Article Type : Research Article
Authors : Humaida IAI and Kegour AB
Keywords : Beliefs; Attitudes; Mental illness; Patients; Religious healers; Sudan
The
study aims to investigate the beliefs and attitudes of mental illness patients
towards religious healers in Khartoum State, and also to identify whether
beliefs and attitudes of mental illness patients attending religious healers in
Khartoum State were affected by other variables such as: educational level,
gender, age, and marital status. The sample comprised (174) mental illness
patients attending religious healing centres, they were selected through
purposive sample. The instrument of data collection was a scale for measuring
patients' beliefs and attitudes designed by researchers, and reliability of the
Scale was (0.71). Statistical package for social sciences (SPSS) was used for
data analysis. The results indicated that beliefs and attitudes of most
patients towards religious healing is positive, there was no significant
difference in patients' beliefs and attitudes towards religious healing
according to gender, age, and educational level. In conclusion, the study
suggested some recommendations, the most important is to highlight the positive
impact and role of religious healer’s treatment on patient’s health, so their
role should not be neglected and they should work in collaboration with the
mental health system and integrating them into primary health care. At the end
of this research, there were some recommendations as well as suggestions for
further studies.
Traditional healing is considered as old and
everlasting medical process before the advent of modern medication. Traditional
healing varies across cultures, and almost all people around the globe have
developed such practice, therefore, traditional medicine has been carried out
in all cultures [1]. Due to the fact that traditional medicine as an indigenous
healing has been developed over generations within various societies. The World
Health Organization (WHO), defines traditional healing as "the product of
the knowledge, skills, and practices based on the theories, beliefs, and
experiences relevant to specific culture [2]. Traditional healing implies
various health practices, approaches, techniques and exercises offered to
maintain well-being as well as to diagnose and treat mental disorders [3]. A
majority of the Sudanese adopts traditional religious healing to enhance their
primary health care needs. In addition to religious healing is available and
accessible as it is a part of their belief system [4]. During El Tigani El
Mahi's era (1911-1970) who was a famous Sudanese psychiatrist, traditional
healing has remarkably developed and is widely accepted among the Sudanese, not
only among illiterates but also among well educated people, influencing all
aspect of the Sudanese lives [4].
The majority of mentally ill patients in Sudan prefer
to attend nonmedical practitioners such as religious healers because of their
beliefs, trust on their healing, affordability, in addition to lack of awareness
among the Sudanese, ease of the service, and that psychiatric illness requires
long duration under treatment, owing to mental ill patients look for fast
recovery, there for the problem of this research lies in the role of illness
beliefs and attitudes of mental illness patients, the demographic
characteristics which leads patients to choose religious healers treatment.
This research raises the following questions:
· What was trend of
patients' beliefs towards religious healing in Sudan?
·Was there a significant
difference in patients' beliefs and attitudes towards religious healers in
Khartoum State owing to gender, age, and educational level?
· To examine the general
trend of beliefs and attitudes of mental illness patients towards Religious
Healers in Sudan.
· To investigate the effect
of some other variables such as age, gender, and educational level on patients,
beliefs towards traditional healing.
· Patient’s beliefs and
attitudes towards religious healing were positive.
· There was no significant
statistical difference in patients' beliefs and attitudes towards religious
healers in Khartoum State attributed to age, gender, and educational level.
In Sudan, religious healing which is known to be as form of traditional healing, based on deep belief in metaphysical supernatural powers as causative factors, therefore, patients with metal illnesses seek traditional healers. This research has an important scientific value, as it tackles a significant and popular way of treating psychiatric patients suffering from mental illness. However, coordination with the formal psychiatrists is highly needed in dealing with specific health problems and in emergency psychiatric disorders.
Research
limitations
The study was carried out in Khartoum State, two
religious healing centres were selected, (Umm Dawan ban and Saim Dema for Sufi
and Quran healing). About one hundred and seventy-four (174) of mental illness
patients attending these religious centres were interviewed.
Definitions
of terms
Beliefs: are states or conditions of mind in which
confidence is placed in persons or things [5].
Attitudes: they are relatively fixed feelings toward
a person, idea, or object. Attitudes whether positive or negative, are
influenced by both external and internal forces [6].
Mental illness: is
a health problem that makes a person feels, thinks, behaves in an abnormal way
[1].
Traditional
healer: is someone who believes he can treat and
heal sick people using prayers or supernatural powers [7].
Preface
The incidence of mental disorders is globally accepted as major health disaster affecting human well-being and normal functioning. Statistics have shown that the number people with mental illness is increasingly growing, therefore, procedures of prevention and therapeutic techniques of mental illness should be made available to all mentally disturbed individuals all over the world, with regard to their races, diversity in their attitudes, beliefs, and deeply rooted tradition. The importance of spiritual factor in mental health is now widely accepted. Religious healing has been practiced by many cultures for many years, and is an accepted mode of treatment in different cultures. Permanent seeking for traditional healers in both urban and rural areas in Sudan in particular, and worldwide have led to the development of folk psychotherapy to cure a wide range of psychological problems. It is clear that that healing beliefs and practices are beneficial to mental health.
Mental
illness
With regard to definition of specific nature of mental illness, however, psychologists often state that mental disorder involve behaviour that is distressing, dysfunctional, and different from the social norms. Theories that have attempted to explain the etiology of mental illness include the biological approach, the psychodynamic, the behavioural, and the sociocultural. The most frequently used sources for classifying mental disorders are: Diagnostic and Statistical Manual of Mental Disorders (DSM); the first edition was published in195, and the most recent edition, called DSM-1V. The other classification is International Classification of Diseases (ICD) – (WHO) [8]. Mental illnesses have different types and degrees of severity. Neuroses or disorders based on anxiety, patients who experience these disorders usually report being restless, however, these people typically live in the community, rather than in a hospital. According to statistics, this group of anxiety –related disorders affects many people all over the world. In other words, millions of people are anxious, unhappy, and afraid. Anxiety-related disorders include: Generalized anxiety disorders, Panic disorders, Phobic disorders, Obsessive-Compulsive disorders, Post-traumatic stress disorders, and Conversion disorders. The most common characteristics among patients suffering from neuroses are their touch with the reality. As observed by the researchers in this study, patients' beliefs in traditional healers and well-oriented with the nature of their disorders and stress [9]. Psychoses are major mental illnesses that are characterized by severe symptoms such as delusions, hallucinations, disturbances of the thinking process, and defects of judgment and insight. Psychotic patients show thought distortion, emotional unrest, and abnormal patterns of behaviour. Such patients are often off reality (derealisation), do not know that they are ill (lack of insight) and they have obvious confusion concerning the outside world. Generally, psychoses are divided into organic and functional psychoses. Organic psychoses are those disturbances connected with a physical defect of or brain damage, e.g. Alzheimer and Epilepsy. Whereas, functional psychoses occur due to psychological or non-organic factors e.g. Schizophrenia and Affective psychoses. Nevertheless, many researchers believe that this distinction between organic and functional is probably inaccurate, because almost all psychoses are currently believed to result from some structural or biochemical change in the brain [10].
Traditional
healing
According to World Health Organization (WHO),
traditional medicine is an overall product of knowledge, skills and practices
based on beliefs and experiences relevant to a distinct or particular people.
Traditional healing aims to achieve certain objectives such as maintenance of
health, as well as prevention, diagnosis, and treatment of physical and mental
illness. Spiritual healing is dated back an ancient from of healing to
ancestors who believed in superstition and supernatural forces such as devils and
evil spirits as causative of mental disorders. Hence, the role of spiritual was
to get rid of such demons from the patient’s brain [11]. Most of religious
healers claim that cure is from the God, and they have a belief in verified
ways of healing process. In Sudan native religious healers throughout northern
Sudan is known as the faki. The faki usually share the value and attitudes of
his community. He plays multiple roles as a religious healer, teacher, diviner
and religious leader. Also plays a very important role, especially in rural
Sudan, in addition, he is a community leaders and he is usually consulted in a
number of social issues, they well known, trusted and respected by all the
members of his community. The treatment of the faki is based mainly on the holy
Quran and Sunna.
Traditional
medicine in Sudan
Sudan traditional healing or medicine; is regarded as
being unique because it combines a mixture of Islamic, Arabic, and African
cultures. In poor and remote parts of the country, traditional medicine has
become the most practical treatment for a variety of mental disorders and their
patients. According to the Sudanese general traditional medicine, plants and
herbs are intensively used in curing different diseases and ailments, specific
traditional medicine on contrast, can also be divided into two separate
entities: Religious healing, which based on Islamic culture; uses The Holy
Quran and Prophetic tradition. Non-religious healing, which is based on African
culture; believes in secular practices such as black magic and Zar. As matter
of fact, traditional medicine makes use of different natural elements.
Therefore, traditional medicine experts are well-versed on the use of plants
and herbs for both medical and nutritional purposes to patients, as well as
being recognized as professionals on patients' attitudes and beliefs towards
traditional healing [12]. Traditional healer is characterized as an outstanding
individual who claims ability or having a healing power to cure mental illness,
or a particular skill to treat specific types of physical complaints. In Sudan,
traditional healing is the popular and widely spread way of treating people
with psychiatric illness, owing to traditional healers have high reputation and
recognized among in the society. Traditional healers as they are aware of local
treatment options, as well as about the physical, emotional and spiritual lives
of the people they serve, are able to influence their behaviour. Therefore, it
is necessary to consider traditional healers as effective health care providers
for patients suffering from mental disorders, and also to consider their
remarkable contribution in meeting the needs of those helpless patients [7].
The religious healers in traditional and religious centres in Sudan use many techniques
and methods for healing and treatment for mental illness, such as the
traditional management includes reading Quran on the patient, drinking water
with papers soaked, wearing amulets and fumigation.
Attitudes are complex psychological constructs which
can be acquired through experience and they are also viewed as an individual's
predisposed state of mind, which in turn influences the individual's thought
and behaviour (M Richard, 2010, p, 40). Attitudes formation takes place as a
result of various ways, and they begin forming since early childhood. Many
psychologists view that attitudes formation occurs through direct experiences,
persuasion, and media, however, contemporary researchers have suggested that
attitudes may emerge out as a result of psychological needs, social
interactions, and genetic factors. Attitudes have three components or domains:
conative, cognitive, and affective [13].
Religious
beliefs
Religious beliefs comprise a wide range of practices
and rituals, these practices vary across cultures such as prayers, meditations,
yoga, transcendental meditation, and involvement with community religious
groups. It is of prime importance to examine closely the concept of religious
belief, as it concerns only with human perception. On the other hand, spiritual
beliefs are derived from ideas that are exclusive to religion, relate to the
existence, and worship including explanations for the values and practices
centred on the teachings of a spiritual healing. It is worth stating that both
religious and spiritual beliefs can find answers to the existential questions
concerning mental illness and the possibility of being cured. Helping patients
and family members to find meanings for their experiences, however, still
constitutes a challenge for health professionals, due to the fact that
psychotherapists maybe not able to deal with patients’ religious and spiritual
beliefs [14]. It is necessary for patients' religious beliefs be recognized and
integrated in the development of a plan that guarantees and keeps mental health
care [15]. Beliefs can play an important role in living with mental illness
since they can be determinants of patients’ health behaviour in managing
illness, therefore, words such as ‘perception’, ‘cognitive representation’ and
‘explanation’ can be used synonymously with beliefs, but the term ‘belief’ is
the most preferred [16]. Having a belief in the nature of mental illness and
its causes affects how religious healers deal with it and remains fundamental
for a number of theoretical models of illness behaviour, causation and
medication compliance knowing a patient’s beliefs regarding their condition is
clinically relevant for managing their condition and can also help predict
recovery from mental disorders. Spiritual healers are recognized as effective
factors that contribute to mental health in many persons. The concept of such
healing is found in all cultures and societies, and it is expressed in an
individual's constant search for ultimate meaning through active involvement in
religion and/or belief in God [17].
Attitudes of patients with psychiatric illness towards traditional healing [18,19]
The aim of this study is to evaluate the attitude of
patients toward traditional healing in Khartoum teaching hospital in Sudan,
Patients who attended the outpatient clinic were asked about previous history
of seeking treatment from traditional healers. A questionnaire was administered
to patients. The results reported that about (84%) of patients had a previous
history of seeking traditional treatment for psychiatric illness. Besides, no
significant difference was found between the two groups regarding psychiatric
diagnosis and demographic characteristics such as age, gender and educational
level. The majority of participants (55.9%) believe that their psychiatric
symptoms are due to evil eye, and 20.7% believe that the symptoms are due to
magic.
magic.
The
significance of faith healers in the treatment of mood disorders in in United
Arab Emirates [20]
The study is meant to explore the role of faith
healers in the treatment mood, and the procedures are Mini International
Neuropsychiatric Interview, Help-Seeking Pattern, and Experience Questionnaire
The results showed that majority of patients had visited faith healers before
seeking medical services. Families from rural areas looked at mental illness as
a real disease as any other organic disease. In faith healing, different
diagnoses, which included touch, evil eye, witchcraft, and demon possession
were more common among patients' resident in rural and urban areas.
The
impact of traditional healing in caring for patients with affective disorder in
Egypt [21]
This research is done to reveal the impact of
traditional healing on patients with affective disorder. Clinical Interview for
DSM-IV Axis I Disorder (SCID-I) was adopted. The results concluded that 40.8%
sought traditional healers. And of those, 62.2% were before seeking psychiatric
services and 37.8% after. Furthermore, the study emphasized that most of the
patients suffering from mental illness prefer to experience religious healers
rather than psychiatric thereby.
The
incidence of mental disorders Among Visitors to religious healers in Saudi
Arabia
The research attempts to investigate the prevalence of
psychiatric disorders among visitors to religious healers in Riyadh, Saudi
Arabia. Research method is cross-sectional study among the visitors and a
questionnaire as well as Mini International Neuropsychiatric Interview were
implemented on samples. The results showed that most of the participants were
youths with intermediate and secondary education. Moreover, Depressive and
anxiety disorders were the most common among the respondents.
Attitudes
towards traditional healing: Implications for integration of traditional
healing and modern medicine in South Africa [22]
The study is conducted to examine health care
practitioners’ attitudes traditional healers. The methodology is telephonic
conversation with hospital clinical managers and health care practitioners.
Health care practitioners working in rural and urban hospitals in South Africa
were tested. The results showed a significant difference among health care
practitioners with regard to their attitudes towards traditional healers, and
no significant difference found pertaining to health care practitioners’
knowledge of traditional healing.
Treatment plans of
psychotic disorders by traditional healers in Sudan [23]
This research is intended to investigate plans of
treating patients with psychotic disorders by traditional healers as well as
their interventions. The methodology based on quantitative approach, and the
selected samples were diagnosed through neuropsychiatric assessment. The
results stated that the age of the patients brought for treatment to the
traditional healer centres ranged from 19 to 52 years old, were single, and had
basic education only. The mean for the overall Positive and Negative Syndrome
Scale score was (118.36) on admission and (69.36) on discharge.
Some
demographic characteristics of patients with mental illness at traditional
healers’ centers in Sudan [24]
The study is about the demographic characteristics of
patients with mental disorders at traditional healers' centres in Sudan. The
researchers used a cross-sectional study, and administered specially designed
questionnaire and structured interview. The results found that patients mean
ages were 35 years, illiterate, and jobless. Furthermore, the patients were
diagnosed as having psychotic disorder.
The
Socio-demographic characteristics of people with mental disorders who seek
treatment from traditional healers in Sudan [25,26]
The study is conducted to highlight the
socio-demographic characteristics of people with mental disorders who seek
treatment from traditional healers. In order to fulfil that aim, both
qualitative and quantitative research methods were used, as well as structured
questionnaires for data collection. The result pointed out that there should be
a mutual cooperation between traditional healers and mental health
professionals that can be attained through seminars and programs, and
workshops.
The
effect of some variables on patients’ attitudes towards traditional medicine
treatment
The aim of this study is to know the reasons behind
the attitudes of some patients who resort to traditional medicine. Also to know
the socio - economic and characteristics of traditional healers found within
the study society, as well as knowing the diseases they are able to treat, and
the means they follow in such treatment. The study used comparative analytical
descriptive method, used stratified sampling, and standardized interview
targeting the head of household was used as the basic means for data
collection, as well as the scientific observation. Additionally, the researcher
tried to conduct interviews with some of the patients in the native treatment
centres in Shendi city but no response was obtained there.
Techniques
of traditional healing of mental disorders in Sophia Centres [27]
The study aims to examine how Sheikhs in traditional
healing centres deal with mental disorders. To achieve that end, a descriptive
method was used, and the data was collected through questionnaires. The
analysis of questionnaires indicated that similarity of techniques used in
dealing with mental disorders among Sheikhs depending on their knowledge about
signs, symptoms and causes of these disorders. Besides, there was a
relationship between the treatment of mental disorders and patients' beliefs,
in addition to, there are many practices in the treatment in the Sophia centres
that similar to what is going on at modern psychiatric centres.
Mental
disorders among patients seeking for traditional healers in urban Tanzania [28]
This research was conducted to investigate the
prevalence of common mental disorder among patients attending traditional
healing centres in Dar el Salaam. A clinical interview was carried out to
determine the prevalence of mental disorders in 178 patients from traditional
healer centres. The result found that (48%) of patients suffering from mental
disorders at traditional healer centres.
Patients,
Attitudes towards medical treatment and traditional healing in Sudan [29]
The aim of this research is to investigate the
patients' treatment dilemma and reasons that lead patients to switching between
the two health care systems (medical treatment and traditional healing). The
methodology is questionnaire to two types of practitioners (psychiatrists and traditional
healers) also questionnaire to patients attending psychiatric hospitals and
patients attending traditional healing centre. Three hospitals are Altigani
Almahi, Khartoum North and Khartoum Teaching Hospital. Also seven traditional
centers in and around Khartoum are: Massed Sheikh Alyagout, Shiekh Algeili Abd
Almahmowd, Umm Dwanban, Sheikh Abo Groun, Sheikh Abd Alrahim Albra’ai, Sheikh
Shernobe centre, for Sufi healing and Sheikha Nafisa centre for Zar healing
lies at Khartoum north. Both quantitative and qualitative methods are
implemented. The results showed that attitudes of mentally disturbed people
towards traditional healing in Sudan were positive. And no correlation found
between attitudes towards traditional healing and level of education (Tables
1-3).
Research
methodology: To
fulfil the objectives of the study, a quantitative research methodology was
implemented through using the descriptive inquiry.
Population and sample: The population consisted of patients with mental illness who were attending religious healers in Khartoum State. A purposive sample method was adopted, therefor, the sample size was (174) respondents.
Instruments
The researchers designed a measurement about beliefs and attitudes of mental illness, it includes four dimensions consisted of 51 statements , the first dimension is about knowledge of religious healing of patients with mental illness attending religious healing consisted of 10 statements, second dimension is about the behaviour of patients towards religious healing consisted of 7 statements, third dimension is about emotion towards religious healing consisted of 9 statements and the fourth dimension is about belief in psychological illness consists of 25 statements.
Table 1: Characteristics of sample
Variables
|
Gender |
Age |
Region |
Education |
M. status |
Income |
|
Male (73) 42% |
Less than 20 (11) 6.3% |
North (47) 27% |
Law (33) 19% |
Married (107) 61.5% |
High (21) 12.1% |
Female (101) 58% |
20-40 (83) 47.7% |
West (29) 16.7% |
Medium (107) 61.5% |
Widow (4) 2.3% |
Medium (118) 67.8% |
|
|
41-60 (68) 40.2% |
East (8) 4.6% |
High (34) 19.5 |
Divorce (1) .6% |
Low (35) 20.1% |
|
|
Over 60 (10) 5.8% |
Khartoum (68) 39.1% |
|
Single
(61) 35.6% |
|
|
|
|
Centre (22) 12.6% |
|
|
|
|
|
|
|
|
|
|
|
Data analysis: Data
was analysed using statistical package (SPSS) version 21 to analyse the
quantitative data, using below tests:
·
T- Test for one sample.
·
T. Test for two samples.
·
One -way ANOVA.
·
Frequency and percentage.
Table 2: Shows internal consistency of the scale.
Dimensions |
No |
Correlation |
No |
Correlation |
No |
Correlation |
Knowledge of
religious healing in patients with mental illness attending religious healing |
1 |
0.191 |
5 |
0.672 |
9 |
0.731 |
2 |
0.458 |
6 |
0.426 |
10 |
0.407 |
|
3 |
0.047- |
7 |
0.729 |
|
|
|
4 |
0.738 |
8 |
0.624 |
|
|
|
The behaviour
of patients towards religious healing |
11 |
0.172 |
14 |
0.691 |
17 |
0.29 |
12 |
0.734 |
15 |
0.231 |
|
|
|
13 |
0.127 |
16 |
0.684 |
|
|
|
Emotion
towards Religious Healing |
18 |
0.49 |
21 |
0.465 |
24 |
0.218 |
19 |
0.618 |
22 |
0.223 |
25 |
0.183 |
|
20 |
0.443 |
23 |
0.149 |
26 |
0.569 |
|
Belief in
Psychological Illness |
27 |
0.248 |
36 |
0.513 |
45 |
0.187 |
28 |
0.253 |
37 |
0.629 |
46 |
0.488 |
|
29 |
0.387 |
38 |
0.017 |
47 |
0.54 |
|
30 |
0.475 |
39 |
0.358 |
48 |
0.398 |
|
31 |
0.607 |
40 |
0.506 |
49 |
0.505 |
|
32 |
0.374 |
41 |
0.223 |
50 |
0.357 |
|
33 |
0.449 |
42 |
0.57 |
51 |
0.626 |
|
34 |
0.196 |
43 |
0.533 |
|
|
|
35 |
0.508 |
44 |
0.335 |
|
|
Procedures
A questionnaire was pre- tested on a sample of 30
patients for both centres to determine the validity and reliability of the
questionnaire and the measurement before they are applied in the survey. Also
the researchers consulted some specialists in this field to ensure validity of
measurement. The above table shows the consistency for the dimensions of the
scale, some questions are deleted, others changed, these changes done under the
judgment of expertise in this field.
Validity
and Reliability: Validity
and reliability are used to determine the psychometric properties of the
measurements. The above table shows the reliability values for the dimensions
of the scale are about (0.705), and the validity is about (0.839), which
indicates that the measurement (scale) had a rate of validity and reliability
which justify its use on this study.
Table 3: Shows reliability and validity of scale.
Validity
by square root (Sqrt) |
Reliability
by Cronbach's Alpha |
No
of questions |
Dimensions
|
0.88 |
0.79 |
10 |
Knowledge of religious healing in patients
with mental illness attending religious healing |
0.81 |
0.65 |
7 |
The behaviour of patients towards religious
healing |
0.75 |
0.56 |
9 |
Emotion towards Religious Healing |
0.91 |
0.825 |
25 |
Belief in Psychological Illness |
0.84 |
0.71 |
51 |
Total |
Table 4: Shows one sample t. test to determine the trend of patients' beliefs and attitudes towards religious healers in Khartoum State.
Dimensions |
N |
Mean |
Test value |
Std.
Deviation |
t. value |
sig |
Interpretation |
Knowledge of religious healing in patients with mental illness
attending religious healing |
174 |
39.05 |
30 |
2.84 |
64.95 |
0.00 |
the dimension is high at average, at statistical level 0.05 |
The behaviour of patients towards religious healing |
174 |
24.06 |
21 |
1.65 |
24.43 |
0.00 |
the dimension is high at average, at statistical level 0.05 |
Emotion towards Religious Healing |
174 |
32.94 |
27 |
2.32 |
33.70 |
0.00 |
the dimension is high at average, at statistical level 0.05 |
Belief in Psychological Illness |
174 |
84.69 |
75 |
4.83 |
26.07 |
0.00 |
the dimension is high at average, at statistical level 0.05 |
Total |
174 |
180. 78 |
153 |
8.82 |
40.71 |
0.00 |
the dimension is high at average, at statistical level 0.05 |
Dimensions |
Comparing groups |
N |
Mean |
Std.
Deviation |
t. value |
Sig |
Interpretation |
Knowledge of religious healing in patients with mental illness
attending religious healing |
Male |
73 |
38.7260 |
2.98729 |
1.227
|
0.222
|
There is no statistical difference |
Female |
101 |
39.2574 |
2.69315 |
||||
The behaviour of patients towards religious healing |
Male |
73 |
23.5890 |
2.12678 |
3.270
|
0.001
|
There is statistical difference in favour of female group |
Female |
101 |
24.3960 |
1.08701 |
||||
Emotion towards Religious Healing |
Male |
73 |
33.1644 |
2.44389 |
1.099
|
0.273
|
There is no statistical difference |
Female |
101 |
32.7723 |
2.23106 |
||||
Belief in Psychological Illness |
Male |
73 |
84.4247 |
5.37979 |
0.459
|
0.647
|
There is no statistical difference |
Female |
101 |
84.7624 |
4.31312 |
||||
Total |
Male |
73 |
179. 792 |
10.73023 |
0.959
|
0.339
|
There is no statistical difference |
Female |
101 |
181. 092 |
7.07262 |
Hypothesis
1: Beliefs and attitudes of mental illness
patients towards religious healers in Khartoum State were positive. To verify
this hypothesis, the researchers used one-sample t-test. Table 4 shows one
sample t. test to determine the trend of patients' beliefs and attitudes
towards religious healers in Khartoum State. The above table shows the t-test
to verify whether beliefs and attitudes of patients towards religious healing
are positive. It is noted that the values of T (T) respectively in all
dimensions (64.950, 24.432, 33.698, 26.074, 40.701) and the means are (39.0465,
24.0575, 32.9368, 84.6864, 180. 772) respectively in all dimensions, and the
probability values respectively in all dimensions is (0.00), which indicates
that all dimensions of the beliefs and attitudes of patients towards religious
healers are high, at the significance level 0.05 (Table 4).
Discussion
From the above table, it is clear that t-test is
respectively in all dimensions (64.950, 24.432, 33.698, 26.074, 40.701) and the
probability values respectively in all dimensions is (0.00), that the dimension
is high on average, at statistical level less than (0.05), which confirm &
agree with the researcher hypothesis that is patient’s illness beliefs and
attitudes towards religious healing are high. The result agrees with the study
of, which found most of visitors had strong belief in religious (sheikhs)
healing. Also the result agrees with study of who found (98%) of respondent’s
their belief in God, and religious, about (58%) were very strong in their
beliefs [30]. In this regard, patients and their relatives' belief that only
religious healers can understand the supernatural etiological basis of mental
disorders rather than psychiatrists, and thus, their tendency towards
traditional healing was found to be significant and positively [29]. Most
patients’ belief in healers as source of blessing, advice or for forgiving.
Also most people have their own way (tarega), they are followers, they belief,
and consult sheikhs in everything during their life. They belief in sheikh’s
treatment more than doctors' treatment. They attend massed because they found
psychological and spiritual comfort, they belief that Allah (God) and Quran
bring their final cure. Many reasons that people attending religious healing
(healers) respect and trust healers and their healing, leading to a good
relation build between healers and patients based on confidence, effectiveness
and respect, the most of them seek help and advice for other problems such as
family, business, or other social or financial problems. Stigmatization play an
important role that patients attended religious healers, some people and their
family still have the stigma of mental illness, most of those people and
families have low awareness of psychiatric health and illness, so they refuse
to bring the patient to psychiatrists, so no one will know they have a mental
patient, to avoid this stigma and shame they actually take their patients to
traditional healer who is accepted by their community, all those reasons lead
patients to have positive and high beliefs and attitudes towards religious
healing [31]
(Table 5).
Hypothesis
2: It predicted that there was no significant
difference in patients' beliefs and attitudes towards religious healing
attributed gender. The researchers used t-test for two independent groups.
Table 5 shows the two independent samples t. test to find out whether there are
differences in beliefs and attitudes of mental illness patients towards
religious healers in Khartoum State according to gender. It was found that the
calculated T values were respectively (1.227, 3.270, 1.099, 0.459, 0.959), and
the probability value are (0.222, 0.001, 0.273, 0.647, 0.339), which indicate
that there are no statistically significant differences in all dimensions of
patient belief and attitudes towards religious healing according to gender.
Except the dimension of behaviour of patients towards religious treatment which
found that there were differences of function by type in favour of the female
group at the significance level 0.05. The
results found that there was no significant difference in all dimensions of
patient belief and attitudes towards religious healing according to gender,
this results disagree with the researcher's hypothesis that (there is
correlation between religious healing and patient gender). The result agrees with
the study on the Attitudes of patients with psychiatric illness toward
traditional healing which found that there is no significant difference in
gender, however, this result disagrees with the study Ehab. For the dimension
of “The behaviour of patients towards religious healing” the result found that
there is statistical difference in favour of female group, this result agrees
with the researcher hypothesis and this agrees with the study. The researchers
expected that females are more attendants to religious healing than males for
many reasons, first, most of female are belief that they are facing
psychological problems in their live, because of males' dominance, which may be
of the low socio-economic status in their society, culturally males are more dominant
in decision making and at home. Another reason woman had limited access to
health awareness especially in rural areas. Socialization, cultural beliefs,
economic and social conditions for both females and males play an important
role in their beliefs and attitudes towards religious healing [32-40].
Hypothesis 3: It hypothesized that there was no significant difference in beliefs and attitudes towards religious healing owing to patient's educational level. The researchers used one-way ANOVA to determine whether there was a differences in beliefs and attitudes of mental illness patients attending religious healers in Khartoum State according to education level (Table 6,7).
It shows the result of one- way ANOVA to test the
difference in beliefs and attitudes of mental illness patients towards
religious healers in Khartoum State according to education level. The above
table showed that there are no statistically significant differences in all
dimensions of belief and attitudes towards religious healers according to
educational level, except the dimension of emotion towards religious healing
where it found statistical significant differences according to educational
level at the significance level 0.05. The researcher hypothesis is there were
no statistically significant differences between belief and attitudes towards
religious healing and patient’s educational levels, researcher expected that
all people with different educational levels are attending and belief in
religious healing. So the result found that there is no statistical difference
in the illness beliefs and attitudes of patients towards religious healing
according to educational level, which confirms and agreed with the researcher
hypothesis. The result was consistent with the study of which found that there
are no significant differences in educational level, in addition to the study.
The result disagrees with, which found that most visitors were illiterate or
with only primary basic education, and also the result. On the other hand, the
results of the dimension of emotion towards religious healing which found there
is statistically significant differences according to educational level. And at
the significance level 0.05, this result agrees with the study who revealed
that majority of the patients were illiterate regarding education. Some studies
found that when level of education increases, the belief and attitude towards
religious healing will decrease. The effect of religiosity should play role in
seeking help from religious healers which indicates that cultural attitudes are
directly influenced by religious beliefs. This confirm that most of patients
with different educational levels attend religious healers according to their
rural cultural beliefs, that religious healing is accepted by their
communities, most of people belief in sheikhs' treatment as a main source of
treatment, in addition to the strong belief that religious healing should
facilitate and improve knowledge, attitude and manage their illness.
Socialization plays an important role in the patient’s beliefs towards
traditional (religious) healing; most of rural families are strong believers in
traditional medicine more than hospital or modern medicine (psychiatrics),
although education leads to changes the negative perceptions towards mental
illness to positive and correct concepts about the psychological and mental
illness [41-50].
Table 6: shows the result of one- way ANOVA to test the difference in beliefs and attitudes of mental illness patients towards religious healers in Khartoum State according to education level.
Education level |
Sum of
Squares |
df |
Mean
Square |
F |
Sig. |
Interpretation |
|
Knowledge of religious healing in patients
with mental illness attending religious healing |
Between Groups |
36.754 |
5 |
7.351 |
0.919 |
0.470 |
|
Within Groups |
1343.040 |
168 |
7.994 |
|
|
There is no statistical difference |
|
Total |
1379.793 |
173 |
|
|
|
||
The behaviour of patients towards religious healing |
Between Groups |
23.053 |
5 |
4.611 |
1.728 |
0.131 |
There is no statistical difference |
Within Groups |
448.372 |
168 |
2.669 |
|
|
||
Total |
471.425 |
173 |
|
|
|
||
Emotion towards Religious Healing |
Between Groups |
95.985 |
5 |
19.197 |
3.847 |
0.003 |
There is statistical difference |
Within Groups |
838.320 |
168 |
4.990 |
|
|
||
Total |
934.305 |
173 |
|
|
|
||
Belief in Psychological Illness |
Between Groups |
175.943 |
5 |
35.189 |
1.567 |
0.172 |
There is no statistical difference |
Within Groups |
3773.022 |
168 |
22.458 |
|
|
||
Total |
3948.966 |
173 |
|
|
|
||
Total |
Between Groups |
816.782 |
5 |
163.356 |
2.187 |
0.058 |
There is no statistical difference |
Within Groups |
12546.350 |
168 |
74.681 |
|
|
||
Total |
13363.132 |
173 |
|
|
|
?Table 7: Shows One-way ANOVA to determine whether there was difference in beliefs and attitudes of mental illness patients towards Religious Healers in Khartoum State according to age.
Age |
Sum of
Squares |
df |
Mean
Square |
F |
Sig. |
Interpretation |
|
Knowledge of religious healing in patients
with mental illness attending religious healing |
Between Groups |
47.989 |
3 |
15.996 |
|
|
No difference |
Within Groups |
1331.804 |
170 |
7.834 |
2.042 |
0.110 |
||
Total |
1379.793 |
173 |
|
|
|
||
The behaviour of patients towards religious healing |
Between Groups |
6.465 |
3 |
2.155 |
|
|
No difference |
Within Groups |
464.960 |
170 |
2.735 |
0.788 |
0.502 |
||
Total |
471.425 |
173 |
|
|
|
||
Emotion towards Religious Healing |
Between Groups |
30.228 |
3 |
10.076 |
|
|
No difference |
Within Groups |
904.077 |
170 |
5.318 |
1.895 |
0.132 |
||
Total |
934.305 |
173 |
|
|
|
||
Belief in Psychological Illness |
Between Groups |
11.101 |
3 |
3.700 |
|
|
No difference |
Within Groups |
3937.865 |
170 |
23.164 |
0.160 |
0.923 |
||
Total |
3948.966 |
173 |
|
|
|
||
Total |
Between Groups |
129.227 |
3 |
43.076 |
|
|
No difference |
Within Groups |
13233.905 |
170 |
77.846 |
0.553 |
0.647 |
||
Total |
13363.132 |
173 |
|
|
|
Hypothesis
4: No significant difference in patients.
Beliefs and attitudes towards traditional healers attributed to age. The
researchers used one- way ANOVA to verify the above-mentioned hypothesis. It
appears that no significant statistical difference in patients' beliefs and
attitudes towards religious healing attributable to age. The result found that there was no statistical difference in
beliefs and attitudes of patients towards religious healing, which means that
all people with different ages are attending religious healing, this result
disagrees with the researcher hypothesis, which supposed that there is
correlation between patients age and belief and attitudes towards religious
healing. The result agrees with the study which found that there was no
significant difference attributed to age. The result disagrees with the study
of, who indicated that most of the patients’ ages range between 25 and 45 years
old. Also the result disagrees with the study of which found that most of the
visitors were the age of 31 years. The researcher expected that old people were
the most categories attending religious healers, that they have positive belief
and attitudes towards religious healing and treating by traditional medicine,
that maybe because of their social culture towards traditional healing,
although there are medical serves available now. The researcher also expected
that patients in middle age will prefer to attend or go to medical treatment
more than traditional treatment because they are well educated and they have
strong power to reach medical treatment anywhere.
Patients' illness beliefs and attitudes towards
religious healing in Khartoum State are positive, patients' beliefs in the
abilities of religious healers and their treatment, beside social, cultural
beliefs and their role in healing. It is worth noting that the majority of
Sudanese people belong to one of the different Islamic sofia (Tarega) with
leaders (Sheikhs), and they emotionally, socially attended them when they feel
psychological and spiritual suffering. Religious healers working as part of the
original of old traditional medicine, people still belief that mental illness
should be treated by religious healers, because they used spiritual
psychotherapy as main source of healing, and also religious healing have
acceptance by their communities at all [51-54].
According
to the findings of the research, some recommendations are suggested:
·
Government should take
attention to psychiatric health, by building Psychiatric clinics in general
hospitals, especially those who are near to the rural areas, and also provide
medicine and services.
·
The Ministry of Health
should have a clear strategy on training and motivation of religious healers so
as to formalize their practice.
·
To emphasize the
significance of cultural beliefs in the prevention and cure of mental
disorders.
·
Religious healers should
be trained in order to play effective role in providing mental health services.
·
To raise people's
awareness about the special nature of mental illness.
To provide
counselling programs to families of mentally ill patients to improve their
knowledge and attitudes towards traditional healing.
·
Studies in religious
therapy between acceptance and rejection by psychiatrists.
·
Studies in religious
healing as complementary or alternative treatment.
·
Studies in the attitudes
of psychiatric doctors and health practitioners towards religious healing
practices.
·
Studies in the field of
religious psychotherapy and to know the methods which used in the treatment and
their benefit healing.
·
To conduct comparative cross-cultural
studies on traditional healing versus current psychotherapy.