Illness beliefs of Chinese American immigrants with major depressive disorder in a primary care setting.
Illness beliefs of Chinese American immigrants with major depressive disorder in a primary care setting.
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DOI：
10.1016/j.ajp.2014.12.005
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发表时间：
2015-02
影响因子：
9.5
通讯作者：
Yeung, Albert S
中科院分区：
文献类型：
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作者：
Chen, Justin A;Hung, Galen Chin-Lun;Parkin, Susannah;Fava, Maurizio;Yeung, Albert S
在美国，精神卫生服务的利用不足在少数种族/族裔中更为严重，尤其是华裔美国人。基于文化的疾病信念影响寻求帮助的行为，并可能提供洞察力的战略，提高弱势群体的利用率。这是第一次使用标准化工具对抑郁症华裔美国移民患者的疾病信念进行大型描述性研究。190抑郁症的中国移民寻求初级保健在南湾社区卫生中心完成了解释性模型访谈目录，探讨不同维度的疾病信念：主诉，疾病的标签，耻辱的看法，因果归因，和寻求帮助的模式。通过独立评分员将反应分类，并将结果与在同一地点使用相同仪器进行的早期研究进行比较。与先前的研究结果相反，抑郁症的中国人往往主要表现为躯体症状，受试者更有可能报告与抑郁情绪有关的主诉和疾病标签，而不是躯体症状。近一半的人报告说，他们会对别人隐瞒自己的问题。平均耻辱水平显着高于以前的研究。大多数受试者认为心理压力是他们问题的最可能原因。根据最近的研究，中国移民的疾病信念对于他们的症状的心理解释是值得注意的，这可能反映了对西方生物医学框架的接受程度增加。然而，据报道，对这些症状的耻辱感也有所增加。随着亚裔美国移民人口越来越多地接受抑郁症的心理模型，污名可能成为一个越来越重要的目标，以解决心理健康服务利用的差距。
Underutilization of mental health services in the U.S. is compounded among racial/ethnic minorities, especially Chinese Americans. Culturally based illness beliefs influence help-seeking behavior and may provide insights into strategies for increasing utilization rates among vulnerable populations. This is the first large descriptive study of depressed Chinese American immigrant patients’ illness beliefs using a standardized instrument. 190 depressed Chinese immigrants seeking primary care at South Cove Community Health Center completed the Explanatory Model Interview Catalogue, which probes different dimensions of illness beliefs: chief complaint, labeling of illness, stigma perception, causal attributions, and help-seeking patterns. Responses were sorted into categories by independent raters and results compared to an earlier study at the same site and using the same instrument. Contrary to prior findings that depressed Chinese individuals tend to present with primarily somatic symptoms, subjects were more likely to report chief complaints and illness labels related to depressed mood than physical symptoms. Nearly half reported they would conceal the name of their problem from others. Mean stigma levels were significantly higher than in the previous study. Most subjects identified psychological stress as the most likely cause of their problem. Chinese immigrants’ illness beliefs were notable for psychological explanations regarding their symptoms, possibly reflecting increased acceptance of Western biomedical frameworks, in accordance with recent research. However, reported stigma regarding these symptoms also increased. As Asian American immigrant populations increasingly accept psychological models of depression, stigma may become an increasingly important target for addressing disparities in mental health service utilization.