Psychosocial health of asylum seeking women living in state-provided accommodation in Germany during pregnancy and early motherhood: A case study exploring the role of social determinants of health
Psychosocial health of asylum seeking women living in state-provided accommodation in Germany during pregnancy and early motherhood: A case study exploring the role of social determinants of health
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DOI：
10.1371/journal.pone.0208007
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发表时间：
2018-12-28
期刊：
影响因子：
3.7
通讯作者：
Bozorgmehr, Kayvan
中科院分区：
文献类型：
--
作者：
Gewalt, Sandra Claudia;Berger, Sarah;Bozorgmehr, Kayvan
背景寻求庇护的孕妇和新妈妈面临着可能影响其健康并增加其脆弱性的重大挑战。该研究的目的是调查寻求庇护的妇女在怀孕和早期孕产期间居住在德国南部一个联邦州的国家提供的住宿中的经历和感知需求，特别关注社会心理因素。方法在这项探索性案例研究中，对怀孕期间和长达六周的产后评估的参与者进行了单独的半结构化访谈。两名女性采访员在女性专业口译员的协助下进行采访。采访以数字方式记录并逐字转录。采用归纳法对访谈材料进行内容分析。 结果 21 对 9 名在怀孕和早期母亲寻求庇护的妇女进行了访谈。妇女分享了她们的经历以及对其社会心理健康的感知后果。在内容分析过程中确定了以下五个关键主题：a）社会心理压力源，b）有压力的生活环境，c）有压力的人际关系，d）社会支持和e）应对方式。心理社会因素是参与者精神压力的重要来源，特别是由于与寻求庇护过程相关的未来不确定性。生活环境也充满压力，包括缺乏隐私、言语和身体威胁以及无力感。与未出生孩子父亲的紧张关系造成了进一步的紧张和情绪压力。社会支持和个人应对方式为一些参与者提供了缓解。结论这项研究深入了解了居住在国家提供的住宿中的怀孕寻求庇护者和新妈妈的经历和感知需求。主要结果确定了社会心理因素，例如未来的不确定性、紧张的生活环境和紧张的人际关系，这些因素被认为是对妇女健康产生不利影响的健康社会决定因素。充足的社会支持和个人应对方式可以增强寻求庇护过程中的复原力并抵消社会心理压力。
BackgroundPregnant women and new mothers seeking asylum are subject to major challenges that may affect their health and increase their vulnerability. The study aim was to investigate asylum seeking women's experiences and perceived needs during pregnancy and early motherhood whilst living in state-provided accommodation in one federal state in Southern Germany, with a particular focus on psychosocial factors.MethodsIn this exploratory case study, individual semi-structured interviews were conducted with participants in pregnancy and up to the six-week postnatal assessment. Two female interviewers performed interviews assisted by female professional interpreters. Interviews were recorded digitally and transcribed verbatim. An inductive approach was taken to content analysis of interview material.Results21 interviews were performed with nine women seeking asylum in pregnancy and early motherhood. Women shared experiences and perceived consequences on their psychosocial health. The following five key themes were identified during content analysis: a) psychosocial stressors, b) stressful living circumstances, c) stressful relationships, d) social support and e) coping styles. Psychosocial factors were a significant source of mental stress for participants, especially due to future uncertainties linked with the asylum seeking process. Living circumstances were also marked by stressors including a lack of privacy, verbal and physical threats and experiences of powerlessness. Further strain and emotional pressure were caused by stressful relationships with the unborn child's father. Social support and personal coping styles provided relief for some participants.ConclusionsThis study provides in-depth insights into the experiences and perceived needs of pregnant asylum seekers and new mothers living in state-provided accommodation. Key results identified psychosocial factors such as future uncertainties, stressful living circumstances and stressful relationships, as social determinants of health that were perceived to adversely affect women's health. Adequate social support and individual coping styles increased resilience and counterbalanced psychosocial stressors during the asylum seeking process.