Australian Centre for Heart Health, Melbourne, Australia; Faculty of Health, Deakin University, Burwood, Australia.
Australian Centre for Heart Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Australia.
Soc Sci Med. 2017 Aug;187:164-173. doi: 10.1016/j.socscimed.2017.06.046. Epub 2017 Jul 1.
There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health.
The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community.
The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used.
Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied.
It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a diverse range of research and clinical settings.
人们越来越认识到,除了普遍认可的幸福感领域和指标(如人口健康和预期寿命)之外,还需要额外的框架来充分解释和衡量原住民的幸福感。特别是,澳大利亚原住民的幸福感在很大程度上取决于殖民化、历史创伤、悲伤、失落和持续的社会边缘化。因此,基于生物医学模式的主流幸福感指标可能不够充分,在原住民背景下并不完全相关。“标准”幸福感工具可能无法充分评估具有更整体健康观的社会中的健康和幸福感指标。
本批判性评价旨在确定、记录和评估澳大利亚原住民社区中社会和情绪幸福感测量工具的使用情况。
系统地描述了工具的内在特性(例如,通用与特定疾病、评估的领域、跨文化适应的程度和心理测量特性)及其在研究中的用途(例如,研究设置、干预、临床目的或调查)。我们共纳入 33 项研究,其中使用了 22 种不同的工具。
确定了三大类社会和情绪幸福感工具:未经修改的标准工具(10 种)、跨文化适应的标准工具(6 种)和原住民开发的测量工具(6 种)。为评估澳大利亚原住民社会和情绪幸福感的研究人员和从业者提出了建议,这些建议也可能适用于其他应用更整体幸福感框架的少数族裔群体。
建议仅在标准工具已经过正式的跨文化适应过程的情况下使用,并且原住民开发的工具继续在各种研究和临床环境中得到开发、改进和验证。