Loan Iain, Cunningham Wayne, Jaye Chrystal
General Practitioner, Taupo and MGP student, Department of General Practice and Rural Health, University of Otago, NewZealand.
Professor, Department of Family Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain, Al Muharraq, Bahrain.
J Prim Health Care. 2016 Mar;8(1):67-74. doi: 10.1071/HC15046.
BACKGROUND The Tokelauan language lacks a word for 'depression' and this can make diagnosing and treating depression in Tokelauan patients difficult for general practitioners. AIMS To describe the experience of depression in Tokelauans and thereby assist diagnosis and treatment of the illness. METHOD Ten semi-structured in-depth interviews were conducted. The transcripts were thematically analysed using an immersion crystallisation technique. RESULTS An illness involving profound sadness exists in the Tokelauan culture. Tokelauans recognise isolation and withdrawal from family and community activities as indicators of extreme sadness. Privacy and pride are important cultural characteristics, which may be barriers to recognising sadness. Often the smiling Tokelauan face becomes the mask hiding sadness. CONCLUSION This research demonstrates the complexity of relationships between patients, their illness and their culture, that impacts on how depression manifests. This research indicates that therapy must have a whole person approach involving family, church, community and patients' spiritual beliefs. KEYWORDS Depression; Pacific health.
背景 托克劳语中没有“抑郁症”这个词，这使得全科医生很难诊断和治疗托克劳族患者的抑郁症。目的 描述托克劳族人患抑郁症的经历，从而协助对该疾病进行诊断和治疗。方法 进行了10次半结构化深度访谈。使用沉浸结晶技术对访谈记录进行主题分析。结果 托克劳文化中存在一种涉及极度悲伤的疾病。托克劳族人将与家庭和社区活动隔离及退出视为极度悲伤的指标。隐私和自尊是重要的文化特征，可能成为识别悲伤情绪的障碍。通常，面带微笑的托克劳人面孔成了隐藏悲伤的面具。结论 本研究表明患者、其疾病和其文化之间的关系很复杂，这会影响抑郁症的表现方式。本研究表明，治疗必须采用整体治疗方法，涉及家庭、教会、社区和患者的精神信仰。关键词 抑郁症；太平洋地区健康
