally adapted explanatory model interviews rooted in a common framework. The first aim is to compare and contrast three different conceptual explanatory models for thinking about mental illness with an eye towards identifying the assumptions upon which each model is. Illness perception models consist of theoretical frameworks to organise information on patients beliefs and expectations into distinct but. Loss, motions, avoidance and construction lmac explanatory model. The energy group showed a first to second factor ratio of 3. This could affect politics if a judge had an explanatory model that people with schizophrenia were inherently violet, the judge might choose harsher sentencing and punishments for those with mental illness if they have a biased explanatory model influenced by false reports, such as in the metzl video where hospitals were aiming to link. Efforts to develop the emic were motivated by research experience in cultural psychiatry and tropical medicine that demonstrated a need to integrate epidemiological and anthropological research methods more effectively. Explanatory model an overview sciencedirect topics. Users are free to download and distribute fast facts for. An explanatory model for the concept of mental health in iranian youth read the latest article version by ahdieh chinekesh, seyed ali hosseini, farahnaz mohammadi, mohammad esmael motlagh, monir baradaran eftekhari, shirin djalalinia, gelayol ardalan, at fresearch. The explanatory model can also be useful in interpreting the culture of western medicine to others who find our explanatory model peculiar. Explanatory models of mental disorders among traditional and. It is an integrated model that takes into account environmental, social, and cultural factors and patients beliefs about health and illness.
As one of the most prevalent diseases globally and as an important cause of disability, depressive disorders are responsible for as many as one in every five visits to primary care doctors. I find that eliciting a patients explanatory model is helpful with most. Illness explanatory frameworks may function as pointers to the kinds of causes that should be recruited in illness explanations. In this study we investigated ethnic differences in beliefs about the causes of tneir illness and use of different sources of care for treating depression. This study attempts to explore the explanatory models of common mental disorders cmd with the goal of identifying how they could help in improving the recognition, leading to effective treatment in primary care. Explanatory models of illness amongst primary health care users in. Assessment of explanatory models of mental illness. A framework for the study of coping, illness behaviour and outcomes.
Use of kleinmans 1980 concept of explanatory models ems is explored first, by describing the concept as it was developed by kleinman, and second, by illustrating how it was used in three research studies conducted between 1990 and 1994. A nursing model for chronic illness management based upon the trajectory framework. It describes how an individual constructs an internal representation of what is happening when they experience physical or psychological symptoms. To facilitate planning of new services for aidsaffected families, a modified version of the emic was employed to study representations of hiv in rural karagwe, tanzania. Cultural variations in clinical presentation, sometimes make it difficult to recognize the disorder resulting in. Explanatory models for psychiatric illness american journal. Mona haugum department of community medicine institute of health and society the faculty of medicine university of oslo may 2011. While the model seems to be an ideal explanatory framework for communication research, theoretical limitations have limited its use in. Explanatory frameworks are sets of assumptions about what types of causes and causal principles are relevant to a particular phenomenon. Explanatory model for asthma disparities in latino. In this weeks readings and lectures we learned about explanatory models and how they are different for different people. How can we best develop explanatory models for psychiatric disorders.
Together these form the proposed lmac loss, motions, avoidance and construction model of sexual intimacy following lpc treatment. Jul 19, 2006 in this model the explanatory factors may be inherent to the conceptual and institutional framework to which policy makers adhere, or they may be real world factors such as badlydefined performance indicators or cyclical economic problems. Explanatory models of health and disease among south asian. To facilitate planning of new services for aidsaffected families, a modified version of the.
Pdf characterizing explanatory models of illness in healthcare. Mar 21, 2015 the definition of the term explanatory model of illness underscores the nonuniversal nature of the manner in which illness is defined and experienced bringing to bear the thesis that illness is a socially constructed experience and not solely the result of purely biological factors. The health belief model hbm posits that messages will achieve optimal behavior change if they successfully target perceived barriers, bene. With the concept of explanatory models of illness as a framework, we examined the notions of different categories of traditional and. Assessing explanatory models and health beliefs cambridge. Expla nations that are inconsistent with a preferred explanatory framework. The work involvement scale and the stress model demonstrated the smallest explanatory power. Individuals have their own explanatory models about health and illness that could influence their health seeking behavior, adherence to treatment regimens and health outcomes. However, the nursing literature contains little about how to elicit cultural beliefs. Weiss, m 1997 explanatory model interview catalogue emic. This is the view of domainspeciwcity theory, which posits that explanatory frameworks for certain kinds of phenomena, including illness, are tied to speciwc cognitive domains. Jul 11, 2017 this could affect politics if a judge had an explanatory model that people with schizophrenia were inherently violet, the judge might choose harsher sentencing and punishments for those with mental illness if they have a biased explanatory model influenced by false reports, such as in the metzl video where hospitals were aiming to link. Schwarzer, in international encyclopedia of education third edition, 2010.
Citeseerx document details isaac councill, lee giles, pradeep teregowda. Understanding the explanatory model of the patient on. Kleinmans explanatory model of illness, in achieving cultural competency. We have introduced test anxiety as a major predictor of performance and have presented the basic framework of cor theory and offered it as a possible explanatory model for the study of assessment of student learning, stress, and anxiety. Explanatory model interview catalogue emic sage journals. Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable. The common sense model csm of ir underpins the conceptual model for this study.
Assessing the stability of schizophrenia patients explanatory models of illness over time. But one important reason may be that the patients way of explaining his illness to himself is at odds with that of the physician. Giduthuri jg, maire n, joseph s, kudale a, schaetti c, sundaram n, et al. The explanatory model interview catalogue emic is a semistructured interview guide used by cultural epidemiologists to collect data on illness representations in different cultural contexts. An individuals explanatory model of illness is an example of an internal factor that can either facilitate or impede helpseeking and influence treatment outcomes kleinman, 1987. The explanatory models of depression and anxiety in. Explanatory models for psychiatric illness american. A new explanatory model for policy analysis and evaluation by. Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of. Explanatory models of illness the way people perceive, interpret and respond to it. Explanatory models of mental disorders among traditional. Understanding the explanatory model of the patient on their. An important part of appraising an illness is making sense of it, and patients often search for causes to which they attribute the onset of an illness. Citeseerx explanatory model of helpseeking and coping.
This chapter examines the concept and underpin nings of the explanatory model framework, its appeal to health professionals and social scientists. Implications for other cultural models of illness are discussed. To facilitate planning of new services for aidsaffected families, a modified version of the emic was employed to study representations of hiv in rural. Explanatory model for asthma disparities in latino children. In particular, while the integration of biological, psychological, and social elements into. Development of an explanatory model of sexual intimacy. Understanding these explanatory models is therefore essential for the effective delivery of healthcare. In bridging the interests of psy chiatry, medicine and medical anthropology its influence has been unrivalled. The illness explanatory model framework as it is now commonly understood developed in the late 1970s, and it is associated most closely with the influence of arthur kleinman and networks in cul tural psychiatry, medicine and medical anthropo logy. In the first section, i propose a central role for multilevel mechanisms. Explanatory models of illness northwestern university.
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