Poudel-Tandukar Kalpana, Jacelon Cynthia S, Chandler Genevieve E, Gautam Bhuwan, Palmer Paula H
1 College of Nursing, University of Massachusetts Amherst, MA, USA.
2 Bhutanese Society of Western Massachusetts, Springfield, MA, USA.
Int Q Community Health Educ. 2019 Apr;39(3):135-145. doi: 10.1177/0272684X18819962. Epub 2019 Feb 13.
This qualitative study aimed to identify cultural influences on seeking mental health support among Bhutanese refugees resettled in Western Massachusetts. Bhutanese refugees aged 18 years or older were recruited for eight focus group discussions, organized by age and gender ( N = 67, 49.3% female, mean age = 38, SD = 15.9). The PEN-3 cultural model was used as the theoretical framework to examine the roles of cultural perceptions that influence mental health-seeking behaviors. Focus group discussions were audio taped to facilitate the thematic-analysis. Younger participants (<35 years) reported experiencing stressors relating to economic hardships and difficulties in developing academic and social skills as they juggle breadwinner and care-giving responsibilities for their families. Older participants reported frustration with the difficulties in learning English and increased dependence on their children. Family members provided the initial frontline support to persons with mental health problems. If family support did not work, they consulted with their relatives and trustworthy community members for further assistance. Psychological factors such as fears of emotions, social norms, beliefs, and self-esteem associated with cultural norms and values influenced seeking mental health support. All participants expressed the need to have a culturally tailored intervention to develop acquired skills to improve their self-esteem and self-efficacy in order to integrate into their new social and cultural environment. Because family members make important decisions about seeking mental health support, involving family members in developing and delivering culturally appropriate skill development interventions could be a potential strategy to reduce their stress and increase resilience in this refugee community.
这项定性研究旨在确定文化对定居在马萨诸塞州西部的不丹难民寻求心理健康支持的影响。招募了18岁及以上的不丹难民参加8次焦点小组讨论，这些讨论按年龄和性别组织（N = 67，49.3%为女性，平均年龄 = 38岁，标准差 = 15.9）。PEN - 3文化模型被用作理论框架，以检验影响寻求心理健康行为的文化观念的作用。焦点小组讨论进行了录音，以方便进行主题分析。较年轻的参与者（<35岁）报告称，在兼顾家庭经济支柱和照顾家人责任的同时，经历了与经济困难以及发展学术和社交技能困难相关的压力源。年长的参与者报告称，在学习英语方面遇到困难并对子女的依赖增加感到沮丧。家庭成员为有心理健康问题的人提供了最初的一线支持。如果家庭支持不起作用，他们会向亲戚和值得信赖的社区成员寻求进一步帮助。与文化规范和价值观相关的恐惧情绪、社会规范、信仰和自尊等心理因素影响了寻求心理健康支持。所有参与者都表示需要进行文化针对性干预，以培养获得性技能，提高自尊和自我效能感，以便融入新的社会和文化环境。由于家庭成员在寻求心理健康支持方面做出重要决定，让家庭成员参与制定和提供文化适宜的技能发展干预措施可能是减轻该难民社区压力并增强其恢复力的潜在策略。
