CONTEXTUAL FACTORS AFFECTING PSYCHOLOGICAL AND PHYSICAL WELL-BEING AMONG SYRIAN REFUGEES IN TURKEY

Yıl 2024, Cilt: 14 Sayı: 2, 65 - 82, 30.12.2024

Merve Armagan Bogatekin , Ivy Ho

https://doi.org/10.20493/birtop.1524139

Öz

There are a total of 6.3 million Syrian refugees, equal to almost one-third of world’s total refugee population. Refugees face significant mental and physical health issues, including depression posttraumatic stress disorder and infectious diseases. This paper is a literature review that integrates current knowledge on the psychosocial factors associated with mental and physical well-being among Syrian refugees in Turkey. It focuses on issues of social issues such as social integration, social isolation, social support; cultural issues such as linguistic and religious factors; and distal factors including immigration and economic policits in Turkey. Finally, suggestions for future directions in this area of work are provided.

Anahtar Kelimeler

well-being, refugees, health, syrian

Türkiye'deki Suriyeli Mülteciler Arasında Psikolojik ve Fiziksel Refahı Etkileyen Bağlamsal Faktörler

Öz

Toplam 6,3 milyon Suriyeli mülteci var ve bu, dünyanın toplam mülteci nüfusunun neredeyse üçte birine eşit. Mülteciler, depresyon, travma sonrası stres bozukluğu ve bulaşıcı hastalıklar gibi önemli zihinsel ve fiziksel sağlık sorunlarıyla karşı karşıyadır. Bu makale, Türkiye'deki Suriyeli mülteciler arasında zihinsel ve fiziksel refahla ilişkili psikososyal faktörler hakkındaki güncel bilgileri birleştiren bir literatür taramasıdır. Sosyal entegrasyon, sosyal izolasyon, sosyal destek gibi sosyal sorunlar; dilsel ve dini faktörler gibi kültürel sorunlar; ve Türkiye'deki göç ve ekonomik politikalar gibi uzak faktörler konularına odaklanmaktadır. Son olarak, bu çalışma alanında gelecekteki yönler için öneriler sunulmaktadır.

