“Knowledge, Attitudes and Practices regarding Ashta vibhrama assessment among Ayurvedic practitioners: A cross-sectional study to inform development of a standardized assessment tool”

Background Ashta vibhrama comprising eight domains of mental and behavioural disturbances described in Ayurveda Psychiatry forms an important component of the clinical assessment of unmada. However, its clinical assessment remains largely practitioner dependent with limited standardization and variability in interpretation and application. Objective To assess the knowledge, attitude, and practice (KAP) of Ayurvedic practitioners regarding the Ashta Vibhrama assessment, identify areas requiring improvements and examining their association with years of clinical experience. Methods A cross-sectional, questionnaire-based exploratory needs assessment study was conducted among Ayurveda practitioners involved in teaching and/or practice of Manasa Roga. An 18-item researcher developed questionnaire, comprising 16 closed ended and 2 open ended questions was administered online through REDCap and distributed via e-mail and WhatsApp. The questionnaire was informed by the classical Ashta vibhrama framework and the KAP approach and underwent expert review for relevance of content and clarity. However, it was not formally retested. Quantitative data were analysed using descriptive statistics, while open ended responses were analysed thematically. Results Sixty-three practitioners participated in the survey among them 47 (74.6%) were faculty members and 16 (25.4%) were independently practicing clinicians. Most respondents demonstrated familiarity with the conceptual framework of Ashta vibhrama. Approximately 81% perceived variability in its assessment. 84% indicated a need for greater standardization and 93.7% endorsed the need for a standardized assessment tool. Qualitative responses highlighted the need for standardized assessment protocols, operational definitions, structured scoring, clinical guidance and training with barriers including inter-practitioner variability, difficulty in assessing mental and behavioural changes. Conclusion The findings provide preliminary need assessment evidence supporting the development and psychometric validation of a standardized Ashta vibhrama assessment instrument. These findings should be interpreted as exploratory because the KAP questionnaire was not formally pretested or psychometrically validated.