Why local concepts matter: Using cultural expressions of distress to explore the construct validity of research instruments to measure mental health problems among Congolese women in Nyarugusu refugee camp.
M Claire Greene, Peter Ventevogel, Samuel L Likindikoki, Annie G Bonz, Rachael Turner, Susan Rees, Lusia Misinzo, Tasiana Njau, Jessie K K Mbwambo, Wietse A Tol
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引用次数: 1
Abstract
There is considerable variation in the presentation of mental health problems across cultural contexts. Most screening and assessment tools do not capture local idioms and culturally specific presentations of distress, thus introducing measurement error and overlooking meaningful variation in mental health. Before applying screening and assessment tools in a particular context, a qualitative exploration of locally salient idioms and expression of distress can help assess whether existing measures are appropriate in a specific context as well as what adaptations may improve their construct validity. We aimed to employ a mixed-methods approach to describe and measure cultural concepts of distress among female Congolese survivors of intimate partner violence in Nyarugusu refugee camp, Tanzania. This sequential study used data from 55 qualitative (free-listing and in-depth) interviews followed by 311 quantitative interviews that included assessments of symptoms of common mental disorder to explore whether the symptom constellations were consistent across these methodologies. Results from thematic analysis of qualitative data and exploratory factor analysis of quantitative data converged on three concepts of distress: huzuni (deep sadness), msongo wa mawazo (stress, too many thoughts), and hofu (fear). The psychometric properties of these constructs were comparable to those of the three original common mental disorders measured by the quantitative symptom assessment tools-anxiety, depression, and post-traumatic stress disorder-adding weight to the appropriateness of using these tools in this specific setting. This mixed-methods approach presents an innovative additional method for assessing the local "cultural fit" of globally used tools for measuring mental health in cross-cultural research.
在不同的文化背景下,心理健康问题的表现有很大的差异。大多数筛选和评估工具没有捕捉到当地习语和特定文化的痛苦表现,从而引入了测量误差,忽视了心理健康方面有意义的变化。在将筛选和评估工具应用于特定语境之前,对当地显著习语和痛苦表达进行定性探索可以帮助评估现有措施是否适用于特定语境,以及哪些调整可以提高其结构效度。我们的目的是采用一种混合方法来描述和测量坦桑尼亚尼亚鲁古苏难民营中遭受亲密伴侣暴力的刚果女性幸存者的痛苦文化概念。这项连续研究使用了55个定性(自由列表和深度)访谈的数据,随后是311个定量访谈,包括对常见精神障碍症状的评估,以探索这些方法的症状星座是否一致。从定性数据的专题分析和定量数据的探索性因子分析的结果中,我们可以归纳出三个痛苦的概念:huzuni(深深的悲伤)、msongo wa mawazo(压力,太多的想法)和hofu(恐惧)。这些构式的心理测量特征与量化症状评估工具(焦虑、抑郁和创伤后应激障碍)测量的三种原始常见精神障碍的心理测量特征相当,这增加了在这种特定情况下使用这些工具的适当性。这种混合方法为评估跨文化研究中全球使用的衡量心理健康的工具的当地“文化契合度”提供了一种创新的附加方法。
期刊介绍:
Transcultural Psychiatry is a fully peer reviewed international journal that publishes original research and review articles on cultural psychiatry and mental health. Cultural psychiatry is concerned with the social and cultural determinants of psychopathology and psychosocial treatments of the range of mental and behavioural problems in individuals, families and human groups. In addition to the clinical research methods of psychiatry, it draws from the disciplines of psychiatric epidemiology, medical anthropology and cross-cultural psychology.