Anahtar Kelimeler

mülteci, suriye, türkiye, sağlık

Kaynakça

• Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Cuijpers, P., & Aker, T. (2015). EMDR for Syrian refugees with posttraumatic stress disorder symptoms: Results of a pilot randomized controlled trial. European Journal of Psychotraumatology, 6, 27414. doi: 10.3402/ejpt.v6.27414
• Alghothani, N., Alghothani, Y., & Atassi, B. (2012). Evaluation of a short-term medical mission to Syrian refugee camps in Turkey. Avicenna Journal of Medicine, 2, 84-88. doi: 10.4103/2231-0770.110738
• Alpak, G., Unal, A., Bulbul, F., Sagaltici, E., Bez, Y., Altindag, A., ... & Savas, H. A. (2015). Post-traumatic stress disorder among Syrian refugees in Turkey: A cross-sectional study. International Journal of Psychiatry in Clinical Practice, 19, 45-50. doi: 10.3109/13651501.2014.961930
• Allport, G. W. (1954). The nature of prejudice. Cambridge, MA: Perseus Books.
• Al-Nuaimi, S., Aldandashi, S., Easa, A. K. S., & Saqqur, M. (2018). Psychiatric morbidity among physically injured Syrian refugees in Turkey. Comprehensive Psychiatry, 80, 34-38. https://doi.org/10.1016/j.comppsych.2017.08.002
• Asik, G. A. (2017, April 13). Turkey badly needs a long-term plan for Syrian refugees. Harvard Business Review. Retrieved from https://hbr.org/2017/04/turkey-badly-needs-a-long-term-plan-for-syrian-refugees
• Başoğlu, M., Livanou, M., Crnobarić, C., Frančišković, T., Suljić, E., Đurić, D., & Vranešić, M. (2005). Psychiatric and cognitive effects of war in former Yugoslavia: Association of lack of redress for trauma and posttraumatic stress reactions. JAMA, 294, 580-590. doi:10.1001/jama.294.5.580
• Berry, J. (1984). Multicultural policy in Canada: A social psychological analysis. Canadian Journal of Behavioural Science, 13, 135–154. http://dx.doi.org/10.1037/h0080859
• Berry, J. (1990). Psychology of acculturation. In J. Berman (Ed.), Nebraska Symposium on Motivation (Volume 37), (pp. 201–234). Lincoln, NE: University of Nebraska Press.
• Best, D., Honor, S., Karpusheff, J., Loudon, L., Hall, R., Groshkova, T., & White, W. (2012). Well-being and recovery functioning among substance users engaged in posttreatment recovery support groups. Alcoholism Treatment Quarterly, 30, 397-406. https://doi.org/10.1080/07347324.2012.718956
• Bhugra, D., Gupta, S., Bhui, K., Craig, T. O. M., Dogra, N., Ingleby, J. D., ... & Stompe, T. (2011). WPA guidance on mental health and mental health care in migrants. World Psychiatry, 10, 2-10. https://doi.org/10.1002/j.2051-5545.2011.tb00002.x
• Boswall, K., & Al Akash, R. (2015). Personal perspectives of protracted displacement: an ethnographic insight into the isolation and coping mechanisms of Syrian women and girls living as urban refugees in northern Jordan. Intervention, 13, 203-215.
• Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 34, 844-850. http://dx.doi.org/10.1037/0003-066X.34.10.844
• Brook, A. T., Garcia, J., & Fleming, M. (2008). The effects of multiple identities on psychological well-being. Personality and Social Psychology Bulletin, 34, 1588–1600. https://doi.org/10.1177/0146167208324629
• Bucak, I. H., Almis, H., & Samet Benli, M. T. (2017). An overview of the health status of Syrian refugee children in a tertiary hospital in Turkey. Avicenna Journal of Medicine, 7, 110-114. doi: 10.4103/ajm.AJM_17_17
• Caplan G. (1974). Support systems and community mental health. New York: Behavioural Publications.
• Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and aging, 25, 453-463. http://dx.doi.org/10.1037/a0017216
• Cheng, C. & Lee, F. (2009) Multiracial identity integration: Perceptions of conflict and distance among multiracial individuals. Journal of Social Issues, 65, 51–68. doi:10.1111/j.1540- 4560.2008.01587.x
• Chou, K. (2009). Pre-migration planning and depression among new migrants to Hong Kong : The moderating role of social support. Journal of Affective Disorders, 114, 85–93. https://doi.org/10.1016/j.jad.2008.06.005
• Clarke, L. K., & Borders, L. D. (2014). “You got to apply seriousness”: A phenomenological inquiry of Liberian refugees' coping. Journal of Counseling & Development, 92, 294-303. https://doi.org/10.1002/j.1556-6676.2014.00157.x
• Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1997). Social ties and susceptibility to the common cold. JAMA, 277, 1940–1944. doi:10.1001/jama.1997.03540480040036
• Coffman, S., & Ray, M. A. (2002). African American women describe support processes during high‐risk pregnancy and postpartum. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31, 536-544. https://doi.org/10.1111/j.1552-6909.2002.tb00078.x
