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Studies on the ways in which women implement coping strategies to recover from intimate partner violence have primarily focused on Western, non-collectivistic societies. To contribute to the scant literature on coping strategies among women in traditional-collectivistic societies, the current study applied the principles of Clinical Ethnographic Narrative Interview to analyze the experiences of 15 Palestinian-Arab citizens of Israel as these women confronted violence within marriage. This exploration is situated within the backdrop of entrenched collectivistic traditional norms and the broader context of the enduring Israeli-Arab conflict. An Interpretative Phenomenological Analysis revealed three themes that translated into a transformative three-phase coping model. The first theme covers navigating violent relationships through avoidance, emotional encapsulation, and cognitive reframing. The second theme describes strategies to mitigate violence and its consequences, including escapist and immediate departure, sustained fulfillment of duties, and maintaining hope amid adversity. The third theme characterizes strategies aimed at achieving self-care and self-empowerment. The findings highlight the importance of acknowledging women's definition of coping and recovery within their cultural constraints as they chart their coping trajectories.
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Cultural and religious norms, as well as trauma-related cognitions and recovery actions, are known to impact the well-being of survivors of intimate partner violence (IPV). Although acknowledged as a key component, there is scant research on the recovery trajectories of women who have experienced IPV, in particular on survivors from collectivistic societies such as the Jewish Ultra-Orthodox (JUO) community in Israel. A mediation model examined the recovery process of 261 Israeli JUO survivors. In particular, it tested whether the normalization of violence and women's endorsement of Jewish religious norms that justify violence would be directly and negatively associated with women's well-being and positively associated with psychopathology. Additionally, it examined whether women's normalization of violence and support of religious norms would positively predict women's negative trauma-related cognitions. In turn, these cognitions were expected to negatively predict women's engagement in recovery actions, help-seeking behaviors, and faith-based responses but positively predict disengagement responses. The model further posited that women's engagement in steps toward recovery, help-seeking behaviors, and faith-based responses would positively predict women's well-being and negatively predict psychopathology. In contrast, women's disengagement responses would negatively predict women's well-being and positively predict their psychopathology. Bootstrap results indicated that supporting religious norms positively predicted women's trauma-related cognitions, which then negatively predicted women's recovery actions, help-seeking behaviors, and faith-based responses but positively predicted women's disengagement responses. Women's recovery actions and faith-based responses positively predicted women's well-being, while disengagement responses positively predicted women's psychopathology. Contrary to expectations, help-seeking behaviors positively predicted psychopathology.
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PURPOSE: To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. METHODS: Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. RESULTS: The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). CONCLUSIONS: Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.
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Photo-experiencing and Reflective Listening (PEARL) is a trauma-informed intervention developed to promote recovery engagement in survivors of gender-based violence (GBV). This study aimed to understand the feasibility and acceptability of PEARL and identify potential healing elements. GBV survivors were recruited in Philadelphia through an online survey (n = 20). Participants completed the PEARL intervention, a postintervention survey, and a follow-up interview. Results revealed PEARL to be both feasible and acceptable, with thematic analysis revealing its ability to facilitate purposeful reflection, connection to the present, and progress toward healing goals. PEARL shows promise as an engaging strategy to promote healing for survivors of GBV.
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Intimate partner violence (IPV) is a pressing public health issue affecting women worldwide. Thirty percent of women experience some form of violence throughout their lifetime globally, and South Asian countries have a higher prevalence of IPV (33%-51%). Notably, IPV has detrimental psychological impacts not only on women but also on their children. Despite this, limited empirical attention has explored protective factors for IPV trauma recovery. This review examines protective factors aiding South Asian immigrant IPV survivors' trauma recovery using Joanna Briggs Institute JBI methodology. The study draws on PubMed, Scopus, and PsychINFO data, resulting in 20 articles retrieved using Rayyan software. Protective factor's themes and subthemes revealed in the literature operated at multiple levels, including personal, interpersonal, community, and professional factors. Personal factors were selfhood, collective self, and adaptation, as well as those that enabled the utilization of interpersonal, community, and professional factors; interpersonal factors were family and friends, children as motivators, and religion; and community and professional factors were resources and technology usage. Immigrant status and culture significantly impacted the protective factors, acting as barriers among some IPV survivors. Therefore, future research should focus on exploring the experiences and cultural values of South Asian immigrant women with other influencing factors that may hinder the development and impact of protective factors on IPV trauma recovery. These findings can help design culturally sensitive support services that incorporate the unique needs of female South Asian immigrant IPV survivors.
