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Qualitative Health Research
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Explanatory Models and Help-Seeking Behavior: Pathways to Psychiatric Care Among Patients Admitted for Depression in Mulago Hospital, Kampala, Uganda

Elialilia S. Okello

Makerere University and Karolinska Institutet

Stella Neema

Makerere University

In this article, the authors present findings from a qualitative study exploring how people diagnosed with depression conceptualize their condition and how their conceptualization shaped their efforts to seek help. They used an interview guide based on an explanatory model framework for data collection. Four major themes emerged from the analysis: (a) somatization, social meaning of illness, and help seeking; (b) meaning and perceived consequences of illness; (c) How did I get here? Making sense of psychiatric admission; and (d) variations in the causal attribution and the role of significant others in help seeking. Somatization of emotional problems, variations in causal attribution between patients and their significant others, the nature of the available health care system, and burden of infectious disease complicate access to care. These findings suggest the need to raise the awareness of primary care providers on how to recognize and help people with depression appropriately in this setting.

Key Words: depression • explanatory model • pathway to care • help seeking • qualitative research

Qualitative Health Research, Vol. 17, No. 1, 14-25 (2007)
DOI: 10.1177/1049732306296433
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W. W. Muhwezi, E. S. Okello, S. Neema, and S. Musisi
Caregivers' Experiences With Major Depression Concealed by Physical Illness in Patients Recruited From Central Ugandan Primary Health Care Centers
Qual Health Res, August 1, 2008; 18(8): 1096 - 1114.
[Abstract] [PDF]