Gameon Julie A, McNamee Alex, FireMoon Paula, Skewes Monica C
University of Texas Health Science Center at Houston, USA.
Montana State University, Bozeman, USA.
J Prev Health Promot. 2024 Apr-Aug;5(2-3):374-401. doi: 10.1177/26320770241267714. Epub 2024 Sep 9.
Complicated grief is both a cause and a consequence of health inequities in Native (American Indian/Alaska Native [AI/AN]) communities. Given disproportionately high rates of physical (e.g., cancer, diabetes, and heart disease) and mental health problems (e.g., substance use disorder, posttraumatic stress disorder) in Native communities, it is common for AI/AN people to suffer many losses each year. Experiences of traumatic or repeated losses may lead to the development of maladaptive grief, often known as complicated grief. The aim of the current study was to understand the perspectives of community members on grief and its connection with health inequities among AI people who have experienced the loss of a person with whom they were close. Using a community-based participatory research framework, we conducted semi-structured interviews with 12 AI adults from a rural reservation community. The ages of the participants ranged from 32 to 80 years ( = 54.33, = 14.46) and women ( = 7, 58.3%) and men ( = 5, 41.7%) were included. The participants reported many barriers to healthy grieving and linked chronic, complicated grief with the development of multifaceted health problems, which were seen as exacerbating health disparities and leading to additional losses and grief. While coping with loss was difficult, many people were able to heal from extraordinary losses through community support and cultural practices. Future research with AI/AN communities is needed to develop, implement, and evaluate culturally responsive therapeutic grief treatments. There is also a pressing need to address current physical and mental health inequities to reduce the mortality rate and, thus, complicated grief in AI/AN communities.
复杂性哀伤既是美国原住民(美洲印第安人/阿拉斯加原住民[AI/AN])社区健康不平等的一个原因,也是其结果。鉴于原住民社区中身体疾病(如癌症、糖尿病和心脏病)和心理健康问题(如物质使用障碍、创伤后应激障碍)的发生率极高,AI/AN人群每年遭受许多损失是很常见的。创伤性或反复性损失的经历可能会导致适应不良的哀伤,通常称为复杂性哀伤。本研究的目的是了解社区成员对于哀伤的看法,以及哀伤与经历过亲近之人离世的AI人群健康不平等之间的联系。我们采用基于社区的参与性研究框架,对来自一个农村保留地社区的12名AI成年人进行了半结构化访谈。参与者的年龄在32岁至80岁之间(平均年龄=54.33岁,标准差=14.46岁),包括女性(n=7,58.3%)和男性(n=5,41.7%)。参与者报告了健康哀伤存在许多障碍,并将慢性、复杂性哀伤与多方面健康问题的发展联系起来,这些问题被视为加剧了健康差距,并导致了更多的损失和哀伤。虽然应对损失很困难,但许多人能够通过社区支持和文化习俗从巨大的损失中恢复过来。需要对AI/AN社区开展进一步研究,以开发、实施和评估具有文化适应性的哀伤治疗方法。当前迫切需要解决现有的身心健康不平等问题,以降低死亡率,从而减少AI/AN社区中的复杂性哀伤。