Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
PLoS One. 2020 Oct 5;15(10):e0239969. doi: 10.1371/journal.pone.0239969. eCollection 2020.
Traumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers.
Care providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring.
The care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible.
The HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future.
创伤后的难民经常遭受各种身心症状的困扰。来自伊拉克北部的雅兹迪女性难民在逃离所谓的“伊斯兰国”袭击后被带到德国，通过一个独特的全球人道主义收容计划（HAP）接受特殊的医疗和心理治疗。在这里，我们从护理人员的角度报告她们的身心症状和有用的策略。
在这个 HAP 中，护理人员（N=84）在个别环境和焦点小组中接受采访，以收集有关 HAP 受益人的身心症状的信息。数据分析遵循迈林的定性内容分析。
护理人员报告了雅兹迪人的五个主要心理负担：1）对损失的不安全感，2）对家庭成员的担忧，3）对留在德国还是返回伊拉克的矛盾心理，4）生活在两个世界之间，5）创伤经历的再现。护理人员注意到的主要心理症状是恐惧、抑郁症状、内疚感以及睡眠和饮食障碍。关于躯体症状，护理人员主要收到头痛、背部、胸部和胃部疼痛的投诉。提供适当医疗保健的有用策略是护理人员与医生合作、准确记录受益人的症状以及在指导受益人通过医疗保健系统方面提供额外支持。关于心理治疗，口译员有助于克服语言障碍、现场心理治疗、灵活的治疗预约、心理教育方法、稳定时间以及在应对日常生活方面的支持。在护理人员的经验中，心理治疗师必须建立信任关系。在悲伤治疗之后，可以以文化适应的方式进行特定创伤的治疗。
HAP 是为高度创伤的难民提供医疗和心理帮助的独特模式的医疗保健计划。护理人员报告了受创伤女性的一些（心理）躯体症状。HAP 护理人员认为有用的策略可以为未来类似的项目推荐。
