“My Head is Like a Bag Full of Rubbish”: Concepts of Illness and Treatment Expectations in Traumatized Migrants

Qualitative Health Research - Tập 21 Số 2 - Trang 233-248 - 2011
Thomas Maier1, Mirjam Straub2
1Department of Psychiatry, University Hospital, Zurich, Switzerland
2University Hospital, Zurich, Switzerland

Tóm tắt

Traumatized migrants increasingly burden health care services in industrialized countries. These patients usually suffer from a broad range of physical and psychological symptoms, with assessment and treatment being complicated and often unsatisfactory. A large potential for misunderstandings between clinicians and traumatized individuals is not only because of a language barrier; very little is known about the concepts of illness and treatment expectations in these patients. We performed semistructured interviews with 13 traumatized migrants, focusing on their concepts of illness and expectations concerning medical treatment. An analysis of the recorded and transcribed statements revealed that most participants had no clear or defined expectations concerning appropriate treatment. The patients knew very little about psychotherapy, and usually had negative prejudices. Nevertheless, participants firmly believed that medical treatment would help them and considered their current suffering to be the result of a multitude of stressors impacting their lives over long periods of time. The patients did not identify single traumatic events as the causes of their complaints. The prevailing concepts of illness among traumatized migrants can be characterized as multifactorial and psychosocial.

Từ khóa


Tài liệu tham khảo

American Psychiatric Association., 1980, Diagnostic and statistical manual of mental disorders, 3

10.1176/ajp.152.7.963

Becker, D., 1990, Procesos de traumatisación extrema y posibilidades de reparación [Processes of extreme traumatization and possibilities of reparation]

10.1023/B:MEDI.0000034421.07612.c8

de Jong, J. T., 2002, Trauma, war and violence: Public mental health in socio-cultural context

10.1016/S0140-6736(03)13692-6

10.1016/S0140-6736(05)61027-6

Foa, E.B., 1999, Journal of Clinical Psychiatry, 60, 4

10.1192/bjp.166.3.360

Helman, C.G., 1985, Medicine and Psychiatry, 9, 1, 10.1007/BF00048535

10.1016/0140-6736(91)91720-F

10.1037/0278-6133.26.1.96

10.1177/1363461506061761

10.1177/070674370004500503

10.1525/9780520340848

Kleinman, A., 1988, The illness narratives: Suffering, healing and the human condition

10.1097/01.nmd.0000146739.26187.15

10.1037/h0035357

Lewis-Fernandez, R., 1995, Psychiatric Clinics of North America, 18, 433, 10.1016/S0193-953X(18)30033-9

Lifton, R.J., 1967, Death in life. Survivors of Hiroshima

10.1016/j.mehy.2005.07.028

10.1007/s10728-006-0013-9

Maier, T., 2007, International Perspectives in Victimology, 3, 18

Mayring, P., 1990, Einführung in die qualitative Sozialforschung [Introduction to qualitative social research]

10.1192/bjp.154.2.221

10.1146/annurev.psych.54.101601.145112

Meichenbaum, D., 1994, Treating post-traumatic stress disorder: A handbook and practice manual for therapy

10.1016/j.forsciint.2003.07.008

Obrist van Eeuwjk, B., 1992, "Ich möchte mit meiner eigenen Hilfe auskommen, aber es geht nicht". Eine medizinethnologische Studie über Krankheitserfahrungen türkischer und kurdischer Menschen in der Region Zürich ["I want to manage on my own, but I can’t." An anthropological study on illness perceptions of Turkish and Kurdish people in the Zurich area]

Patton, M.Q., 2002, Qualitative research and evaluation methods, 3

Prout, M., 1991, International Journal of Short-Term Psychotherapy, 6, 113

10.1037/h0092976

Scientific Software Development GmbH., 1997, Computer software

10.1111/j.1600-0447.1998.tb09984.x

10.1177/1049732309348370

10.1016/S0277-9536(98)00450-X

10.1136/bmj.322.7278.95

10.1192/bjp.182.5.444

van der Kolk, B. A., McFarlane, A. C. & Weisæth, L. (Eds.) (1996). Traumatic stress. The effects of overwhelming experience on mind, body, and society. New York: Guilford.

10.1177/1049732309350686

Wicker, H.R., 1993, Die Sprache extremer Gewalt-Studie zur Situation von gefolterten Flüchtlingen in der Schweiz und zur Therapie von Folterfolgen [The language of extreme violence-A study on the situation of tortured refugees in Switzerland and on therapy of sequelae of torture]

10.4324/9780203310540

10.1177/1524838005285914

World Health Organization., 1992, The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines

10.1176/ajp.152.12.1705

Young, A., 1995, The harmony of illusions: Inventing post-traumatic stress disorder