• Cohen, S., & Janicki-Deverts, D. (2009). Can we improve our physical health by altering our social networks? Perspectives on Psychological Science, 4, 375-378. https://doi.org/10.1111/j.1745-6924.2009.01141.x
• Coutts, A., McKee, M., & Stuckler, D. (2013). The emerging Syrian health crisis. The Lancet, 381, e6-e7. https://doi.org/10.1016/S0140-6736(13)60053-7
• Cruwys, T., Haslam, S. A., Dingle, G. A., Haslam, C., & Jetten, J. (2014). Depression and social identity: An integrative review. Personality and Social Psychology Review, 18(3), 215-238. https://doi.org/10.1177/1088868314523839
• Cutrona, C. E., & Suhr, J. A. (1992). Controllability of stressful events and satisfaction with spouse support behaviors. Communication research, 19(2), 154-174.
• Davis, R. M. (2006). PTSD symptom changes in refugees. Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture, 16, 10-19. https://europepmc.org/abstract/med/17460343
• De Jong, J. P., Scholte, W. F., Koeter, M. W. J., & Hart, A. A. M. (2000). The prevalence of mental health problems in Rwandan and Burundese refugee camps. Acta Psychiatrica Scandinavica, 102, 171-177. doi: 10.1034/j.1600-0447.2000./02003171.x
• Demirtas, U., & Ozden, A. (2015). Syrian refugees: health services support and hospitality in Turkey. Public Health, 129, 1549-1550. doi: 10.1016/j.puhe.2015.08.005
• Doganay, M., & Demiraslan, H. (2016). Refugees of the Syrian civil war: Impact on reemerging infections, health services, and biosecurity in Turkey. Health Decurity, 14, 220-225. https://doi.org/10.1089/hs.2016.0054
• Duzkoylu, Y., Basceken, S. I., & Kesilmez, E. C. (2017). Physical trauma among refugees: Comparison between refugees and local population who were admitted to emergency department: Experience of a state hospital in Syrian border district. Journal of Environmental and Public Health, 2017, 1-5. https://doi.org/10.1155/2017/8626275
• Ek, E., Koiranen, M., Raatikka, V. P., Järvelin, M. R., & Taanila, A. (2008). Psychosocial factors as mediators between migration and subjective well-being among young Finnish adults. Social Science & Medicine, 66, 1545-1556. doi: 10.1016/j.socscimed.2007.12.018
• Ekmekci, P. E. (2017). Syrian refugees, health and migration legislation in Turkey. Journal of Immigrant and Minority Health, 19, 1434-1441. https://doi.org/10.1007/s10903-016-0405-3
• Eltaiba, N. (2014). Counseling with Muslim refugees: Building rapport. Journal of Social Work Practice, 28, 397-403. https://doi.org/10.1080/02650533.2013.875523
• Eray, Ş., Uçar, H. N., & Murat, D. (2017). The effects of relocation and social support on long-term outcomes of adolescents following a major earthquake: A controlled study from Turkey. International Journal of Disaster Risk Reduction, 24, 46-51. https://doi.org/10.1016/j.ijdrr.2017.05.026
• Erdogan, M. (2017). Syrians barometer. Unpublished manuscript available online at https://mmuraterdogan. files. wordpress. com/2016/06/syrians-barometer-executive-summary. pdf. da Silva Rebelo, M. J., Fernández, M., & Achotegui, J. (2018). Mistrust, anger, and hostility in refugees, asylum seekers, and immigrants: A systematic review. Canadian Psychology/Psychologie Canadienne, 59, 239. http://dx.doi.org/10.1037/cap0000131
• Field J. (2003). Social capital. London: Routledge.
• Franks, F., & Faux, S. A. (1990). Depression, stress, mastery, and social resources in four ethnocultural women’s groups. Research in Nursing and Health, 13, 282–292. https://doi.org/10.1002/nur.4770130504
• Garcı́a, M. F. M., Ramı́rez, M. G., & Jariego, I. M. (2002). Social support and locus of control as predictors of psychological well-being in Moroccan and Peruvian immigrant women in Spain. International Journal of Intercultural Relations, 26, 287-310. https://doi.org/10.1016/S0147-1767(02)00005-6
• Göktaş, B., Yılmaz, S., Gönenç, İ. M., Akbulut, Y., & Sözüer, A. (2018). Cancer incidence among Syrian r¬¬efugees in Turkey, 2012–2015. Journal of International Migration and Integration, 19(2), 253-258. https://link.springer.com/article/10.1007/s12134-018-0549-1
• Grosfoguel, R. (1997). Colonial Caribbean migrations to France, the Netherlands, Great Britain, and the United States. Ethnic and Racial Studies, 20, 594–61. https://doi.org/10.1080/01419870.1997.9993977
• Gulacti, U., Lok, U., & Polat, H. (2017). Emergency department visits of Syrian refugees and the cost of their healthcare. Pathogens and Global Health, 111, 219-224. https://doi.org/10.1080/20477724.2017.1349061