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This study investigated the Turkish validity and reliability of the Healing After Gender-based Violence Scale (GBV-Heal) and the relationship between social support perception, posttraumatic growth in university students who are victims of gender-based violence. The study sample consisted of 167 female students who experienced gender-based violence. The Turkish version of GBV-Heal of Kaiser-Meyer-Olkin value was 0.892; the Bartlett Sphericity Test result was determined as χ2 = 195,053, and the obtained variables were found suitable for factor analysis. Perception of social support related to post-violence healing in female university students is effective on posttraumatic growth.
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PURPOSE: To describe clinical research professionals (CRPs)' experiences with electronic patient-reported outcome (ePRO) data collection systems in oncology clinical trials and identify correlates of CRPs' attitude toward technology. METHODS: An online survey was conducted among 210 CRPs from 125 National Cancer Institute-funded research sites. Measures included CRPs' demographic characteristics, working years, employment locations, and previous experiences with various types of ePROs. Their attitude toward technology was measured by the Technology Attitude Scale-Adapted. The Wilcoxon signed-rank test was used to compare two subdomains of attitude (perceived usefulness [PU] and perceived ease of use [PEU]). Multiple linear regression was used to explore correlates of (1) overall attitude, (2) PU, and (3) PEU. The significance level was 5%. RESULTS: Participants' median age was 41 years (range, 21-67). Most were female (90%) and White (82%). More than half of the participants had previous experiences with web-based ePROs using patients' own devices (72%) or site-/sponsor-provided on-site devices (eg, kiosks or tablets; 64%). CRPs who were 60 years or older (ß = -0.32, P < .05) or worked for 10-20 years (ß = -0.11, P < .05) had relatively negative attitudes, controlling for other factors. Previous experiences with more ePRO types were associated with more positive attitudes (ß = 0.08, P = .02). Similar correlates were found with PU but not with PEU. CONCLUSION: This study revealed that CRPs had various experiences with ePRO systems and attitudes toward technology. Age, working years, and previous experiences with ePROs were correlates of overall attitude toward technology and PU. These findings suggest necessary targeted training to facilitate ePRO use in oncology clinical trials by improving CRPs' awareness and attitude toward technology.
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Oncologia , Neoplasias , Humanos , Feminino , Adulto , Masculino , Coleta de Dados , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Neoplasias/terapia , Medidas de Resultados Relatados pelo Paciente , EletrônicaRESUMO
AIM: This study aims to investigate the reliability and predictive validity of the Social Support Questionnaire for Transactions (SSQT) scale. DESIGN: A psychometric design using cross-sectional data. METHOD: This cross-sectional descriptive study was conducted between February-June 2021 using snowball sampling through an online survey panel. 204 Turkish survivors of gender-based violence (GBV) participated in the research. RESULTS: The mean age of participants was 35.66 ± 12.50. Exploratory and confirmatory factor analysis examined the construct validity of the SSQT scale. The principle axis factoring (PAF) estimation method was performed, including oblique rotation (Promax) for EFA, and the diagonally weighted least squares (DWLS) estimation method was used for CFA. Test-retest reliability coefficients (r) were moderate to excellent, ranging from 0.48 to 0.88. The analyzes supported the 5-factor solution, and the reliability was evaluated with Cronbach's Alpha coefficients for Social Friendship, Daily Emotional Support, Problem-Oriented Emotional Support, Daily Instrumental Support, and Problem-Focused Instrumental Support sub-dimensions, and the total score of SSQT showing 0.87, 0.84, 0.90, 0.73, 0.83, and 0.93, respectively. The relationships between sub-dimensions of SSQT showed moderate positive correlations ranging from 0.40 to 0.60. There were weak negative correlations between SSQT and PHQ-9, PHQ-15 and GAD-7, ranging from -0.20 to -0.34, which shows the external validity of the SSQT. CONCLUSION: The relationships between sub-dimensions of SSQT and PHQ-9, PHQ-15, GAD-7 are given in the results support using the SSQT scale as a research and clinical instrument for assessing women who had experienced GBV and have/have not received social support in Turkish culture.
