Scuglik Deborah L, Alarcón Renato D, Lapeyre Andre C, Williams Mark D, Logan Kathleen M
Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Transcult Psychiatry. 2007 Dec;44(4):581-95. doi: 10.1177/1363461507083899.
To identify and explore cultural dynamics influencing the psychiatric care of immigrant Somalis in the USA, we reviewed demographic data from Minnesota Departments of Human Services, and interviewed health professionals, exploring community perceptions of medical/psychiatric needs, cultural characteristics, barriers to care, and potential solutions. An informal survey of 37 members of the Mayo Clinic Department of Psychiatry and Psychology, to determine caregiver perceptions of care of Somali patients, cited language barriers (74%), and cultural misperceptions (68%) as the most frequent obstacles. Difficulties working within the patriarchal family structure, limited community resources, poor compliance, and financial issues ranged between 18 and 8%. Additional barriers mentioned were problems working with interpreters from ;warring clan factions,' patients' fears of being labeled ;crazy,' difficulties viewing illness within an emotional framework, and the need to address mental health from a physical framework through a focus on somatic symptoms. Somalis rarely acknowledge psychiatric problems and common traditional treatments have become ineffective in the new context. Recommendations include alternative health care approaches utilizing family values, ;bargaining,' and educational approaches to acculturation.
为了识别和探究影响美国索马里移民精神科护理的文化动态，我们查阅了明尼苏达州公共服务部的人口统计数据，并采访了医疗专业人员，探讨社区对医疗/精神科需求、文化特征、护理障碍及潜在解决方案的看法。对梅奥诊所精神科和心理学部的37名成员进行的一项非正式调查，以确定护理人员对索马里患者护理的看法，结果显示语言障碍（74%）和文化误解（68%）是最常见的障碍。在父权制家庭结构中工作的困难、社区资源有限、依从性差和财务问题的比例在18%至8%之间。提到的其他障碍包括与“敌对氏族派别”的口译员合作存在问题、患者担心被贴上“疯子”标签、难以在情感框架内看待疾病，以及需要通过关注躯体症状从身体框架角度解决心理健康问题。索马里人很少承认精神科问题，常见的传统治疗方法在新环境中已变得无效。建议包括利用家庭价值观、“讨价还价”和文化适应教育方法的替代医疗保健途径。
