RESUMO
BACKGROUND: Health disparity and under-utilization of health services is prevalent among Asian refugees and migrants in Western countries and can profoundly impact health outcomes. Cambodians who survived extreme physical and emotional trauma during the genocides enacted by the Khmer Rouge regime in the 1970's are particularly vulnerable to poor mental health outcomes decades later. Understanding the experiences of help-seeking and service use by displaced Cambodians in Western countries may help to design more effective and culturally safe healthcare services. AIMS: To identify characteristics or factors associated with help seeking behaviours and service utilization of displaced Cambodians with mental health issues living in Western countries. METHODS: This review followed the Arksey & O'Malley methodological framework for scoping reviews. Articles for review were identified through searches of nine electronic databases and manual searches. Relevant articles were selected, and data was extracted and synthesized into key themes. RESULTS: This review included 15 articles. Most of the studies were conducted in the USA (n = 13) with one each conducted in Canada and New Zealand. Seven studies used qualitative interviews, five used a cross-sectional survey approach, two used a mixed-methods approach and one was a narrative review and case series. Key findings highlighted the impact of Cambodian cultural beliefs about mental health (guilt, shame and help-seeking stigma) on service utilization and the disconnect between Western models of service provision and preferred Cambodian ways of receiving support. CONCLUSION: Mental health services in Western countries are likely to be under-utilized by Cambodians due to a mismatch between health beliefs and Western models of care. Further investigation of the association between health beliefs and barriers to service utilization among adult Cambodian refugees is warranted.
Assuntos
Comportamento de Busca de Ajuda , Serviços de Saúde Mental , Aceitação pelo Paciente de Cuidados de Saúde , Refugiados , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Refugiados/psicologia , Camboja/etnologia , Adulto , Canadá , Transtornos Mentais/terapia , Transtornos Mentais/etnologia , Nova Zelândia , Estados Unidos , População do Sudeste AsiáticoRESUMO
OBJECTIVE: This research aimed to study the effects of the risk communication program through the Cambodian folk song to prevent Opisthorchiasis-linked cholangiocarcinoma (OV-CCA). METHODS: We conducted the quasi-experimental research between August and December 2017 in the Cambodian communities, one-fourth of ethnic minorities residing in multicultural areas of Sisaket Province, Thailand. The samples consisted of 94 equally people divided into experimental group and control group. The experimental group included 47 people at-risk of OV-CCA who received the program for 12 weeks, while the control group received regular services. We collected data by using a questionnaire with a reliability of 0.93. Descriptive and inferential statistics were used for data analysis. RESULTS: The study indicated that the socioeconomic information of both groups was not different. The mean scores of all issues (health beliefs, social support, and prevention behavior in the experimental group were higher than those of the control group with statistical significance. Closer inspection showed that the mean difference of the health beliefs was 55.61 points (95%CI: 52.39-57.42, p<0.001), social support was 9.09 points (95%CI: 8.12-10.05, p<0.001), and prevention behavior was 6.38 points (95%CI: 5.43-7.33, p<0.001). CONCLUSION: Through the Cambodian folk song, the risk communication program by applying the health beliefs and social support to prevent OV-CCA is beneficial for behavior modification in areas with similar cultures.
