The experience of maternal mental distress in The Gambia: A qualitative study identifying idioms of distress, perceptions of contributing factors and the supporting role of existing cultural practices.
The experience of maternal mental distress in The Gambia: A qualitative study identifying idioms of distress, perceptions of contributing factors and the supporting role of existing cultural practices.
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DOI：
10.1371/journal.pgph.0002329
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发表时间：
2023
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产妇心理健康问题在围产期经常出现，在低收入和中等收入国家的妇女中可能高达两倍。用来描述精神疾病症状的术语和导致这些症状的因素受到文化和环境的影响。在与孕妇、保健专业人员和文化领袖举行的14次焦点小组讨论的基础上，这项定性研究旨在了解冈比亚妇女在围产期精神痛苦的经历。为此，它旨在1)确定最常用的痛苦习语，2)确定据信影响妇女围产期心理健康的因素，以及3)探索现有文化习俗，包括音乐习俗，在支持孕产妇和心理健康方面被认为在当地具有重要意义的作用。Sondomoo tenkung baliyaa （Mandinka语）和xel bu dalut （Wolof语）被认为是最常用的表达痛苦的习语，大致可以翻译为缺乏稳定的思想/心灵。通过主题分析，确定了六个主题（医疗保健系统的贫困、文化背景的变化、经济因素、社会因素、精神因素和涉及音乐的文化习俗），以描述影响围产期妇女心理健康经历的因素。缺乏经济资源、卫生系统的普遍贫困、丈夫的不支持以及邪恶的灵魂或女巫的精神攻击是妇女经历产妇精神痛苦的常见原因。与音乐有关的各种现有文化习俗，如生育协会、命名仪式和社区音乐制作，被认为对支持妇女围产期的心理健康很有价值。这项工作强调，支持围产期心理健康的举措应以了解当地社区的文化习俗、知识和经验为基础。
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.