Rationale of the study: The growing incidence and serious impact of depression, the need to address the holistic needs of depressed individuals, the growing emphasis on cultural competence of nurses and other health professionals, the lack of local cultural studies on depression, and the prevailing problems of health care professionals in responding to the cultural needs of depressed patients, and their families prompted the conduct of the study.
Research objectives: The study focused on exploring the cultural perspectives on meanings, causes, attitudes, and culturally-based management on depression among Ilocanos, Kankana-eys, and Maranaos.
Methods: Ethnographic design was employed. The Kankana-ey participants were purposefully selected from Baguio City, Municipalities of Kapangan, Buguias, and Kibungan (n=22), the Ilocano participants were from Vigan City, Ilocos Sur (n=10), while the Maranao participants were from the Muslim community of Baguio City (n=7) identified through purposive- referral and theoretical sampling and are based on saturation. The participants were traditional healers, local cultural experts and community members who have personally witnessed and/or participated in cultural practices related to depression. To enhance the richness of the study, crystallization was employed which is a qualitative research approach that included deep and thick description of data, attention to complexity of interpretation, use of more than one form of inquiry, and reflexivity. As used in the study, thick narratives were made to present the data and thorough analysis was done to identify the cultural themes and presenting both the ‘emic’ and ‘etic’ perspectives. A variety of methods were also employed such as interviews, observations and documentary analysis. Field notes were also done to document observations and interview experiences, as well as, the methodological concerns. Reflexivity was also ensured by clearly articulating and became conscious of research process.
Results: The three cultures have similarities and differences with wide range of attributions to depression including magico-spiritual influence, relational problems, economic pressure, emotional, somatic, and chemical causes. The signs and symptoms of depression are grouped based on physical, social, behavioral, and psychological aspects. Attitude towards depression are described as curiosity, sympathy, and social support. Culturally-based management were grouped in three domains, namely: preventive, curative, and rehabilitative interventions. Spiritual initiatives, social approaches, physical care, and cognitive strategies comprise the preventive management. Along the curative management are immediate medical interventions, magico-spiritual cure, self-employed remedies, and help from significant others. Finally, on rehabilitation domain are physical, social, and spiritual strengthening.
Conclusions: The belief on depression cuts across tradition, culture, religion, and medical influences. These interrelationships form part of their understanding of depression, many of which are still rooted in magico-spiritual approaches.
Recommendations: These findings suggest inclusion of culturally sensitive and appropriate health care to address the needs of a person with depression. The information guide developed on this study can also be used by health care professionals in caring for depressed individuals; and, similar studies can be explored for more comprehensive approach to depression.