Assuntos
Neoplasias dos Ductos Biliares/prevenção & controle , Colangiocarcinoma/prevenção & controle , Comunicação , Folclore , Modelo de Crenças de Saúde , Opistorquíase/complicações , Adulto , Neoplasias dos Ductos Biliares/parasitologia , Camboja/etnologia , Colangiocarcinoma/parasitologia , Intervalos de Confiança , Minorias Étnicas e Raciais , Feminino , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Musicoterapia , Opistorquíase/epidemiologia , Prevalência , Reprodutibilidade dos Testes , Risco , Apoio Social , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto JovemRESUMO
Cambodia harbours a variety of human aboriginal populations that have scarcely been studied in terms of genetic diversity of entire mitochondrial genomes. Here we present the matrilineal gene pool of 299 Cambodian refugees from three different ethnic groups (Cham, Khmer, and Khmer Loeu) deriving from 16 Cambodian districts. After establishing a DNA-saving high-throughput strategy for mitochondrial whole-genome Sanger sequencing, a HaploGrep based workflow was used for quality control, haplogroup classification and phylogenetic reconstruction. The application of diverse phylogenetic algorithms revealed an exciting picture of the genetic diversity of Cambodia, especially in relation to populations from Southeast Asia and from the whole world. A total of 224 unique haplotypes were identified, which were mostly classified under haplogroups B5a1, F1a1, or categorized as newly defined basal haplogroups or basal sub-branches of R, N and M clades. The presence of autochthonous maternal lineages could be confirmed as reported in previous studies. The exceptional homogeneity observed between and within the three investigated Cambodian ethnic groups indicates genetic isolation of the whole population. Between ethnicities, genetic barriers were not detected. The mtDNA data presented here increases the phylogenetic resolution in Cambodia significantly, thereby highlighting the need for an update of the current human mtDNA phylogeny.
Assuntos
Povo Asiático/genética , Mitocôndrias/classificação , Refugiados/classificação , Sequenciamento Completo do Genoma/métodos , Povo Asiático/etnologia , Camboja/etnologia , Feminino , Genoma Mitocondrial , Haplótipos , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Herança Materna , Mitocôndrias/genética , FilogeniaRESUMO
We encountered an outbreak of paragonimiasis among Cambodian technical intern trainees (TITs) at a food-processing factory in Fukuoka, Japan. The patients were 20-28 years old, seven females and two males, who had been in Japan for one to four years. All of them had consumed raw or undercooked Japanese mitten crab they purchased at a local grocery store near their training place. CT images showed multiple lesions not only in the lungs but in the extrapulmonary organs as well, such as subcutaneous tissues, abdominal muscles, and mesentery, in most of the patients. Their medical records indicated that all of them acquired infection in Japan, not in Cambodia. Diagnosis was made serologically and the patients were treated with praziquantel successfully. Foreign workers and TITs are increasing in Japan so rapidly, that food borne-infections, including paragonimiasis, should be considered in people from developing countries who have exotic dietary habits.
Assuntos
Surtos de Doenças , Pneumopatias Parasitárias/epidemiologia , Pulmão/patologia , Paragonimíase/epidemiologia , Paragonimus westermani/isolamento & purificação , Adulto , Animais , Camboja/etnologia , Feminino , Humanos , Japão/epidemiologia , Pneumopatias Parasitárias/parasitologia , Pneumopatias Parasitárias/patologia , Masculino , Paragonimíase/parasitologia , Paragonimíase/patologia , Adulto JovemRESUMO
Based on an ethnographic study of the Cambodian pharmaceutical system conducted in an urban and a rural setting between January 2015 and June 2016, we report on the complex dynamics surrounding the issue of self-medication in that country. We describe the history of the circulation of pharmaceuticals in Cambodia, and we discuss the contemporary relationship individuals have with these medicines and with those who distribute them. We illustrate the specific dynamics of the pharmaceuticalization of Cambodian society, where private drug vendors are playing a key role.