• Haslam, S. A., O'Brien, A., Jetten, J., Vormedal, K., & Penna, S. (2005). Taking the strain: Social identity, social support, and the experience of stress. British Journal of Social Psychology, 44, 355-370.
• Haslam, C., Holme, A., Haslam, S. A., Iyer, A., Jetten, J., & Williams, W. H. (2008). Maintaining group memberships: Social identity continuity predicts well-being after stroke. Neuropsychological Rehabilitation, 18, 671-691. https://doi.org/10.1080/09602010701643449
• Hernández‐Plaza, S., Pozo, C., & Alonso‐Morillejo, E. (2004). The role of informal social support in needs assessment: Proposal and application of a model to assess immigrants' needs in the south of Spain. Journal of Community & Applied Social Psychology, 14, 284-298. https://doi.org/10.1002/casp.782
• Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS medicine, 7, 1-20. doi:10.1371/journal. pmed.1000316
• Huppert, FA. (2014). The state of well-being science: concepts, measures, interventions and policies. In: Huppert FA, Cooper CL, editors. Interventions and policies to enhance well-being. Oxford: Wiley-Blackwell.
• Hynie, M., Crooks, V. A., & Barragan, J. (2011). Immigrant and refugee social networks: determinants and consequences of social support among women newcomers to Canada. Canadian Journal of Nursing Research, 43, 26-46. https://europepmc.org/abstract/med/22435307
• Jetten, J., Haslam, C., Haslam, S. A., Dingle, G., & Jones, J. M. (2014). How groups affect our health and well‐being: the path from theory to policy. Social Issues and Policy Review, 8), 103-130. https://doi.org/10.1111/sipr.12003
• Jones, J. M., & Jetten, J. (2011). Recovering from strain and enduring pain: Multiple group memberships promote resilience in the face of physical challenges. Social Psychological & Personality Science, 2, 239-244. doi:10.1177/1948550610386806
• Johnson, B. T., Redding, C. A., DiClemente, R. J., Mustanski, B. S., Dodge, B. Sheeran, P., Warren, M. R., Zimmerman, R. S., Fisher, W. A., Connor, M. T., Carey, M. P., Fisher, J. D., Stall, R. D., & Fisbein, M. (2010). A network-individual-resource model for HIV prevention. AIDS and Behavior, 14, 204–221. https://doi.org/10.1007/s10461-010-9803-z
• Karaman, M. A., & Ricard, R. J. (2016). Meeting the mental health needs of Syrian refugees in Turkey. The Professional Counselor, 6, 318-327. doi:10.15241/mk.6.4.318
• Kulis, S., Napoli, M. & Marsiglia, F. (2002) .Ethnic pride, biculturalism, and drug use norms of urban American Indian adolescents. Social Work Research, 26, 101–112. https://doi.org/10.1093/swr/26.2.101
• Kwong, J. (2011) Education and identity: the marginalisation of migrant youths in Beijing. Journal of Youth Studies, 14, 871–883. doi:10.1080/13676261.2011.607435.
• Lee, R. M. (2005). Resilience against discrimination: ethnic identity and other-group orientation as protective factors for Korean Americans. Journal of Counseling Psychology, 1, 36-44. doi: 10.1037/0022-0167-52.1.36.
• Lin, C. (2016). The roles of social support and coping style in the relationship between gratitude and well-being. PAID, 89, 13–18. https://doi.org/10.1016/j.paid.2015.09.032
• Mahdi, A. A. (2003). Teen life in the Middle East. Westport, CT: Greenwood Publishing Group.
• Melrose, K. L., Brown, G. D. A., & Wood, A. M. (2015). When is received social support related to perceived support and well-being ? When it is needed. Personality and Individual Differences, 77, 97–105. https://doi.org/10.1016/j.paid.2014.12.047
• Mollica, R. F., Wyshak, G., & Lavelle, J. (1987). The psychosocial impact of war trauma and torture on Southeast Asian refugees. The American Journal Of Psychiatry, 144, 1567–1572. doi: 10.1176/ajp.144.12.1567
• Ni, S., Chui, C. K., Ji, X., Jordan, L., & Chan, C. W. (2016). Subjective well‐being amongst migrant children in China: unravelling the roles of social support and identity integration. Child: Care, Health and Development, 42, 750-758. https://doi.org/10.1111/cch.12370
• Norris, F. H., Stevens, S. P., Pfefferbaum, B.,Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as ametaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127–150. https://doi.org/10.1007/s10464-007-9156-6
• Ozdogan, H. K., Karateke, F., Ozdogan, M., & Satar, S. (2014). Syrian refugees in Turkey: effects on intensive care. The Lancet, 384, 1427-1428. https://doi.org/10.1016/S0140-6736(14)61862-6
• Phinney, J. S., Horenczyk, G., Liebkind, K., & Vedder, P. (2001). Ethnic identity, immigration, and well‐being: An interactional perspective. Journal of Social Issues, 57, 493-510.. https://doi.org/10.1111/0022-4537.00225