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Violência de Gênero , Humanos , Feminino , Psicometria , Reprodutibilidade dos Testes , Estudos Transversais , Inquéritos e Questionários , Apoio SocialRESUMO
BACKGROUND: Stigma experiences contribute to psychological distress and negatively affect healthcare-seeking behavior in people with chronic obstructive pulmonary disease (COPD). Most evidence comes from qualitative research, and no well-established measure of COPD-related stigma exists. Prior research yielded a preliminary measure of COPD-related stigma, but it required item reduction and validation. OBJECTIVES: The purpose of this study was to revise the preliminary measure, reduce the number of items, identify underlying constructs, and evaluate the reliability and validity of the shortened version. METHODS: A descriptive, cross-sectional study was conducted. Participants (N = 148; mean = 64 ± 7.27 years) completed the 51-item preliminary COPD-related Stigma Scale (COPDSS). Item-level analysis was conducted before running exploratory factor analysis (EFA). Reliability was assessed using Cronbach's alpha. Convergent validity and known-groups validity were evaluated. RESULTS: In the item-level analysis, eight items were deleted, leaving 43 items for factor analysis. A four-factor model with 24 items (α = 0.93) was derived from EFA: social stigma (α = 0.95), felt stigma (α = 0.95), anticipated stigma-oxygen (α = 0.80), and smoking-related stigma (α = 0.81). The 24-item COPDSS was significantly correlated with the 8-item Stigma Scale for Chronic Illness (r = 0.83), the Hospital Anxiety and Depression Scale (r = 0.57), and the PROMIS Physical Function (r = -0.48). The 24-item COPDSS discriminated between known groups based on age (p = .03), use of inhalers (p = .002) and use of supplemental oxygen (p < .001), and psychological distress levels (ps < .001). CONCLUSION: Findings support the reliability and validity of the 24-item COPDSS. This instrument can be used to understand underlying stigma processes in people with COPD.
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Doença Pulmonar Obstrutiva Crônica , Estigma Social , Humanos , Psicometria , Reprodutibilidade dos Testes , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
This study investigated the reliability and predictive validity of the Sense of Coherence (SOC) scale for 299 American survivors of gender-based violence (GBV). First, confirmatory factor analysis examined the construct validity of the SOC-13. Then, relationships between SOC and clinical scales were examined. Confirmatory factor analysis supported the 3-factor solution, and Cronbach's alpha reliability values for comprehensibility, manageability, and meaningfulness subscales and total score of SOC-13 were: .62, .53, .65, and .81, respectively. Multiple regression revealed that age, posttraumatic growth, depression, and posttraumatic stress scores explained 53% of the variance of SOC scores. We interpret this to suggest that SOC is a protective factor in GBV, especially in younger women. Clinical implications are suggested.
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Violência de Gênero , Senso de Coerência , Humanos , Feminino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
AIM: We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. DESIGN: A cross-sectional study using anonymous online surveys. METHODS: This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. RESULTS: The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC. CONCLUSIONS: This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. IMPACT: This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.