Assuntos
Autonomia Pessoal , Farmácias , Automedicação , Antropologia Médica , Camboja/etnologia , Tratamento Farmacológico , HumanosRESUMO
Epilepsy is the most common neurological disorder encountered in primary care in Southeast Asia. People with epilepsy require long-term therapy management. Nonadherence to antiepileptic drugs (AEDs) has been identified as a major factor in suboptimal control of epilepsy. Pharmacies offer patients a first-line point of contact with the healthcare system. Many pharmacies operate with limited or nonqualified human resources that can lead to insufficient knowledge, inappropriate supply of medicines, and insufficient counseling. OBJECTIVE: The aim of this study was to evaluate the qualification and knowledge concerning epilepsy and AEDs among pharmacy-dispensing workers who sell drugs to people with epilepsy. METHOD: A cross-sectional qualitative study was conducted in public and private pharmacies, in both urban and rural areas of Cambodia and Lao People's Democratic Republic (Lao PDR). The knowledge was collected through a questionnaire. RESULTS: A total of 180 respondents from 123 outlets in the two countries were included in this study. A proportion of 40.8% (31) of respondents in Cambodia and 38.5% (40) in Lao PDR were pharmacists, followed by sellers who did not received any healthcare training with a proportion of 18.4% (14) in Cambodia compared to 20.2% (21) in Lao PDR. Head trauma was cited as the main cause of epilepsy by 72.4% (55) in Cambodia and 27.2% (28) in Lao PDR (pâ¯<â¯0.001). Epilepsy was considered as a contagious disease by 6.6% (5) of respondents in Cambodia compared to 18.4% (19) in Lao PDR (pâ¯=â¯0.03). Eighty-seven percent (66) of respondents in Cambodia knew at least one long-term AED versus 67.3% (70) in Lao PDR (pâ¯=â¯0.003). Phenobarbital was mentioned in more than 90.0% of cases in both countries. In overall, 15.4% (21) thought that if seizures are controlled for some months, people with epilepsy could stop taking their AEDs. Only one respondent from Lao PDR was aware of drug-drug interaction between AEDs and oral contraception. CONCLUSION: An educational intervention should be implemented to improve the knowledge of epilepsy and AEDs for pharmacy-dispensing workers. This could include advice for all pharmacy-dispensing workers in order to improve AED management and follow-up of therapeutic adherence.
Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Epilepsia/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Farmácias/normas , Adulto , Camboja/etnologia , Estudos Transversais , Epilepsia/psicologia , Feminino , Humanos , Laos/etnologia , Masculino , Pessoa de Meia-Idade , Farmacêuticos/psicologia , Farmacêuticos/normas , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/normas , Inquéritos e Questionários/normasRESUMO
Ghost encounters were found to be a key part of the trauma ontology among Cambodian refugees at a psychiatric clinic, a key idiom of distress. Fifty-four percent of patients had been bothered by ghost encounters in the last month. The severity of being bothered by ghosts in the last month was highly correlated to PTSD severity (r = .8), and among patients bothered by ghosts in the last month, 85.2% had PTSD, versus among those not so bothered, 15.4%, odds ratio of 31.8 (95% confidence level 11.3-89.3), Chi square = 55.0, p < .001. Ghost visitations occurred in multiple experiential modalities that could be classified into three states of consciousness: full sleep (viz., in dream), hypnagogia, that is, upon falling asleep or awakening (viz., in sleep paralysis [SP] and in non-SP hallucinations), and full waking (viz., in hallucinations, visual aura, somatic sensations [chills or goosebumps], and leg cramps). These ghost visitations gave rise to multiple concerns-for example, of being frightened to death or of having the soul called away-as part of an elaborate cosmology. Several heuristic models are presented including a biocultural model of the interaction of trauma and ghost visitation. An extended case illustrates the article's findings.
Assuntos
Transtorno de Pânico/psicologia , Refugiados/psicologia , Paralisia do Sono/psicologia , Espiritualismo , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Camboja/etnologia , Feminino , Humanos , Masculino , Massachusetts , Pessoa de Meia-Idade , Transtorno de Pânico/etnologia , Índice de Gravidade de Doença , Paralisia do Sono/etnologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Inquéritos e QuestionáriosRESUMO
Efforts to provide culturally appropriate global mental health interventions have included attention to local idioms of distress. This article critically examines the potential gap between lay ethnopsychological understandings of the Cambodian idiom of baksbat (broken courage) on the one hand and clinical conceptualizations of the idiom as a potential indicator of posttraumatic stress disorder. Ethnographic semi-structured interviews with trauma survivors reveal resistance to current clinical translations and hybrid Euro-Western and Khmer treatment interventions. While the notion of idioms of distress is intended to draw attention to everyday non-pathologizing forms of discourse, the creation of hybrid assessment and treatment constructs linking idioms to trauma-related pathology may obscure the pragmatic communicative functions of the idiom, making them subordinate to an existing model of psychiatric disorder and pathologizing everyday modes of coping. Participants' narratives highlight self-perceived connections between stressors that determine the trajectory and outcome of distress and shared cultural worldviews that together uniquely shape their meaning. These observations point to the dilemmas of linking idioms of distress with co-morbid illness constructs in ways that may pathologize normal emotional responses. Results have implications for efforts to develop effective models of post-conflict trauma care in global mental health.
