Fiziksel Semptom mu yoksa Somatizasyon mu? Türk Göçmenlerin Yaygın Ruh Sağlığı Rahatsızlıklarına İlişkin Algıları ve Tecrübeleri: Bir Sistematik Derleme (Tematik Sentez) Çalışması

Öz

Türk göçmenlerin, yaygın ruh sağlığı rahatsızlıklarını nasıl ifade ettiği, deneyimlediği, algıladığı ve bu mevzudaki tercihleri ve ihtiyaçları hakkında literatürde az sayıda ve birbiriyle çelişen çalışma bulunmaktadır. Bu çelişki genellikle tecrübe edilen semptomların ve rahatsızlıkların nedenlerinin neye bağlandığıyla ilişkilidir. Literatürdeki bu tutarsızlık Türk göçmenlere sunulan ruh sağlığı hizmetlerinde istenmedik sonuçlara yol açabilir, bu sebeple bu mevzuyu araştırmak önem arz etmektedir. Bu çalışmanın amacı, Türk göçmenlerin yaygın ruh sağlığı rahatsızlıklarına ilişkin anlayışlarını/algılarını ve deneyimlerini incelemektir. Var olan literatürü değerlendirmek üzere sistematik bir derleme çalışması, Thomas ve Harden’den (2008) uyarlanan tematik sentez tekniği kullanılarak yapılmıştır. Bu amaçla, CINAHL, MEDLINE, PsycArticles ve PsychInfo veritabanları taranmıştır. Tarama sürecinde yalnızca yaygın ruh sağlığı rahatsızlığı yaşamış Türk göçmenlerle yapılan nitel araştırmalar mevcut çalışmaya dahil edilmiştir (n = 10). Analiz tümevarım tekniğiyle gerçekleştirilmiştir. On iki alt temalı üç ana tema oluşturulmuştur. Katılımcılar hem fiziksel hem de duygusal semptomlar yaşadıklarını ifade etmişlerdir. Psikolojik sıkıntılarını, yaşadıkları önemli olaylara ve kronikleşmiş kötü yaşam koşullarına, kişilerarası geçimsizliklere, göçmenliğe ve ayrımcılığa ilişkin problemlere ve sağlık hizmetleriyle yaşadıkları sorunlara bağladıkları görülmüştür. Gözden geçirmenin içinde, geleneksel/manevi ve biyolojik anlayışlar da ayrıca tartışılmıştır. Aile desteği ve sosyal destek, kişisel beceriler ve bazılarının şüpheleri olsa da geleneksel/manevi tedavilerden ve tıbbi kaynaklardan yararlanma başa çıkma stratejileri olarak belirtilmiştir. Bu derleme Türk göçmenlerin, tıpkı başka topluluklar gibi, psikolojik sıkıntılarını hem duygusal hem de fiziksel terimler kullanarak ifade ettiklerini bulmuştur. Psikolojik sıkıntıların kökenlerine ilişkin anlayışları genel olarak psikososyaldir ama biyolojik ve geleneksel/manevi modellerden de ögeler içermektedir. Bu alanda yapılan çalışmalar kısıtlı olduğu için daha fazla ve daha iyi kalitede araştırma yapılması ve politikacılar ile uygulamacılar Türk göçmenler de dahil olmak üzere her topluluk için anlamlı ve etkili olacak ruh sağlığı hizmetleri sağlamaları önerilmektedir.

Anahtar Kelimeler

• Depresyon
• kaygı
• yaygın ruh sağlığı hastalıkları
• ruh sağlığı hastalıklarının kökenleri
• bedenselleştirme
• kültür

Physical Symptoms or Somatisation? Turkish Immigrants’ Experiences and Understandings of Common Mental Health Difficulties: A Systematic Review (Thematic Synthesis)

Öz

There is scarce and conflicting information on how Turkish immigrants express, experience, and understand common mental health difficulties (CMHDs) as well as their preferences and needs. This conflict often emerges in the literature around symptom presentation and the causal attributions of CMHDs. Since inconsistent information may have real life consequences for Turkish immigrants it is important to investigate this area. The aim of this review was to explore the experiences and understandings of common mental health difficulties of Turkish immigrants. A systematic review using thematic synthesis adopted from Thomas & Harden (2008) was conducted to evaluate the existing literature. CINAHL, MEDLINE, PsycArticles and PsychInfo were searched. Onlyqualitative studies conducted with Turkish immigrants with lived experience were included (n = 10). The analysis was data-driven (inductive) leading to three themes with twelve subthemes being generated. Participants reported experiencing both emotional and physical symptoms. They linked their distress to significant life events and chronic adverse conditions, interpersonal conflict, immigration and discrimination related problems and problematic encounters with healthcare workers. Traditional/spiritual and biological understandings of mental health were also discussed. Family and social support, personal resources, and the utilisation of medical and traditional/ spiritual resources were reported as coping strategies, though some were sceptical about the latter. This review found that Turkish immigrants experienced and expressed their distress in both emotional and physical terms, just like many other communities. Their understandings were mainly psychosocial but contained elements of biomedical and traditional models. Since research in this area is limited, further and better research is recommended. Policy makers and practitioners are also advised to provide meaningful and effective care for every community, including Turkish immigrants.

Anahtar Kelimeler

• Depression
• anxiety
• common mental health disorders
• explanatory models
• causal attributions
• somatisation
• culture

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