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Violência de Gênero , Trauma Psicológico , Sobreviventes , Humanos , Estudos Transversais , Violência de Gênero/etnologia , Violência de Gênero/psicologia , Análise de Classes Latentes , Serviços de Saúde Mental/estatística & dados numéricos , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Estados Unidos , Inquéritos e Questionários , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Cultura , Trauma Psicológico/etnologia , Trauma Psicológico/reabilitação , Teoria PsicológicaRESUMO
ABSTRACT Objectives to analyze the perception of women discharged from the prison system about the main stressors that marked their life trajectories and to discuss the feasibility of the Clinical Ethnographic Narrative Interview technique to facilitate the narrative of this group. Method narrative research developed in a social protection center in the interior of São Paulo. Data were collected in 2021 (January and February) using the Clinical Ethnographic Narrative Interview technique, which intersperses narratives and visual aids. The synergy between the concepts of vulnerability and stress was adopted as a theoretical framework, and content analysis was performed. The discussion of viability was based on the criteria of acceptability and expansion. Results The narratives addressed psychosocial difficulties prior to incarceration and the hostile environment of the overcrowded prison as a place of conflict and abuse of power. Family helplessness, estrangement from children, negative emotions, somatic symptoms and traumas were mentioned as consequences of seclusion. The participants also reported coping processes with words that referred to the ideas of overcoming, hope, new beginning and gratitude. It is understood that this high point of the narratives may reflect the potential of the interview technique and corroborates its adequacy. Conclusion The undoubted painful character of the narratives about the different adversities experienced, especially as a result of seclusion, was also permeated by aspects that denoted resilient processes. The adoption of this interview technique made data collection more sensitive, welcoming and timely to expand the repertoire of words in the expression of feelings and revisit painful experiences, envisioning positive possibilities for the future.
RESUMEN Objetivos analizar la percepción de mujeres egresadas del sistema penitenciario sobre los principales estresores que marcaron sus trayectorias de vida y discutir la viabilidad de la técnica de Entrevista Narrativa Etnográfica Clínica para facilitar la narrativa de este grupo. Método investigación narrativa desarrollada en un dispositivo de protección social del interior de São Paulo. Los datos fueron recolectados en 2021 (enero y febrero) utilizando la técnica de Entrevista Narrativa Etnográfica Clínica, que intercala narrativas y ayudas visuales. Se adoptó como marco teórico la sinergia entre los conceptos de vulnerabilidad y estrés y se realizó un análisis de contenido. La discusión de viabilidad se basó en los criterios de aceptabilidad y expansión Resultados Las narrativas abordaron las dificultades psicosociales previas al encarcelamiento y el ambiente hostil de la prisión superpoblada como locus de conflicto y abuso de poder. Se mencionaron como consecuencias de la reclusión el desamparo familiar, el alejamiento de los hijos, las emociones negativas, los síntomas somáticos y los traumas. Los participantes también relataron procesos de afrontamiento con palabras que hacían referencia a las ideas de superación, esperanza, nuevo comienzo y gratitud. Se entiende que este punto alto de las narraciones puede reflejar el potencial de la técnica de la entrevista y corrobora su adecuación. Conclusión El indudable carácter doloroso de las narrativas sobre las diferentes adversidades vividas, especialmente a raíz del encierro, también estuvo permeado por aspectos que denotaban procesos resilientes. La adopción de esta técnica de entrevista hizo que la recolección de datos fuera más sensible, acogedora y oportuna para ampliar el repertorio de palabras en la expresión de sentimientos y revivir experiencias dolorosas, vislumbrando posibilidades positivas para el futuro.