Assuntos
Coragem , Trauma Psicológico/etnologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Terminologia como Assunto , Adulto , Camboja/etnologia , Comorbidade , Etnopsicologia , Feminino , Saúde Global , Humanos , Masculino , Saúde Mental , Trauma Psicológico/diagnóstico , Trauma Psicológico/terapia , Pesquisa Qualitativa , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , SobreviventesRESUMO
Asian Americans are understudied in health research and often aggregated into one homogenous group, thereby disguising disparities across subgroups. Cambodian Americans, one of the largest refugee communities in the United States, may be at high risk for adverse health outcomes. This study compares the health status and healthcare experiences of Cambodian American refugees and immigrants. Data were collected via questionnaires and medical records from two community clinics in Southern California (n = 308). Chi square and t-tests examined the socio-demographic differences between immigrants and refugees, and ANCOVA models compared the mean differences in responses for each outcome, adjusting for age at immigration, education level, and clinic site. Cambodian American refugees reported overall lower levels of health-related quality of life (all p's < 0.05 in unadjusted models) and self-rated health [unadjusted means (SD) = 18.2 (16.8) vs. 21.7 (13.7), p < 0.05], but either similar or more positive healthcare experiences than Cambodian American immigrants. In adjusted analyses, refugees had higher rates of diabetes and cardiovascular disease risk (e.g. heart condition and hypertension; p's < 0.05) compared to Cambodian American immigrants. There were minimal differences in self-reported health behaviors between the two groups. There is a need for more health promotion efforts among Cambodian American refugees and immigrants to improve their health outcomes and perceived wellbeing.
Assuntos
Asiático/psicologia , Emigrantes e Imigrantes/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Refugiados/psicologia , Adulto , Asiático/estatística & dados numéricos , California , Camboja/etnologia , Doença Crônica/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Refugiados/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Studies of relatively recently resettled refugees have noted social disconnection, linked to various physical and mental health outcomes, as a concern. Limited studies have examined whether social disconnection and its effects persists within refugee populations resettled more than 3 decades prior. The relationship between social disconnection and self-reported health was explored in a secondary analysis of a cross-sectional needs assessment survey with a snowball sample of 100 Cambodian refugees residing in Connecticut. Social disconnectedness and comorbid health conditions were prevalent. Lack of religious and community engagement were associated with poor health outcomes, while individuals with a lack of ethnic engagement reported better overall health. This study underscores the importance of understanding the specific risks that social disconnection poses to refugees who have resettled many years before and their offspring that may assist in better serving currently settling refugees within the United States.
Assuntos
Asiático/psicologia , Atitude Frente a Saúde/etnologia , Saúde Mental/etnologia , Refugiados/psicologia , Ajustamento Social , Camboja/etnologia , Depressão/etnologia , Feminino , Humanos , Masculino , Autorrelato , Estados UnidosRESUMO
Southeast Asia contains high numbers of traumatised populations arising from either natural disasters or interpersonal violence. Consequently, the need for empirically based trauma treatments, compromised by insufficiency in appropriately trained clinicians and mental health workers, makes the situation more challenging in addressing traumatic sequelae in local populations. In response, the humanitarian/ trauma capacity building organisation, Trauma Aid Germany, trained 37 therapists in psycho-traumatology, based on EMDR Therapy, which included trauma stabilisation techniques. This research analyses the impact of Trauma Stabilisation as a sole treatment intervention for Post-Traumatic Stress Disorder (PTSD) in adults. Each client was screened for PTSD utilising the Harvard Trauma Questionnaire - pre- and post-treatment. Analysis of the data considered only those interventions focussed on trauma stabilisation, including psychoeducation. Participants receiving trauma confrontation interventions were excluded from the data. Trauma stabilisation - as a sole treatment intervention, was highly effective in alleviating PTSD diagnoses. Results demonstrate PTSD symptoms were reduced in both clinical and sub-clinical trauma groups. The data set suggests trauma stabilisation, as a sole treatment intervention, was safe, effective, efficient and sufficient treatment intervention for PTSD. Furthermore, trauma stabilisation interventions have the advantage of being safe, flexible, and adaptable to the cultural and spiritual context in which they were are applied. The research findings also have implications regarding teaching and learning and the potential utilisation of paraprofessionals, and other allied health professionals in addressing the global burden of psychological trauma.
