与严重围产期抑郁症共存：对泰缅边境劳动移民和难民妇女经历的定性研究。
Living with severe perinatal depression: a qualitative study of the experiences of labour migrant and refugee women on the Thai-Myanmar border.
机构信息
Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak Province, 63110, Thailand.
出版信息
BMC Psychiatry. 2018 Jul 16;18(1):229. doi: 10.1186/s12888-018-1815-7.
BACKGROUND
Perinatal depression is an important contributor to maternal morbidity and mortality worldwide. Migrant women, particularly those resettling within low- and middle-income settings, are at increased risk of perinatal depression due to multiple stressors experienced before, during and after migration. Evidence on migrant perinatal mental health to date has focused largely on women in high-income destination countries, leaving the voices of displaced women in low-income settings unheard. This study addresses the current evidence gap by exploring the experiences of migrant women living on the Thai-Myanmar border.
METHODS
In-depth interviews were conducted with pregnant and post-partum labour migrant and refugee women on the Thai-Myanmar border who had been diagnosed with severe depression. An interview guide covering women's current and past life experiences, social support and the impact of depression on social and occupational functioning was used as a prompt. Thematic analysis was used to identify themes emerging from women's narratives.
RESULTS
Eleven pregnant and post-partum women with severe perinatal depression took part. Participating women provided extensive insight into the many difficult aspects of their lives that they perceived as contributing to their depression status. Predominant themes emerging from women's narratives included difficult relationships with partners, challenging life situations, mechanisms for coping with depression and impressions of mental health care.
CONCLUSIONS
Labour migrant and refugee women with severe perinatal depression face a wide range of chronic stressors at the individual, household and community levels that are likely to have both short- and long-term negative effects on their mental well-being and day-to-day functioning. Participating women responded positively to the mental health support they received, and findings provide important insights into how services might further support their needs.
背景
围产期抑郁是全球孕产妇发病率和死亡率升高的一个重要原因。由于在移民前、移民期间和移民后经历了多种压力源，移民妇女，尤其是那些在中低收入环境中重新安置的妇女，面临着更高的围产期抑郁风险。迄今为止，有关移民围产期心理健康的证据主要集中在高收入目的地国家的妇女身上，而在低收入环境中流离失所的妇女的声音却无人倾听。本研究通过探讨生活在泰缅边境的移民妇女的经历，填补了这一现有证据空白。
方法
对泰缅边境患有严重抑郁症的移民和难民孕妇及产后劳工进行深入访谈。访谈指南涵盖了妇女当前和过去的生活经历、社会支持以及抑郁对社会和职业功能的影响。使用主题分析来确定从妇女叙述中出现的主题。
结果
11 名患有严重围产期抑郁症的孕妇和产后妇女参加了研究。参与研究的妇女详细介绍了她们生活中许多困难的方面，她们认为这些方面促成了她们的抑郁状况。妇女叙述中出现的主要主题包括与伴侣的关系困难、生活困难、应对抑郁的机制以及对精神卫生保健的印象。
结论
患有严重围产期抑郁症的移民和难民劳工在个人、家庭和社区层面面临着广泛的慢性压力源，这可能对她们的心理健康和日常生活功能产生短期和长期的负面影响。参与研究的妇女对她们所获得的精神健康支持反应积极，研究结果提供了重要的见解，了解如何进一步满足她们的需求。
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