RESUMO Objetivos analisar a percepção de mulheres egressas do sistema prisional sobre os principais estressores que marcaram suas trajetórias de vida e discutir a viabilidade da técnica Entrevista Narrativa Etnográfica Clínica para facilitar a narrativa desse grupo. Método pesquisa narrativa desenvolvida em um dispositivo de proteção social do interior de São Paulo. Os dados foram coletados em 2021 (janeiro e fevereiro) utilizando a técnica Entrevista Narrativa Etnográfica Clínica, que intercala narrativas e recursos visuais. A sinergia entre os conceitos de vulnerabilidade e estresse foi adotada como referencial teórico, tendo sido realizada a análise de conteúdo. A discussão da viabilidade foi pautada nos critérios aceitabilidade e expansão. Resultados As narrativas abordaram dificuldades psicossociais pregressas ao encarceramento e o ambiente hostil do cárcere superlotado como lócus de conflitos e abuso de poder. Desamparo familiar, distanciamento dos filhos, emoções negativas, sintomas somáticos e traumas foram mencionados como consequências da reclusão. As participantes também relataram processos de enfrentamento com palavras que remetiam às ideias de superação, esperança, recomeço e gratidão. Entende-se que esse ponto alto das narrativas pode ter reflexos do potencial da técnica de entrevista e corrobora a sua adequação. Conclusão O indubitável caráter doloroso das narrativas sobre as diferentes adversidades vivenciadas, sobretudo em decorrência da reclusão, também foi perpassado por aspectos que denotaram processos resilientes. A adoção da referida técnica de entrevista tornou a coleta de dados mais sensível, acolhedora e oportuna para ampliar o repertório de palavras na expressão dos sentimentos e revisitação de experiências dolorosas, vislumbrando possibilidades positivas para o futuro.
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OBJECTIVE: This study used narrative interviewing and grounded theory analysis to discover the phases of trauma integration for Japanese women who had experienced intimate partner violence (IPV). METHOD: We interviewed 23 Japanese women who had experienced IPV using the Clinical Ethnographic Narrative Interviews (CENI) from November 2017 to September 2018 in Tokyo, Japan. The data from 11 participants who had achieved trauma integration using the Trauma Recovery Rubric were analyzed using a modified grounded theory approach. RESULTS: Six phases of the trauma integration journey after IPV were discovered: (1) Chaos, (2) Burning out, (3) Focusing, (4) Challenging, (5) Deepening insights, and (6) Re-building. The survivors described the processes of exploration of themselves and their reactions to their concurrent challenges. They focused on finding ways to protect, re-discover, and re-embrace themselves by healing from physical, psychological, and spiritual distresses. They also rebuilt relationships with others and acquired knowledge and skills to achieve a new life. Notably, the primary components of their recovery processes were changes in self-perception and self-interpretation of the trauma itself and its impacts on one's life and within oneself from multiple angles. In addition, traditional Japanese norms and gender roles, such as beliefs concerning the "ideal life of a woman" and fear of not behaving differently from others, profoundly influenced their recovery process. CONCLUSION: This study highlights the importance of incorporating individuals' cultures and their phase, needs, and personal self-development timeframes when developing trauma integration interventions.
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Violência por Parceiro Íntimo , Feminino , Teoria Fundamentada , Humanos , Violência por Parceiro Íntimo/psicologia , Japão , Autoimagem , Sobreviventes/psicologiaRESUMO
Despite the high prevalence of adverse health and trauma-related outcomes associated with intimate partner violence (IPV), help-seeking and service utilization among survivors is low. This study is part of a larger mixed-methods and survivor-centered validation study on the Icelandic Barriers to Help-Seeking for Trauma (BHS-TR) scale, a new barriers measure focused on trauma recovery. A mixed-methods legitimation strategy of integration was employed to evaluate the BHS-TR structure in samples of IPV survivors. The merging of qualitative (n = 17) and quantitative (n = 137) data through a joint display analysis revealed mainly complementarity findings, strengthening the scale's overall trustworthiness and validity evidence. Divergent findings involved items about mistrust, perceived rejection, stigmatization, fearing vulnerability, and safeguarding efforts that were significant help-seeking barriers in the survivors' narratives, whereas factor analysis indicated their removal. These BHS-TR items were critically evaluated in an iterative spiraling process that supported the barriers' influence, illuminated core issues, and guided potential refinements. This work contributes to the growing field of mixed methods instrument validation placing equal status on qualitative and quantitative methods and emphasizing integration to provide more complete insights. Moreover, the study's findings highlight the added value of further exploring divergence between two sets of data and the importance of giving attention to the voices of the target population throughout the validation process.