Assuntos
Assistência à Saúde Culturalmente Competente , Avaliação de Processos e Resultados em Cuidados de Saúde , Trauma Psicológico/terapia , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Camboja/etnologia , Feminino , Humanos , Indonésia/etnologia , Masculino , Pessoa de Meia-Idade , Trauma Psicológico/etnologia , Psicoterapia/normas , Transtornos de Estresse Pós-Traumáticos/etnologia , Tailândia/etnologiaRESUMO
This cross-sectional study was conducted to evaluate the effects of work-related factors on work ability among young Cambodian migrant workers in Thailand. The participants consisted of 258 Cambodian migrant workers working in farms in the northeast region of Thailand. Work-related factors consisted of a general work environment and a psychosocial factor. General work environment was assessed by perception of subjects on biological, chemical, physical, and ergonomic factors. The psychosocial factor was assessed by the Job Content Questionnaire. The Work Ability Index was used to evaluate their work ability. Logistic regression analysis was applied to test the association between work-related factors and work ability. The results indicate that a chemical work environment and psychosocial factor associated with Work Ability Index among young Cambodian migrant workers, after adjusting for sociodemographic factors. These findings suggest that improving the work environment would be the most effective way to increase the work ability of Cambodian migrant workers in Thailand.
Assuntos
Migrantes/estatística & dados numéricos , Avaliação da Capacidade de Trabalho , Trabalho/estatística & dados numéricos , Adolescente , Adulto , Camboja/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tailândia , Adulto JovemRESUMO
BACKGROUND: Human trafficking in the fishing industry or "sea slavery" in the Greater Mekong Subregion is reported to involve some of the most extreme forms of exploitation and abuse. A largely unregulated sector, commercial fishing boats operate in international waters far from shore and outside of national jurisdiction, where workers are commonly subjected to life-threatening risks. Yet, research on the health needs of trafficked fishermen is sparse. This paper describes abuses, occupational hazards, physical and mental health and post-trafficking well-being among a systematic consecutive sample of 275 trafficked fishermen using post-trafficking services in Thailand and Cambodia. These findings are complemented by qualitative interview data collected with 20 key informants working with fishermen or on issues related to their welfare in Thailand. RESULTS: Men and boys trafficked for fishing (aged 12-55) were mainly from Cambodia (n = 217) and Myanmar (n = 55). Common physical health problems included dizzy spells (30.2%), exhaustion (29.5%), headaches (28.4%) and memory problems (24.0%). Nearly one-third (29.1%) reported pain in three or more areas of their body and one-quarter (26.9%) reported being in "poor" health. Physical health symptoms were strongly associated with: severe violence; injuries; engagement in long-haul fishing; immigration detention or symptoms of mental health disorders. Survivors were exposed to multiple work hazards and were perceived as disposable when disabled by illness or injuries. Employers struggled to apply internationally recommended Personal Protective Equipment (PPE) practices in Thailand. Non-governmental organizations (NGOs) encountered challenges when trying to obtain healthcare for uninsured fishermen. Challenges included fee payment, service provision in native languages and officials siding with employers in disputes over treatment costs and accident compensation. Survivors' post-trafficking concerns included: money problems (75.9%); guilt and shame (33.5%); physical health (33.5%) and mental health (15.3%). CONCLUSION: Fishermen in this region are exposed to very serious risks to their health and safety, and their illnesses and injuries often go untreated. Men who enter the fishing industry in Thailand, especially migrant workers, require safe working conditions and targeted protections from human trafficking. Survivors of the crime of sea slavery must be provided with the compensation they deserve and the care they need, especially psychological support.
