Maroney Pamela, Potter Marianne, Thacore Vinod Rai
Adult Mental Health Program, Doveton Community Care Unit, Monash Health, Doveton, Victoria, Australia.
Aust Occup Ther J. 2014 Feb;61(1):13-9. doi: 10.1111/1440-1630.12094. Epub 2014 Jan 8.
BACKGROUND/AIM: With a steady increase of refugees arriving in Australia from Afghanistan coupled with reports that prevalence of mental illness amongst Afghan refugees in South-East Melbourne is particularly high, mental health providers will need to acquire cultural competence to provide effective treatment. There is a dearth of literature on the subject of rehabilitation of Afghan psychiatric clients in the Australian context, providing the impetus for this article. To illustrate the impact of Afghan socio-cultural beliefs and attitudes on the implementation of occupational therapy and rehabilitation programmes in a mental health facility and adaptations to accommodate the needs of the clients and their families.
Two case vignettes of Afghan clients are presented to illustrate the variance in goals and expectations of the clients and their families to that of the occupational therapy and rehabilitation programmes offered.
Family expectations and involvement, culture-specific factors and religion play significant roles in the presentation and treatment of clients from the Muslim culture and require modification in implementation of rehabilitation programmes. A need for developing family or community-based services is proposed coupled with culturally responsive practices. Culture sensitive models of occupational therapy will need to be developed as younger generations of refugee families acculturate and need psychological help to deal with conflicts with parents and elders who hold values different from those adopted by their children born and brought up in the Australian socio-cultural environment. These and other issues mentioned above provide fertile fields for research in this evolving area of occupational therapy.
背景/目的：随着从阿富汗抵达澳大利亚的难民数量稳步增加，同时有报道称墨尔本东南部的阿富汗难民中精神疾病患病率特别高，心理健康服务提供者将需要具备文化能力以提供有效的治疗。在澳大利亚背景下，关于阿富汗精神病患者康复主题的文献匮乏，这为本文提供了动力。以说明阿富汗社会文化信仰和态度对心理健康机构中职业治疗和康复计划实施的影响，以及为满足患者及其家庭需求而进行的调整。
呈现两个阿富汗患者的案例 vignettes，以说明患者及其家庭的目标和期望与所提供的职业治疗和康复计划的目标和期望之间的差异。
家庭期望和参与、特定文化因素和宗教在穆斯林文化背景患者的呈现和治疗中发挥着重要作用，并且在康复计划的实施中需要进行调整。建议开发基于家庭或社区的服务，并采用具有文化响应性的做法。随着年轻一代难民家庭融入文化并需要心理帮助来处理与持有不同于在澳大利亚社会文化环境中出生和成长的子女所接受价值观的父母和长辈之间的冲突，将需要开发文化敏感的职业治疗模式。上述这些及其他问题为这个不断发展的职业治疗领域的研究提供了肥沃的土壤。
