Shikha Dixit

Health-Related Quality of Life and Health Management:

The present article discusses the nature of quality of life (QOL) in general and critically evaluates its application in the area of health and illness. As regards health related quality of life (HRQoL), it is now widely recognised that treating a disease in a purely biomedical framework, where emphasis is only on curing the disease and on providing prolonged life to the patient, is not sufficient. Now the focus is also on how to enhance the QOL of patients. In this context this article attempts to identify and critically evaluate some of the contemporary issues relevant in the area of HRQoL. The issues covered in this article include relatively simple issues related to the meaning, importance, usefulness and prevalent approaches in the area of HRQoL research and complex issues such as (i)who would be accountable for a patient’s HRQoL (ii)being HRQoL stable or it changing over time (response shift) for people facing chronic diseases and (iii)whether gender differences exist in this regard. Lastly, the article also discusses the implication of HRQoL in the area of health management and intervention.

Meaning and Explanations of Mental Illness A Social Representations Approach

The notion of mental illness may be closely related to the social values pertinent in any social context. The meaning of mental illness rooted in everyday social psychological processes may be different from scientific and clinical understanding. In order to examine the common meaning of mental illness, the relationship between individual knowledge and implicit social knowledge needs to be explored. This can be achieved by studying the social representation of mental illness. This paper provides an understanding of the content of social representation of mental illness among a group of engineering students, and extends the findings to the broader social context of educated urban middle class youth. A qualitative study was conducted within the theoretical context of the social representations framework. The findings revealed that social representation of mental illness was structured in terms of social understanding of the causes and consequences of mental illness. Further, mental illness derived its meaning from the expectations and norms of society. Mental illness was generally labelled as a form of social deviance and viewed as including an element of volition. The social definition of mental illness appeared to be rooted in the social value that non–normative behaviours that are not in line with the expectations of society are related to mental illness. An interesting feature that was observed was the use of narratives to explain the meaning of mental illness.

Conceptualisation of Health and Illness

The present article attempts to understand the relationship between culture and health through an empirical investigation of health and illness conceptualisation among the members of Bondo tribe of Orissa in India. The investigation of socio-cultural definitions and meanings of health and illness was done using the social representations framework. The dynamic nature of health and illness conceptualisation was investigated among the three groups of Bondos: The upper, isolated group; middle, partially assimilated group; and lower assimilated group. The data was collected through semi-structured interviews, observations and focus group discussions. Qualitative content analysis of responses was done in order to extract the meaning of categories employed by the three groups of Bondos. The content of these categories reflected the content of the social representations of health and illness among the Bondos. The categories employed by the Bondos for sense-making of health and illness states revealed the meanings of health and illness, beliefs regarding causes of illness, healing practices and treatment pattern and the difference in meanings and definitions of health and illness among the three groups of Bondos.

Explanatory models and psychiatric pluralism among family members of mentally Ill persons: a narrative inquiry

ABSTRACT Active involvement of families in mental health care in India is well documented. This study aimed to understand the explanatory models of the family members of persons suffering from common as well as severe mental illness. Narratives were collected through interviews from family members accompanying the patients at a psychiatric clinic. Data were also obtained from professionals at the clinic as well as folk healers. The Constant Comparative Method was used for analysis. The notable findings were: healthcare pluralism at institutional, cognitive and structural levels; conflicting explanatory models about mental illness; and stigma regarding mental illness. The findings suggest that in addition to explanatory models, the accessibility and availability of healers also plays a major role in treatment choices by the families.

Women Living with HIV/AIDS: Psychosocial Challenges in the Indian Context

The main aim of this review article is to outline the factors linked to vulnerability of women to HIV infection and to understand the challenges and possible management of HIV among women. The review is a theoretical endeavour to understand women’s experiences of living with HIV. This review primarily focuses on studies in the Indian set-up, but to further substantiate the arguments and describe the relevant concepts it also takes into account literature from other cultures. On the basis of studies included in this article, it can be surmised that women are more susceptible to HIV due to cultural barriers, health vulnerabilities and social structures. They show less awareness about the treatment facilities, prevention strategies and perceived risk of infection. Women have to face numerous challenges after the infection, such as lack of social support, a higher level of stigma and discrimination, decreased quality of life, mental health issues and adverse coping. To prevent the spread of HIV among women as well as men, it is necessary to plan strategies which deal with empowerment of women, education and awareness regarding the vulnerabilities and knowledge and challenges of HIV infection. There is also a need to address the management of HIV among the infected and even those at risk. This article describes the possible interventions based on existing literature. The review also attempts to suggest certain future directions for the research.