Assuntos
Pesqueiros , Tráfico de Pessoas , Avaliação das Necessidades , Sobreviventes/psicologia , Migrantes/psicologia , Adolescente , Adulto , Camboja/etnologia , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/etnologia , Pesquisa Qualitativa , Sobreviventes/estatística & dados numéricos , Tailândia , Migrantes/estatística & dados numéricos , Adulto JovemRESUMO
The objective of this paper is to determine whether social support and acculturative stress were related to obtaining antenatal and postpartum care for pregnant female migrants, as well as access to health care for migrant children. The study utilized data of 987 migrant workers in Thailand who originated from hill tribes and mountain communities in Myanmar and Cambodia. Regression analysis showed that the language barrier, a crucial factor behind acculturative stress, adversely influenced access to maternal care. Social support reduced the impact of acculturative stress. Migrants with support are more likely to access health care. Based on the Multidimensional Scale of Perceived Social Support, more sources of support either from friends, family members, or other supporters who are significant could increase health care access. Besides friends and family, the support from the Migrant Health Worker Program and Migrant Health Volunteer Program allowed the formal health sector to utilize the informal social networks to improve care for migrants.
Assuntos
Aculturação , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Apoio Social , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Camboja/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Vale do Mecom , Pessoa de Meia-Idade , Mianmar/etnologia , Cuidado Pós-Natal/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto JovemRESUMO
Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. The study aims to provide a comprehensive understanding of the ways in which Cambodians see its causes and effects and to identify and analyse the cultural forces that underpin and shape its landscape. An ethnographic study was carried out with 102 perpetrators and survivors of emotional, physical and sexual violence against women and 228 key informants from the Buddhist and healing sectors. Their views and experiences of it were recorded-the popular idioms expressed and the symptoms of distress experienced by survivors and perpetrators. From these results, the eight cultural forces, or cultural attractors, that are seen to propel a person to violence were identified. Violence stemmed from blighted endowment, or 'bad building' (sÉmnaaÅ mɨn lÊÉÉ) determined by deeds in a previous life (kam). Children with a vicious character (kmeeÅ kaac or dosa-carita) might grow to be abusers, and particular birthmarks on boys were thought to be portents. KrÊÉh, or mishap, especially when a female's horoscope predicted a zodiac house on the descent (riesÉy), explained vulnerability to violence and its timing. Astrological incompatibility (kuu kam) was a risk factor. Lust, anger and ignorance, the 'Triple Poison', fuelled it. 'Entering the road to ruin' (apayamuk), including alcohol abuse, womanising and gambling, triggered it. Confusion and loss of judgement (moha) led to moral blindness (mo baÅ). These were the eight cultural attractors that shaped the landscape of violence against women. The cultural epigenesis of violence against women in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of violence against women. An understanding of the epigenesis of violence could strengthen the primary prevention of violence against women.
Assuntos
Budismo/psicologia , Cultura , Violência de Gênero/etnologia , Religião e Psicologia , Adolescente , Adulto , Antropologia Cultural , Camboja/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto JovemRESUMO
Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. This article brings together two seldom connected fields: Theory of Change (ToC) and cultural responsiveness in international development. It applies these approaches to a priority in global health, which is to prevent violence against women (VAW) and, drawing on my research on the epigenesis of VAW in Cambodia, develops an argument on the need for interventions to work with tradition and culture rather than only highlight it in problematic terms. The research draws on an ethnographic study carried out in Cambodia with 102 perpetrators and survivors of emotional, physical and sexual VAW and 228 key informants from the Buddhist and healing sectors. The eight 'cultural attractors' identified in the author's prior research highlight the cultural barriers to acceptance of the current Theory of Change. ToC for VAW prevention in Cambodia seems to assume that local culture promotes VAW and that men and women must be educated to eradicate the traditional gender norms. There is a need for interventions to work with tradition and culture rather than only highlight it in problematic terms. The cultural epigenesis of VAW in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of VAW.