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Violência por Parceiro Íntimo , Medo , Humanos , Prevalência , Estereotipagem , SobreviventesRESUMO
It is a devastating and tragic estimate that 35% of women worldwide have experienced either physical or sexual violence at some point in their lives (United Nations, 2015) (referred to hereafter as Gender-Based Violence, or GBV). While most research focuses on reducing violence, understanding power and control in families, and evaluating services, this study focuses on overcoming trauma recovery barriers. We document the development and psychometric properties of the development of the Barriers to Help Seeking for Trauma Scale (BHS-TR) scale conducted with 309 GBV survivors. EFA and CFA confirmed a 7-factor solution that explained 68.4% of the variance, with an alpha reliability of 0.87. Factors were Shame, Frozen/Confused, Problem Management beliefs, Unavailable, Financial Concerns, Discrimination, and Constraints. Convergent validity was found with Sense of Coherence (SOC) and Beliefs about Mental Illness (BMI), and external validity was found with all the subscales and depression/PTSD except Problem Management beliefs. Cluster analysis was used to confirm that the barriers factors grouped into Internal and External Barrier dimensions. Regression showed that BMI predicted 24% of External Barriers variance, and SOC predicted 20% of the variance of the Internal barriers. Implications include the need to understand the breadth of help-seeking survivors engage in, differentiate the varieties of barriers from shame and stigma, and work with survivors "where they are" to address perceived barriers.
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Violência de Gênero , Transtornos Mentais , Feminino , Humanos , Reprodutibilidade dos Testes , Estigma Social , SobreviventesRESUMO
The movement for global mental health (GMH) has brought perennial questions about human diversity in mental health to the fore through heightened debates over if and how established knowledge, institutions, and practices should be altered for ethical and effective interventions with diverse peoples around the world. Kirmayer and Pedersen (2014) encouraged dialogue between GMH scholars and communities considered for intervention to address differences and concerns about colonialism. American Indian mental health offers an instructive site for global mental health inquiry to understand frameworks that might facilitate this desired dialogue. Here, we draw from a clinical ethnography in urban American Indian behavioral health conducted between September 2014 and February 2015 to glean insights into a popular response to these differences: Incorporating Indigenous cultural forms into clinical practice. Our findings highlight a predicament this response presents to mental health professionals. They can either eschew their clinical training and its cultural assumptions to take up new lives enabling their representation of Indigenous cultural forms, or they can hold onto their professional training and modify what is clinically familiar to appear culturally different. Rather than a purposeful decision, in the clinic contextual factors-tacit assumptions, clinic structures, and popular culture concepts-powerfully shaped clinical practice and reconfigured Indigenous cultural forms to support familiar clinical processes (e.g., treatment-planning). Although potentially therapeutic, culturally repackaged mental health practices are not the therapeutic alternatives called for by many Indigenous communities, and when advertised as such, risk harmful appropriations and misleading reticent people into participating in culturally prescriptive interventions. Lessons for global mental health point away from incorporating Indigenous cultural forms into clinical practice, which is likely to result in cultural repackaging, toward ethnographically-informed dialogue of differences to inform models for medical and epistemic pluralism providing interested communities more culturally commensurate mental health services alongside well-supported Indigenous therapeutic alternatives.
