Contextualising women's mental distress and coping strategies in the time of AIDS: A rural South African case study
Contextualising women's mental distress and coping strategies in the time of AIDS: A rural South African case study
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DOI：
10.1177/1363461514526925
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发表时间：
2014-12-01
影响因子：
2.5
通讯作者：
Campbell, Catherine
中科院分区：
文献类型：
--
作者：
Burgess, Rochelle;Campbell, Catherine
人们越来越重视艾滋病毒/艾滋病对妇女心理健康的影响，这种影响往往受到脱离背景的精神病学对情绪困扰和治疗的理解。我们通过探索受艾滋病毒/艾滋病影响的妇女自身对其痛苦的叙述，重点关注社会背景的影响，以及妇女在医疗支助服务之外的应对努力，为扩展这些调查结果的小型定性文献作出了贡献。在南非夸祖鲁-纳塔尔的一项更广泛的服务研究中，对经历抑郁或焦虑样症状的妇女进行了19次深入采访。主题分析的框架是萨默菲尔德对背景和韧性的强调。妇女强调指出，家庭冲突(特别是男性的遗弃)、社区一级的暴力、贫穷和艾滋病毒/艾滋病是痛苦的驱动因素。虽然艾滋病毒/艾滋病给妇女带来了沉重的负担，但贫穷和关系困难在她们的账户中更为重要。确定了四种应对机制。妇女利用当地土著资源对消极情况进行心理重塑，并从人际网络、教会和艾滋病毒支助团体中动员情感和财政支持。不太常见的是，他们向传统治疗师、医疗服务或社会工作者寻求专家建议，但获得这些建议的机会有限。尽管所有人都试图用创收努力来补充政府拨款，但只有少数人认为这些努力是成功的。调查结果支持正在进行的努力，以支持与支持团体紧张的精神健康服务，这些团体往往提供宝贵的情感和实际支持。然而，如果没有平行的扶贫战略，支助团体有时可能只会鼓励被动地接受妇女遭受贫穷的必然性，这可能会加剧妇女的绝望情绪。
Increasing attention is paid to impacts of HIV/AIDS on women's mental health, often framed by decontextualized psychiatric understandings of emotional distress and treatment. We contribute to the small qualitative literature extending these findings through exploring HIV/AIDS-affected women's own accounts of their distressfocusing on the impacts of social context, and women's efforts to cope outside of medical support services. Nineteen in-depth interviews were conducted with women experiencing depression or anxiety-like symptoms in a wider study of services in KwaZulu-Natal, South Africa. Thematic analysis was framed by Summerfield's emphasis on contexts and resilience. Women highlighted family conflicts (particularly abandonment by men), community-level violence, poverty and HIV/AIDS as drivers of distress. Whilst HIV/AIDS placed significant burdens on women, poverty and relationship difficulties were more central in their accounts. Four coping mechanisms were identified. Women drew on indigenous local resources in their psychological re-framing of negative situations, and their mobilisation of emotional and financial support from inter-personal networks, churches and HIV support groups. Less commonly, they sought expert advice from traditional healers, medical services or social workers, but access to these was limited. Though all tried to supplement government grants with income generation efforts, only a minority regarded these as successful. Findings support ongoing efforts to bolster strained mental health services with support groups, which often offer valuable emotional and practical support. Without parallel poverty alleviation strategies, however, support groups may sometimes offer little more than encouraging passive acceptance of the inevitability of sufferingpotentially exacerbating the hopelessness underpinning women's distress.