Effects of religions and tradition on home-based caregivers of psychiatric patients in the conflict areas of Southern region

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     The continuing violent conflict in southern Thailand since 2004 has increased anxiety and fear among the citizens of Southern region. The instability effects common citizens and government officers who have had to cope with uncertainty in their daily living – having to withhold any religious rituals or changing commuting route to work for safety and lacking transportation options at a certain time of day due to curfew or unrest, for example. These factors inadvertently cause calamity among psychiatric service provision and delivery. 

     PSU researchers have collected data from psychiatric home care providers at Yala hospital. Previous study conducted by Wantaya et al (2010) highlighted five major categories of need among psychiatric caregivers – participation in care planning; knowledge and information; training in caring skills, caring based on cultural and religious beliefs; and support system. A questionnaire for the current study was adapted from Wantaya’s 2010 questionnaire as a tool. Data analysis revealed consistent results – caregivers ranked knowledge and information to be the highest of needs. Caregivers were interested to learn about characteristics and cause of illnesses, type and method of cares, nature of patient’s mood swing, influence of medication and side effects, and information from various sources. The hospital team must thus respond to these needs by facilitating access to indicated information. Well-informed home-based caregivers can mitigate the negative effects of the southern unrest; information can help caregivers reduce travelling and expense while increase safety and stability to long-term care provision. Moreover, PSU researchers used this research opportunity to provide consultation as well as exchange of knowledge with the caregivers in Yala.

     The need for caring based on cultural and religious beliefs presented as a unique topic for researchers to tackle. Caregivers sought advice on how to integrate their individual patient’ religious principles with modern psychiatric care – from praying to listening to sermons or reading the Koran, participating in religious rituals such as visiting Buddhist temples or mosques, practicing mindfulness and meditation, performing Buddhist ordainment or Muslim Dawa, to involving religious leaders in the process of psychiatric rehabilitation. Majority of caregivers are Muslim whose belief focuses on faith to Allah the God who they believe designs all of beings and suffering. These religious or cultural elements, Buddhist and Muslim alike, should guide caregivers to consistently provide positive reinforcement to their patients; positivity and optimism are believed to uplift the mental hence physical health.  The religious beliefs are already at work as an important influence to the mind of these patients, the caregivers just need to reinforce its connection to life and living for them. One important matter for caregivers to observe is that even though religious practice has been applied to psychiatric care, such as through meditation or prayers, much of it has yet to be appropriated to each patient’s socio-cultural context and environment. Patients living in the conflict zones of southern Thailand present a very unique context, both individually and collectively. Therefore, the practice must be suitable to these contexts. It is also believed that if caregivers treat their patients as their own relatives, the connection between them shall be strengthened as a baseline for successful care in the long run.

     Thanks to information and funding support from Princess Mondharoph Kamalaana Foundation, the Nursing Association of Thailand.

 

Asst. Prof. Tippa Chetchaovalit and Ms. Wilawan Christraksa

Division of Psychiatric and Mental Health Nursing, Faculty of Nursing, Prince of Songkla University

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