title: Etiological beliefs of patients with neurological disorders attending a tertiary care center: A cross-sectional study.
abstract: BACKGROUND
  The understanding and management of neurological disorders is undergoing revolutionary changes over the last three decades in the background of ever increasing advances in medical technologies, diagnostic techniques, therapeutic processes and, molecular and genetic medicine. The fruits of these advances can reach patients only if the psychosocial hurdles in their delivery are identified, acknowledged and addressed.
  
  
  OBJECTIVE
  To explore the beliefs and practices of patients with neurological disorders in a tertiary care center in the eastern Nepal.
  
  
  METHODS
  One hundred patients attending neurology/medicine outpatient for neurological disorders were interviewed about their beliefs regarding the triggering factors, causation and treatment-seeking behavior particularly from traditional healers.
  
  
  RESULTS
  Of the 100 patients (49 males, 51 females) recruited in the study, 51% expressed having 'no idea' about their illness. Only 20% patients gave medically congruent explanation for their illness. Psychological factors were attributed as triggering factors by 16% of patients, of which two-thirds were females. Chance, destiny and 'jadu tona' topped the list of triggering factors. Forty-four percent patients had sought help of traditional faith healers ('Dhami Jhakri') before seeking medical help. Traditional faith healers were approached by patients irrespective of their educational background. Fifty-nine percent of patients who first sought traditional faith healers, believed in 'jadu-tona'. Of those interviewed, 16% were planning to go to a faith healer in near future.
  
  
  CONCLUSIONS
  The beliefs of patients with neurological disorders frequently do not conform to current medical opinion. There is need for greater communication and education of patients by their treating physicians.
authors.affiliation: Department of Neurology, PGIMER and Dr. RML Hospital, New Delhi, India.
authors.forename: Bhupender Kumar
authors.initials: BK
authors.lastname: Bajaj
authors.affiliation: BPKIHS, Dharan, Nepal.
authors.forename: Shipra
authors.initials: S
authors.lastname: Chaudhary
authors.affiliation: BPKIHS, Dharan, Nepal.
authors.forename: Runa
authors.initials: R
authors.lastname: Shrestha
keywords: Attitude; beliefs; neurological disorders; practices