The changing role of a Vaidya (non-codified traditional doctor) in the community health of Kerala, Southern India: comparison of treatment-seeking behaviours between the Vaidya's patients and community members.

BACKGROUND: This study aimed at exploring the roles of a Vaidya - an uncodified traditional doctor - in a community in Kerala State, India. Special attention was paid to the characteristics of the Vaidya's patients in comparison with the treatment-seeking behaviour of the community members. METHODS: Both qualitative and quantitative data about the Vaidya, 97 of his patients, and 31 community members were gathered via participatory fieldwork and open-ended interviews. RESULTS: It was found that the community members seldom consulted the Vaidya who lived in their community; thus, the role of the Vaidya as the community's primary health care provider had nearly disappeared. Nonetheless, the Vaidya was deeply respected as one of the community's leaders by its members because of the spiritual and financial support he provided to them. On the other hand, a number of patients visited the Vaidya from outside the village, which implied that the Vaidya played a new role under the changes caused by medical pluralism. Even a codified traditional medicine, Ayurveda, was less popular among the community members. These findings were interesting, because while the traditional Indian medical system has been becoming popular and common in other societies, such as European societies, as an alternative medicine, the traditional medical system was becoming less important in the rural Indian context. CONCLUSION: It is thus concluded that the medical practice has changed depending on its cultural and social contexts, even though its medicinal effects had been proven by scientific survey.

Factor structures of a Japanese version of the Geriatric Depression Scale and its correlation with the quality of life and functional ability.

We investigated the 15-item Geriatric Depression Scale (GDS-15) with regard to its factors and, reproducibility, as well as its relationship to activities of daily living, social factors, medical conditions, and quality of life for community-dwelling elderly people in Japan. The study population consisted of 736 community-dwelling elderly participants aged 65 or older. Exploratory factor analysis of the data and correlation coefficients between factors and activities of daily living, quality of life, social factors, and medical conditions were calculated for two consecutive years. The reproducibility of the results was also evaluated. As the result, GDS-15 had three reproducible factors specified as follows: factor I, "energy loss and pessimistic outlook"; factor II, "positive mental status (reversed)"; and factor III, "empty feeling." Comparing our findings with a review of research in this area, positive items (excluding "feel full of energy") seem to compose an universal factor. Factor I correlated best with quality of life, factor II with activities of daily living, and factor III with subjective cognitive function. These results suggest the GDS-15 can be used to assess the functional ability and quality of life, as well as depressive mood in older adults.