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Serviços Comunitários de Saúde Mental , Indígenas Norte-Americanos , Antropologia Cultural , Diversidade Cultural , Humanos , Indígenas Norte-Americanos/psicologia , Saúde Mental , Indígena Americano ou Nativo do AlascaRESUMO
Vulnerable women are considered a priority in public policies and research agendas. It is necessary to understand better the specificities of their daily lives and the meanings they attribute to their experiences, as this undoubtedly contributes to more grounded and culturally appropriate practices. Additionally, innovative techniques in qualitative research are demanded in academia. This narrative research study was carried out with fourteen women from a Brazilian socioeconomically vulnerable neighborhood. We used the body-mapping technique to investigate the experiences of women with mental health disorders or psychosocial distress. The aim was to analyze the self-perception about daily stressors and discuss the feasibility of this technique to facilitate this group's storytelling. Data collection was performed through focus groups, guided by the body-mapping technique steps, and supplemented with individual interviews. Interpersonal conflicts and violence were the main stressors. These strongly impacted the well-being of these women and their children. Some important personal qualities and resilience were identified. Body-mapping played a fundamental role in facilitating storytelling. It amplified the linguistic possibilities for participants to express their feelings and promoted reflections about the present, past, and glimpses into the future.
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Emoções , Relações Interpessoais , Criança , Feminino , Grupos Focais , Humanos , Pesquisa Qualitativa , ViolênciaRESUMO
Narrative data analysis aims to understand the stories' content, structure, or function. However narrative data can also be used to examine how context influences self-concepts, relationship dynamics, and meaning-making. This methodological paper explores the potential of narrative analysis to discover and compare the processes by which culture shapes selfhood and meaning making. We describe the development of the Comparative Ethnographic Narrative Analysis Method as an analytic procedure to systematically compare narrators' experiences, meaning making, decisions, and actions across cultures. This analytic strategy seeks to discover shared themes, examine culturally distinct themes, and illuminate meta-level cultural beliefs and values that link shared themes. We emphasize the need for a shared research question, comparable samples, shared non-biased instruments, and high-fidelity training if one uses this qualitative method for cross-cultural research. Finally, specific issues, trouble-shooting practices, and implications are discussed.
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Despite the promise of photography in research, few methods offer a guide to leverage this medium in conjunction with experience sampling to facilitate individual reflection while capturing the experiences of participants as they interact with their social world. The purpose of this paper is to introduce a new photo-elicitation method to add to the photography research repertoire, Photo-experiencing and Reflective Listening (PEARL). PEARL leverages the benefits of experience sampling, mindful self-awareness, and trauma-informed interviewing to document daily health experiences. After engaging in an at-home photography activity, participants meet for a one-on-one interview to share and cluster their photographs to discuss key themes and needs going forward. Using a study aimed to understand the recovery experiences of survivors of sexual violence, we illustrate how PEARL can be applied to study a population of interest. The products developed through PEARL provide rich opportunities for analysis, dissemination, story amplification, and action, making it a research method helpful for those interested in improving health equity and catalyzing social change. Because of the high satisfaction voiced by the participants of this approach, PEARL shows promise as a therapeutic data collection method, where the participants leave with some benefit through new awareness gained.
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Equidade em Saúde , Projetos de Pesquisa , Avaliação Momentânea Ecológica , Humanos , Fotografação , SobreviventesRESUMO
Current literature has primarily equated gender-based violence recovery with an improvement of physical or mental health symptoms, causing a gap in our understanding of the impact of interventions beyond the amelioration of adverse symptomology. The purpose of this research was to create an instrument to holistically measure gender-based violence recovery based on survivor healing goals. Ethnographic interviews were conducted in women-identifying gender-based violence survivors (ages 18-76) to determine healing domains and develop items using survivor language (n = 56). Focus groups with academic and community experts (n = 12) and cognitive interviews with gender-based violence survivors (n = 12) were conducted to ensure content and face validity, as well as to evaluate acceptability. This yielded a 31-item instrument to measure healing progress on a 5-point Likert scale. The Healing after Gender-based Violence Scale has the potential to highlight survivor strength and growth while more accurately measuring their recovery process based on survivor goals and desires.