African Cultural Values and Psychological Health in Adult Persons with Sickle Cell Disease in Ghana

Abstract

Although spirituality has been found to reduce psychological symptoms, the factors that intervene in the relationship remain unclear. The present study aimed at determining whether African cultural values would moderate the relationship between spirituality and psychological health, and whether this observation was unique to SCD participants. Additionally, the study explored reasons for the use of African cultural values in coping. Finally, the study aimed at developing a model of coping with SCD. The study was cross sectional using quantitative and qualitative methods. The quantitative data was collected through questionnaire administered to a purposive sample of 201 adult SCD participants. Two hundred and three (203) healthy and 201 diabetic participants were used as comparison groups. The qualitative data was obtained from a subsample of 23 SCD interviewees. Significant results that emerged from the quantitative study revealed that first, the three groups generally demonstrated significant differences in the variables studied. Second, SCD participants differed significantly from comparison groups on specific African cultural values subscales and on specific psychological symptoms. Third, specific African cultural values predicted psychological health in specific BSI subscales among SCD participants. The rest of the quantitative results did not find anything significant. In the qualitative analyses, participants reported using specific African cultural values for transcendental, social support, psychological relaxation, and minimum physical exercise purposes to promote psychological health. However, medical treatment was the mainstay. Aspects of African cultural values that did not support these functions were associated with poor psychological health. Some of these observations emerged in the larger sample while others did not. These results implied that there were significant differences between SCD and diabetic or healthy participants on endorsement of specific African cultural values and their effects on psychological health. It further implied that SCD individuals used other strategies to complement African cultural values to promote psychological health. Implications of the two studies were evaluated in a revised conceptual model for SCD. Psychological health of SCD participants was a function of factors in the biopsychosocial-spiritual model and based in African cultural values and in the cultural context of patients. Socio-demographic and disease characteristics and other unknown factors added to the equation. The implications of the findings for future research, clinical practice, patient management, and policy matters, were subsequently discussed.