The pathways to health care a comparison between psychotic illness and epilepsy
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Date
2006
Authors
Yasin, Mohd Azhar Mohd
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
INTRODUCTION: Identifying the pathways which patients take to reach health care is
in1portant, as patients' experience of the first pathway to care n1ay determine their future
compliance and progression of the illness. Understanding the type of pathways, hhich
patients take and the associated factors that influence the selection are crucial infonnation
for future intervention to irnprove the quality of health care. Studies on patlnvays to C'.!rc
were sparse and patlnvays to care an1ong local psychiatric patients had not been explored.
A Irv1: The airn of the study \Vas to describe the patlnvays to health care of psychotic
patients (schizophrenia and schizophreniforn1 disorder) to the tertiary health center
(psychiatry and n1edical specialized clinics in HUSM); and to cxatnine the dctnographic,
social, clinical and other fl1ctors influencing the patln\'ay to care. Sin1ilar assessrnents
\vere done in epilepsy patients for con1parison.
f\1ETHOD: The nun1ber and type of previous healers (n1odern and traditional) visited by
patients since onset of illness were assessed using nntltiplc sources of infonnation in 60
psychotic (schizophrenia and schizophrenifonn disorder) and 60 epileptic patients
attending the respecti\·e specialist clinics for the first tin1e during the study period. The
pathways taken by the patients before reaching the clinics were explored by using scnlistructured
interview questionnaires and char1ed on a con1n1on diagram. Patients'
sociodernographic data, details of the illness, and infonnation regarding the decision
tnakers were also gathered during the interview from patients, and family members
CONCLUSION: Epileptic and psychotic illness such as schizophrenia and
schizophrcnifonn disorder have a slight different pathway in help seeking behavior. Asignificant higher nurnber of psychotic than epileptic patients consulted
traditional/alternative healers. As a con1plen1entary treatrnent in Malay society, bon1oh is
n1ore popular than the well-established alternative n1edicine in treating such illness. The
author concluded that the study of path\vay to health care could provide a framework for
better understanding of health services utilization and the associated factors that affect the
services utilization. The effects of socio-cultural belief on the studied population were not
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much different as con1pared to the findings fron1 the earlier studies. f Icnce there is a need
for further understanding about traditional, con1plernentary and alternative medicine and
collaboration between traditional/alternative and modern health services.
Description
Keywords
Epilepsy