Assuntos
Antropologia Cultural/métodos , Budismo/psicologia , Violência de Gênero/etnologia , Religião e Psicologia , Adolescente , Adulto , Camboja/etnologia , Feminino , Violência de Gênero/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Teoria Psicológica , Adulto JovemRESUMO
There are significant health disparities among Southeast Asian Americans. As an initial step toward understanding the psychosocial factors associated with these disparities, the present study examined primary care providers' perspectives of health status, healthcare utilization, health-related behaviors, and stressors among one subset of Southeast Asian Americans-Cambodian American women between the ages of 18 and 24 years. Interviews with five primary care providers indicated that cultural, historical, psychological and social issues were associated with health outcomes and health behaviors. Results also pointed to clinical considerations and research directions that would improve treatment and understanding of health problems among young Cambodian American women.
Assuntos
Asiático , Atitude do Pessoal de Saúde , Nível de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Camboja/etnologia , Dieta , Relações Familiares , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Acessibilidade aos Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente/etnologia , Percepção , Apoio Social , Estresse Psicológico/etnologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
A community needs assessment was conducted to explore barriers and facilitators to good physical and mental health among Cambodian and Latino residents in an urban community in Southern California. Thirty-six Cambodians and 29 Latinos completed the interviewer-facilitated survey administered door-to-door, and another 20 Cambodian and 18 Latino residents participated in focus groups. Crime, limited knowledge of positive health behaviors, lack of access to affordable healthcare, and lack of access to safe spaces for recreational activities were identified as threats to good health. Participant recommendations to support health in the community included increasing police presence to improve safety and reduce violence, and increasing opportunities/locations for physical exercise. While differences between Cambodian and Latino residents exist, the identified threats and suggested improvements were primarily associated with environmental factors, highlighting the need for systems level approaches that recognize the relationship between community context and health.
Assuntos
Povo Asiático/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Hispânico ou Latino/estatística & dados numéricos , Saúde Mental/etnologia , Adulto , Idoso , California/epidemiologia , Camboja/etnologia , Meio Ambiente , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Entrevistas como Assunto , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Assistência Centrada no Paciente/estatística & dados numéricos , Saúde Pública , Segurança , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The collective view of Asian Americans as model minorities is evident with the extensive amount of statistical data showing support for the academic and socioeconomic success of Asian Americans in the United States. This perception, however, often presents an inaccurate portrayal of Asian Americans, in general, as it overlooks many of the difficulties and hardships experienced by Asian American ethnic groups such as Southeast Asians. Within this group, Cambodian Americans are at the highest risk for experiencing socioeconomic hardships, behavioral health problems, substance use disorders, and contact with the criminal justice system, with deportation also being a prevailing issue. Unfortunately, research in this area is scant and contemporary research on Cambodian Americans has several limitations. To begin to address this issue, the present article merges information from existing research on this population from a sociohistorical, criminological, and theoretical standpoint to call for more comprehensive research on Cambodian Americans.
Assuntos
Asiático , Crime/etnologia , Camboja/etnologia , Criminologia , Humanos , Pobreza/etnologia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/etnologia , Estresse Psicológico/etnologia , Estados Unidos/epidemiologiaRESUMO
This article profiles visual auras among traumatized Cambodian refugees attending a psychiatric clinic. Thirty-six percent (54/150) had experienced an aura in the previous 4 weeks, almost always phosphenes (48% [26/54]) or a scintillating scotoma (74% [40/54]). Aura and PTSD were highly associated: patients with visual aura in the last month had greater PTSD severity, 3.6 (SD = 1.8) versus 1.9 (SD = 1.6), t = 10.2 (df = 85), p < 0.001, and patients with PTSD had a higher rate of visual aura in the last month, 69% (22/32) versus 13% (7/55), odds ratio 15.1 (5.1-44.9), p < 0.001. Patients often had a visual aura triggered by rising up to the upright from a lying or sitting position, i.e., orthostasis, with the most common sequence being an aura triggered upon orthostasis during a migraine, experienced by 60% of those with aura. The visual aura was often catastrophically interpreted: as the dangerous assault of a supernatural being, most commonly the ghost of someone who died in the Pol Pot period. Aura often triggered flashback. Illustrative cases are provided. The article suggests the existence of local biocultural ontologies of trauma as evinced by the centrality of visual auras among Cambodian refugees.