Using Critical Ethnography to Explore Issues among Immigrant and Refugee Women Seeking Help for Postpartum Depression

AimTo conduct a meta-ethnographic study of the experiences, meanings and ways of ‘dealing with’ symptoms or a diagnosis of postnatal depression amongst migrant women living in high income countries.BackgroundPrevalence of postnatal depression is highest amongst women who are migrants. Yet many women do not seek help for their symptoms and health services do not always respond appropriately to migrant women’s needs. Studies have reported migrant women’s experiences of postnatal depression and it is timely to synthesise findings from these studies to understand how services can be improved.DesignA meta-ethnographic synthesis of 12 studies reported in 15 papersData sourcesFive databases were searched for papers published between January 1999 and February 2016Review methodsThe quality of included studies was assessed using the Critical Appraisal Skills Program tool. The synthesis process was guided by the seven steps of meta-ethnography outlined by Noblit and Hare.FindingsFour key metaphors were identified: “I am alone, worried and angry—this is not me!”; ‘Making sense of my feelings’ ‘Dealing with my feelings’ and ‘What I need to change the way I feel!’. Primarily women related their feelings to their position as a migrant and as women, often living in poor socio-economic circumstances and they were exhausted keeping up with expected commitments. Many women were resourceful, drawing on their personal strengths and family / community resources. All the studies reported that women experienced difficulties in accessing appropriate services.ConclusionThe meta-ethnographic study demonstrates the impact of migration on perinatal mental health, particularly for women lacking family support, who have no employment, a precarious migration status and/or relationship conflict. Migrant women are resourceful and this requires support through appropriate services. Further research is needed to evaluate effective support strategies for migrant women in the perinatal period.

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“…O’Mahony [44] emphasised the importance of women’s personal strengths and resolve to work hard to achieve their goals:…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, in many cultures it is not acceptable to seek help for mental health problems [11, 44, 48]. In some instances, women cannot afford health care [11, 43].…”

Section: Resultsmentioning

confidence: 99%

Migrant women’s experiences, meanings and ways of dealing with postnatal depression: A meta-ethnographic study

et al. 2017

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“…Qualitative research has been criticized by the lack of ''objectivity'' and the potential influence of the researcher on the data (Ahern, 1999). To help minimize the effects of researcher bias throughout the study, an informal journal of researchers' experiences, views and judgements must be kept (O'Mahony & Donnelly, 2012). The journal is a way to practice reflexive processes.…”

Section: Rigormentioning

confidence: 99%

“…It is significant to note that member checking was widely used in the health research literature to account for rigor (Braaf et al, 2014;Liu et al, 2012;Magilvy et al, 1987;O'Mahony & Donnelly, 2012;Pino et al, 2013).…”

Section: Rigormentioning

confidence: 99%

The Encounters and Challenges of Ethnography as a Methodology in Health Research

Rashid

Caine

Goez

2015

International Journal of Qualitative Methods

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Medical anthropology has existed since the early 1960s, and the encounters of ethnography in health research are recent. We will trace key historical markers and highlight several ethnographic studies in health research in this article. In particular, we are interested how aspects of classic ethnographic work have been taken up, and how the use has changed over time, as ethnographies, such as focused ethnographies and other forms of ethnography, have developed in health research. Understandings of culture have shifted and led to redefinitions of culture, and some key elements of ethnographic research have been lost. Ethnographies conducted in health research often do not focus on culture from a broader perspective; instead, the focus is on single health-related issues. Health researchers appear to spend less time in the field, time spent in the field is regarded as less important, and the importance of the context of field notes is underestimated.

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“…, O'Mahony et al . ,b); consequently, it was unclear whether sufficient data were collected. Another notable limitation was that some authors did not critically examine their own role in the research or their relationship with participants (Ahmed et al .…”

Section: Resultsmentioning

confidence: 99%

Engaging with culturally and linguistically diverse communities to reduce the impact of depression and anxiety: a narrative review

Baker

Procter

Ferguson

2015

Health Soc Care Community

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Culturally and linguistically diverse (CALD) communities in Australia face significant challenges in terms of reducing barriers to information and support for depression and anxiety. Increased stigma surrounding mental ill‐health in some cultures and related concerns about trust and confidentiality all impact upon timely access to information, services and support for consumers and carers from CALD backgrounds. For health services, there is a need to understand how to better engage CALD communities in mental healthcare. The objective of this narrative review was to identify examples of evidence‐based, best practice for what works effectively for engaging with CALD communities to reduce the impact of depression and anxiety. In January 2014, we searched Academic Search Premier, CINAHL, Health‐Source Consumer Edition, PsycARTICLES, PsycINFO (all databases within the EbscoHost platform) and PubMed for peer‐reviewed articles published between 1994 and 2014. The search revealed a total of 706 records contained within the EbscoHost platform and 689 records in PubMed; 15 matched the inclusion criteria. Six key themes were identified: (i) setting the scene for engagement; (ii) cultural values and preferences; (iii) language considerations; (iv) ‘engagers’ in the therapeutic process; (v) opening out engagement to include others; and (vi) engaging through the use of technology and alternative mediums. The literature obtained provides a small body of evidence regarding approaches to engaging CALD communities, with findings highlighting the importance of processes which are tailored to the CALD community of interest and which take into account different cultural explanatory models of mental ill‐health. Review findings are also discussed within the framework of intersectionality, in which broader structural inequalities and power imbalances – in areas such as gender and social class – collectively impact on help‐seeking and mental health outcomes. This review supports further enquiry into how such societal issues influence engagement – and disengagement – in mental health services for CALD communities.

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Using Critical Ethnography to Explore Issues among Immigrant and Refugee Women Seeking Help for Postpartum Depression

Cited by 37 publications

References 17 publications

Migrant women’s experiences, meanings and ways of dealing with postnatal depression: A meta-ethnographic study

Migrant women’s experiences, meanings and ways of dealing with postnatal depression: A meta-ethnographic study

The Encounters and Challenges of Ethnography as a Methodology in Health Research

Engaging with culturally and linguistically diverse communities to reduce the impact of depression and anxiety: a narrative review

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