Sanfilippo Katie Rose M, McConnell Bonnie, Darboe Buba, Huma Hajara B, Glover Vivette, Stewart Lauren
Psychology Department, Goldsmiths, University of London, London, United Kingdom.
School of Music, The Australian National University, Canberra, Australia.
PLOS Glob Public Health. 2023 Sep 7;3(9):e0002329. doi: 10.1371/journal.pgph.0002329. eCollection 2023.
Maternal mental health problems are experienced frequently in the perinatal period and can be up to twice as common in women from low- and middle-income countries. The terms used to describe mental illness symptoms and the factors that contribute to developing these symptoms are affected by culture and context. Based on 14 focus group discussions held with pregnant women, health professionals and cultural leaders, this qualitative study aimed to understand women's experiences of mental distress during the perinatal period in The Gambia. To do this it aimed to 1) identify the most commonly used idioms of distress, 2) identify the factors believed to affect women's perinatal mental health and 3) explore the role of existing cultural practices, including musical practices, that were identified as locally significant in supporting maternal and mental health. Sondomoo tenkung baliyaa (Mandinka) and xel bu dalut (Wolof) were identified as the most commonly used idioms of distress which roughly translate to lack of a steady mind/heart. Using thematic analysis, six themes (Poverty of the healthcare system, Shifting cultural context, Economic factors, Social factors, Spiritual factors, and Cultural practices involving music) were identified to describe the factors that shape women's experience of mental health during the perinatal period. Lack of economic resources, the prevailing poverty of the health system, an unsupportive husband and spiritual attack by evil spirits or witches were common reasons given for a woman experiencing maternal mental distress. Various existing cultural practices involving music, such as fertility societies, naming ceremonies and community music-making, were recognised as valuable for supporting women's mental health during the perinatal period. This work emphasises that initiatives to support perinatal mental health should be grounded in an understanding of local community cultural practices, knowledge, and experiences.
围产期女性经常会出现心理健康问题，在低收入和中等收入国家，这种情况的发生率可能高达其他国家女性的两倍。用于描述精神疾病症状的术语以及导致这些症状的因素会受到文化和背景的影响。基于与孕妇、卫生专业人员和文化领袖进行的14次焦点小组讨论，这项定性研究旨在了解冈比亚女性在围产期的精神痛苦经历。为此，该研究旨在：1）确定最常用的痛苦习语；2）找出被认为会影响女性围产期心理健康的因素；3）探讨包括音乐活动在内的现有文化习俗在支持孕产妇心理健康方面所发挥的作用，这些习俗在当地被视为具有重要意义。“Sondomoo tenkung baliyaa”（曼丁哥语）和“xel bu dalut”（沃洛夫语）被确定为最常用的痛苦习语，大致可译为“心神不定”。通过主题分析，确定了六个主题（医疗保健系统匮乏、文化背景变化、经济因素、社会因素、精神因素以及涉及音乐的文化习俗）来描述影响女性围产期心理健康体验的因素。经济资源匮乏、医疗系统普遍薄弱、丈夫不支持以及被恶鬼或女巫进行精神攻击，是女性出现孕产妇精神痛苦的常见原因。各种现有的涉及音乐的文化习俗，如生育社团活动、命名仪式和社区音乐活动，被认为对支持女性围产期心理健康具有重要价值。这项研究强调，支持围产期心理健康的举措应以对当地社区文化习俗、知识和经验的理解为基础。
