Lasater Molly E, Beebe Madeleine, Warren Nicole E, Souko Fatoumata, Keita Mariam, Murray Sarah M, Bass Judith K, Surkan Pamela J, Winch Peter J
Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205-2103, USA.
School of Nursing, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Cult Med Psychiatry. 2018 Dec;42(4):930-945. doi: 10.1007/s11013-018-9579-6.
Perinatal mental health problems such as depression and anxiety are prevalent in low and middle-income countries. In Mali, the lack of mental health care is compounded by few studies on mental health needs, including in the perinatal period. This paper examines the ways in which perinatal women experience and express mental distress in rural Mali. We describe a process, relying on several different qualitative research methods, to identify understandings of mental distress specific to the Malian context. Participants included perinatal women, maternal health providers, and community health workers in rural southwest Mali. Participants articulated several idioms of distress, including gèlèya (difficulties), tôôrô (pain, suffering), hamin (worries, concerns), and dusukasi (crying heart), that occur within a context of poverty, interpersonal conflict, and gender inequality. These idioms of distress were described as sharing many key features and operating on a continuum of severity that could progress over time, both within and across idioms. Our findings highlight the context dependent nature of experiences and expressions of distress among perinatal women in Mali.
抑郁症和焦虑症等围产期心理健康问题在低收入和中等收入国家普遍存在。在马里，心理健康护理的缺乏因包括围产期在内的心理健康需求研究较少而更加严重。本文探讨了马里农村地区围产期妇女体验和表达精神痛苦的方式。我们描述了一个依赖几种不同定性研究方法的过程，以确定马里背景下对精神痛苦的理解。参与者包括马里西南部农村地区的围产期妇女、孕产妇保健提供者和社区卫生工作者。参与者阐述了几种痛苦的习语，包括gèlèya（困难）、tôôrô（疼痛、痛苦）、hamin（担忧、关切）和dusukasi（哭泣的心），这些习语出现在贫困、人际冲突和性别不平等的背景下。这些痛苦的习语被描述为具有许多关键特征，并在严重程度的连续体上运作，随着时间的推移，在习语内部和习语之间都可能发展。我们的研究结果强调了马里围产期妇女痛苦体验和表达的情境依赖性。
