TY - JOUR
T1 - Developing a culturally sensitive group support intervention for depression among HIV infected and non-infected Ugandan adults
T2 - A qualitative study
AU - Nakimuli-Mpungu, Etheldreda
AU - Wamala, Kizito
AU - Okello, James
AU - Alderman, Stephen
AU - Odokonyero, Raymond
AU - Musisi, Seggane
AU - Mojtabai, Ramin
N1 - Funding Information:
The authors would like to acknowledge the support of the management of the Gulu and Kitgum local government administration and regional referral hospitals where the two PCAF trauma clinics are situated, as well as the mental health section of the Ministry of Health, Uganda. We appreciate the support from the Peter C. Alderman Foundation. We are extremely grateful for the hard work of all research assistants especially Jean Laker, Milton Ojede and Elizabeth Nakanjako who collected data for this project. Lastly, we thank the study participants for their time and trust.
Funding Information:
The study was funded by the Grand Challenges Canada: Rising Stars in Global Health Award, Grant no. 0124-01.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2014/7
Y1 - 2014/7
N2 - Background Depression is ranked first among neuropsychiatric diseases that contribute to the burden of disease in low- and middle-income countries. However, access to antidepressants is limited and there is a dearth of locally developed psychotherapeutic interventions targeted to treat depression. Aim We aimed to obtain information on the cultural understanding of depression symptoms, complications and treatment methods used in post-conflict communities in northern Uganda in order to inform the development of an indigenous group support intervention to treat depression. Methods Focus group discussions (FGDs) were conducted with a total of 110 men and women aged 19-68 years. FDGs took place in a private space, lasted about 2-3 h and were conducted in the local language for patients and their caregivers and in English for health workers. Interview transcripts from the FGDs were reviewed for accuracy, translated into English and transcribed. QRS Nvivo 10 qualitative data analysis software was used for coding and thematic analysis. Results Our study revealed community misperceptions about etiology, presentation and treatment of depression. Regardless of HIV status, most FGD participants who were not health workers linked depression symptoms to HIV infection. Although there were concerns about confidentiality of issues disclosed, many FGD participants were supportive of a group support intervention, tailored to their gender and age, that would not only focus on treating depression but also provided them with skills to improve their livelihoods. Simple CBT techniques were deemed culturally appropriate and acceptable. Limitation Generalizability of study findings may be limited given that the sample was primarily of Luo ethnicity yet there are different ethnic populations in the region. Conclusion Local communities can directly inform intervention content. The participants' preferences confirmed the need for a gender-specific intervention for depression that extends beyond medications and empowers them emotionally, socially and economically.
AB - Background Depression is ranked first among neuropsychiatric diseases that contribute to the burden of disease in low- and middle-income countries. However, access to antidepressants is limited and there is a dearth of locally developed psychotherapeutic interventions targeted to treat depression. Aim We aimed to obtain information on the cultural understanding of depression symptoms, complications and treatment methods used in post-conflict communities in northern Uganda in order to inform the development of an indigenous group support intervention to treat depression. Methods Focus group discussions (FGDs) were conducted with a total of 110 men and women aged 19-68 years. FDGs took place in a private space, lasted about 2-3 h and were conducted in the local language for patients and their caregivers and in English for health workers. Interview transcripts from the FGDs were reviewed for accuracy, translated into English and transcribed. QRS Nvivo 10 qualitative data analysis software was used for coding and thematic analysis. Results Our study revealed community misperceptions about etiology, presentation and treatment of depression. Regardless of HIV status, most FGD participants who were not health workers linked depression symptoms to HIV infection. Although there were concerns about confidentiality of issues disclosed, many FGD participants were supportive of a group support intervention, tailored to their gender and age, that would not only focus on treating depression but also provided them with skills to improve their livelihoods. Simple CBT techniques were deemed culturally appropriate and acceptable. Limitation Generalizability of study findings may be limited given that the sample was primarily of Luo ethnicity yet there are different ethnic populations in the region. Conclusion Local communities can directly inform intervention content. The participants' preferences confirmed the need for a gender-specific intervention for depression that extends beyond medications and empowers them emotionally, socially and economically.
KW - Culture
KW - Depression
KW - Group support psychotherapy
KW - HIV/AIDS
KW - Northern Uganda
KW - Social support
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U2 - 10.1016/j.jad.2014.03.042
DO - 10.1016/j.jad.2014.03.042
M3 - Article
C2 - 24836082
AN - SCOPUS:84898805670
SN - 0165-0327
VL - 163
SP - 10
EP - 17
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -