CONICET | Buscador de Institutos y Recursos Humanos

IntroductionThe theories and explanations about the disease reflect the cultural traverses that exist in health care. Disease narratives allow us to identify how patients integrate the factors that underlie the etiology and the perpetuation of their symptoms.The most common themes between and within the narrative of the participants can be grouped as Explanatory Models (ME) (Kleinman, 1981). In the development of these models, patients delineate a set of knowledge and individual and collective experiences, which can impact on essential aspects of health care, such as therapeutic choice, adherence to treatment, doctor-patient communication (Kirmayer, Guzder, & Rousseau, 2014; Whitley, Kirmayer, & Groleau, 2006), mood and quality of life (Kemp, Morley, & Anderson, 1999; Sarudiansky et al., 2018; Shallcross et al., 2015)Purpose: To describe explanatory models (EMs) about their illness reported by patients with drug-resistant epilepsy, in two public hospitals in Buenos Aires (Argentina).Methods: A qualitative approach was used. In-depth interviews(Groleau, Young, & Kirmayer, 2006) were administered to 51 patients admitted to the VEEG units of the Hospital Ramos Mejía and Hospital El Cruce (Argentina), in order to obtain their perspectives about epilepsy. A thematic analysis of the content of the interviews was carried out, starting with open coding of the data. The data was organized into topics, depending on the relationship between the codes initially identified. As a preliminary data analysis, the frequencies of each category were obtained.Results: The codes were grouped into four major categories:1) Biomedical EMs (biological explanations);2) Psychological/psychosocial EMs (explanations related to emotions and to the effects of the environment);3) Religious and traditional EMs (explanations related to deities or spirits, or to popular medicine)4) Explanations about the factors that increase the seizure frequencyMost respondents (N = 46) reported more than one explanatory model about epilepsy in their narratives.Conclusions: Patients´ explanatory models about epilepsy are complex: they involve biological, psychological and supernatural aspects. Biological EMs were expected to be found since these patients have been attending hospitals for many years. Psychosocial EMs were also frequent, which is consistent with the dissemination and acceptance of psychotherapy in Argentina. Religious and traditional EMs implies that epilepsy can be interpreted both as a divine message, as the loss of the soul or as curses from nearby people. These beliefs are often associated with the use of unconventional treatments, such as traditional healing.Patients´ EMs, therefore, can differ from those used by their physicians and affect the communication between them. Being aware of these aspects will enable better health care.