Botlhoko, botlhoko! How XXXX talk about their musculoskeletal complaints in rural Botswana: a focused ethnography.

@entity1 @entity1183 @entity1742 @entity158 @entity221
BACKGROUND: Conflicting interpretations about the structure and function of the body contribute to discordance in communication between healthcare professionals and lay @entity1 . Understanding musculoskeletal (MSK) complaints presents additional complexities when discussed in more than one language or in cross-cultural settings. In low- and middle-income countries (LMICs), few healthcare professionals have specialist MSK training and not all practitioners speak the primary language of @entity1 . OBJECTIVE: Our goal was to understand how @entity1 in rural Botswana perceive and express MSK complaints. DESIGN: Ethnographic fieldwork for 8 months in the Botswana Central District included @entity1 observations and interviews with 34 community members with MSK complaints. Audio-recorded interviews were typically conducted in Setswana with an interpreter, transcribed verbatim, and contextually translated into English. Abductive qualitative analysis was used as the interpretive methodology. RESULTS: Whereas initial responses about MSK troubles yielded the exclamation botlhoko, botlhoko! combined with animated @entity1742 and facial expressions indicating @entity158 , in-depth interviews revealed the complexities of @entity158 expression among respondents. MSK @entity158 were described as 'bursting, exploding, aching, @entity1183 , hot, pricking, stabbing, swollen, and @entity158 in the heart'. Language subtleties manifested during interviews, where 'meat' or 'flesh' implied soft tissue @entity158 ; waist @entity158 were voiced yet portrayed as low back or @entity158 ; and 'veins' variously referred to structural and functional types of @entity158 . Psychological and social stressors accompanied many accounts of MSK troubles. CONCLUSIONS: Respondents offered diverse MSK symptom descriptions consistent with @entity221 models, yet few communicated complaints using the biomedical language of healthcare providers. Although research interview and transcription processes may not be practical for clinicians, working with interpreters who communicate detailed @entity1 accounts for MSK troubles will complement @entity1 -provider encounters. Community member perceptions of their MSK @entity158 and associated conditions should be explored and incorporated into healthcare interventions and innovations for rural communities in LMICs.
