Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

Lim, Andrew; Stock, Lawrence M.; Oo, Eh Kalu Shwe; Jutte, Douglas P.

doi:10.1186/1752-1505-7-15

Cited by 19 publications

(27 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Participants in the current study reported higher levels of trauma than those found in other "traumatized" populations of health providers working in conflict zones in Eastern Myanmar (M ϭ 10.7, SD ϭ 5.0; Lim, Stock, Shwe Oo, & Jutte, 2013) or among long-term refugees in Nepal (M ϭ 13.77, SD ϭ 7.01; Jordans, Semrau, Thornicroft, & van Ommeren, 2012). Furthermore, when cases were identified using the presence/absence scoring method, one fifth (19.9%) of the sample reported values above the cutoff for the GHQ-12.…”

Section: Resultsmentioning

confidence: 76%

Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers.

Veronese

Pepe

2014

American Journal of Orthopsychiatry

View full text Add to dashboard Cite

Palestinian health providers are widely recognized to be at risk of developing trauma. Research has examined the role of sense of coherence (SOC) as a determinant or component of psychological distress in emergency workers. In the current study, we expected that SOC would mediate the relationship between individual health providers' primary responses to the traumatic environment (as assessed using intrusion and avoidance measures) and the secondary effects suffered in terms of general psychological distress as reflected in levels of anxiety, social dysfunction, and loss of confidence. Participants (N = 218) were recruited at public hospitals in 3 different areas. The General Health Questionnaire, SOC Scale, and Impact of Event Scale were administered. Mediation analysis was conducted to assess whether and to what extent SOC influenced the effects of trauma among health providers. SOC was found to be a determinant of the relationship between impact of traumatic events and anxiety, social dysfunction, and loss of confidence. Mediation analysis confirmed that SOC partially mediated the impact of trauma on both anxiety and social dysfunction whereas it fully mediated the relationship between trauma and loss of confidence. Clinical and practical implications are discussed.

show abstract

Section: Resultsmentioning

confidence: 76%

Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers.

Veronese

Pepe

2014

American Journal of Orthopsychiatry

View full text Add to dashboard Cite

show abstract

“…Cluster 1 was the most varied cluster, indicated by extreme branching within the cluster dendrogram. CCDs included Kareni seik lo’shaa (Lim, Stock, Oo, & Jutte, 2013), Latino susto (Baer et al, 2003), and Yemeni fijac (Swagman, 1989). Because of the prominence of somatic symptoms and nonspecific dysphoric symptoms, we labeled Cluster 1 somatic dysphoria.…”

Section: Resultsmentioning

confidence: 99%

Posttraumatic stress in emergency settings outside North America and Europe: A review of the emic literature

Rasmussen

Keatley

Joscelyne

2014

Social Science & Medicine

View full text Add to dashboard Cite

Mental health professionals from North America and Europe have become common participants in postconflict and disaster relief efforts outside of North America and Europe. Consistent with their training, these practitioners focus primarily on posttraumatic stress disorder (PTSD) as their primary diagnostic concern. Most research that has accompanied humanitarian aid efforts has likewise originated in North America and Europe, has focused on PTSD, and in turn has reinforced practitioners’ assumptions about the universality of the diagnosis. In contrast, studies that have attempted to identify how local populations conceptualize posttrauma reactions portray a wide range of psychological states. We review this emic literature in order to examine differences and commonalities across local posttraumatic cultural concepts of distress (CCDs). We focus on symptoms to describe these constructs – i.e., using the dominant neo-Kraepelinian approach used in North American and European psychiatry – as opposed to focusing on explanatory models in order to examine whether positive comparisons of PTSD to CCDs meet criteria for face validity. Hierarchical clustering (Ward’s method) of symptoms within CCDs provides a portrait of the emic literature characterized by traumatic multifinality with several common themes. Global variety within the literature suggests that few disaster-affected populations have mental health nosologies that include PTSD-like syndromes. One reason for this seems to be the almost complete absence of avoidance as pathology. Many nosologies contain depression-like disorders. Relief efforts would benefit from mental health practitioners getting specific training in culture-bound posttrauma constructs when entering settings beyond the boundaries of the culture of their training and practice.

show abstract

“…In other programs, peer support is likely happening within the context of peer supervision, though their support of one another has not been closely studied. An example of a method to mobilize this organic peer support process was adopted in a study in Myanmar through providing workshops for trauma management medics to learn techniques to promote personal and peer mental wellbeing [51]. By providing lay providers with both the tools and collaborative spaces to work through their issues, such as with peer support groups or targeted workshops, they can become more proactive in dealing with problems that may arise in their work.…”

Section: Implications/recommendationsmentioning

confidence: 99%

What about lay counselors’ experiences of task-shifting mental health interventions? Example from a family-based intervention in Kenya

Wall

Kaiser

Friis-Healy

et al. 2020

Int J Ment Health Syst

View full text Add to dashboard Cite

Background:A key focus of health systems strengthening in low-and middle-income countries is increasing reach and access through task-shifting. As such models become more common, it is critical to understand the experiences of lay providers because they are on the forefront for delivering care services. A greater understanding would improve lay provider support and help them provide high-quality care. This is especially the case for those providing mental health services, as providing psychological care may pose unique stressors. We sought to understand experiences of lay counselors, focusing on identity, motivation, self-efficacy, stress, and burnout. The goal was to understand how taking on a new provider role influences their lives beyond simply assuming a new task, which would in turn help identify actionable steps to improve interventions with task-shifting components.Methods: Semi-structured interviews (n = 20) and focus group discussions (n = 3) were conducted with three lay counselor groups with varying levels of experience delivering a community-based family therapy intervention in Eldoret, Kenya. Thematic analysis was conducted, including intercoder reliability checks. A Stress Map was created to visualize stress profiles using free-listing and pile-sorting data collected during interviews and focus group discussions. Results:Counselors described high intrinsic motivation to become counselors and high self-efficacy after training. They reported positive experiences in the counselor role, with new skills improving their counseling and personal lives. As challenges arose, including client engagement difficulties and balancing many responsibilities, stress and burnout increased, dampening motivation and self-efficacy. In response, counselors described coping strategies, including seeking peer and supervisor support, that restored their motivation to persevere. At case completion, they again experienced high self-efficacy and a desire to continue. Conclusions:Findings informed suggestions for ways to incorporate support for lay providers into task-shifting interventions at initiation, during training, and throughout implementation. These include acknowledging and preparing counselors for challenges during training, increasing explicit attention to counselor stress in supervision, fostering peer support among lay providers, and ensuring a fair balance between workload and compensation. Improving and building an evidence base around practices for supporting lay providers will improve the effectiveness and sustainability of lay provider-delivered interventions.© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s ...

show abstract

Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

Cited by 19 publications

References 39 publications

Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers.

Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers.

Posttraumatic stress in emergency settings outside North America and Europe: A review of the emic literature

What about lay counselors’ experiences of task-shifting mental health interventions? Example from a family-based intervention in Kenya

Contact Info

Product

Resources

About