• Platt, J. M., Lowe, S. R., Galea, S., Norris, F. H., & Koenen, K. C. (2016). A longitudinal study of the bidirectional relationship between social support and posttraumatic stress following a natural disaster. Journal of Traumatic Stress, 29, 205-213. https://doi.org/10.1002/jts.22092
• Sani, F., Herrera, M., Wakefield, J. R., Boroch, O., & Gulyas, C. (2012). Comparing social contact and group identification as predictors of mental health. British Journal of Social Psychology, 51, 781-790. https://doi.org/10.1111/j.2044-8309.2012.02101.x
• Sevinç, S., Kılıç, S. P., Ajghif, M., Öztürk, M. H., & Karadağ, E. (2016). Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses. International Nursing Review, 63, 406-414. https://doi.org/10.1111/inr.12259
• Sirois, F. M., Millings, A., & Hirsch, J. K. (2016). Insecure attachment orientation and well-being in emerging adults : The roles of perceived social support and fatigue. PAID, 101, 318–321. https://doi.org/10.1016/j.paid.2016.06.026
• Smith, K. P., & Christakis, N. A. (2008). Social networks and health. Annual Review of Sociology, 34, 405–429. https://doi.org/10.1146/annurev.soc.34.040507.134601
• Stewart, M., Anderson, J., Beiser, M., Mwakarimba, E., Neufeld, A., Simich, L., & Spitzer, D. (2008). Multicultural meanings of social support among immigrants and refugees. International Migration, 46, 123-159. https://doi.org/10.1111/j.1468-2435.2008.00464.x
• Thoits, P. (1992). Social support functions and network structures: A supplemental view. In H. Veiel, & U. Baumann (Eds.), The meaning and measurement of social support, (pp. 57–62). New York: Hemisphere.
• Thomas, M., & Choi, J. B. (2006). Acculturative stress and social support among Korean and Indian immigrant adolescents in the United States. Journal of Sociology & Social Welfare, 2, 123-143.
• United Nations High Commissioner for Refugees (2012). Displacement: The new 21st century challenge, Retrieved from https://reliefweb.int/sites/reliefweb.int/files/resources/UNHCR%20GLOBAL%20TRENDS%202012_V05.pdf United Nations High Commissioner for Refugees (2017). Global trends: Forced displacement in 2017. Retrieved from https://www.refworld.org/docid/5b2d1a867.html
• United Nations Women (2018). Needs assesment of Syrian women and girls under temporary protection status in Turkey. Retrieved from http://www2.unwomen.org/-/media/field%20office%20eca/attachments/publications/country/turkey/the%20needs%20assessmentengwebcompressed.pdf?la=en&vs=3139.
• Ussher, J. M. (2010). Are we medicalizing women’s misery? A critical review of women’s higher rates of reported depression. Feminism & Psychology, 20, 9-35. https://doi.org/10.1177/0959353509350213
• Sahlool, Z., Sankri-Tarbichi, A. G., & Kherallah, M. (2012). Evaluation report of health care services at the Syrian refugee camps in Turkey. Avicenna Journal of Medicine, 2, 25-28. doi: 10.4103/2231-0770.99148
• Stewart, M., Anderson, J., Beiser, M., Mwakarimba, E., Neufeld, A., Simich, L., et al. (2008). Multicultural meanings of social support among immigrants and refugees. International Migration, 46, 123–159. https://doi.org/10.1111/j.1468-2435.2008.00464.x
• Tajfel, H., Turner, J. C. (1979). An integrative theory of intergroup conflict. In W. G. Austin, & S. Worchel (Eds.). The social psychology of intergroup relations (pp. 33-37). Monterey, CA: Brooks/Cole. Turner, J. C., Hogg, M. A., Oakes, P. J., Reicher, S. D., & Wetherell, M. S. (1987). Rediscovering the social group: A self-categorization theory. Cambridge, MA: Basil Blackwell.
• Van Den Akker‐Scheek, I., Stevens, M., Spriensma, A., & Van Horn, J. R. (2004). Groningen orthopaedic social support scale: Validity and reliability. Journal of Advanced Nursing, 47, 57-63.https://doi.org/10.1111/j.1365-2648.2004.03065.x
• Vezzali, L., Hewstone, M., Capozza, D., Giovannini, D., & Wölfer, R. (2014). Improving intergroup relations with extended and vicarious forms of indirect contact. European Review of Social Psychology, 25(1), 314-389. https://doi.org/10.1080/10463283.2014.982948
• Whittemore, R., Rankin, S. H., Callahan, C. D., Leder, M. C., & Carroll, D. L. (2000). The peer advisor experience providing social support. Qualitative Health Research, 10, 260-276. https://doi.org/10.1177/104973200129118408
• Zaatari, Z. (2014). Unpacking gender: The humanitarian response to the Syrian refugee crisis in Jordan. Retrieved from https://data2.unhcr.org/en/documents/download/39910
• Záleská, V., Brabcová, I., & Vacková, J. (2014). Migration and its impact on mental and physical health: social support and its main functions. Kontakt, 16, e236-e241. https://doi.org/10.1016/j.kontakt.2014.05.007