270448 Female Afghan refugees making sense of traumatic events: An explanatory model

Wednesday, October 31, 2012

Valerie Smith, PhD , Department of Communication, California State University, East Bay, Hayward, CA
Background: Refugees are confronted with multiple adverse political, socio-cultural, and economic stressors that challenge their health and wellness. For more than two decades, Afghans comprised the largest refugee population in the world. With more than 60,000 Afghan refugees in the United States, the largest concentration resides in Northern California. Purpose: As part of a larger dissertation study, this research examined how female Afghan refugees conceptualized and made sense of stressful situations throughout their premigration, migration, and resettlement processes. Methods: The researcher conducted 40 in-depth qualitative interviews, averaging two hours each and including limited-English proficient women; a focus group; participant observation in the refugee community for more than two years; and consultation with key cultural informants. Interview respondents were asked to explain their experiences and perceptions of each important and difficult situation they encountered from the events that led up to their leaving Afghanistan to the present. Maximum variation purposive sampling was used for the interviews. Results: Qualitative inductive analysis yielded 262 stressful situations and five thematic conceptualizations of stressful events: (1) imminent and overwhelming dangers in the homeland; (2) suffocating losses of family members and friends; (3) resolving to flee; (4) bewilderment and confusion in the new country; and (5) struggling to adjust. The study shows how sense making about these often traumatic experiences can exacerbate family tensions, community reputation concerns, and health problems. Conclusions: Public health practitioners working with refugees should be aware of the perspectives of female Afghan refugees about mental health stressors to inform culturally competent care.

Learning Areas:
Communication and informatics
Diversity and culture
Provision of health care to the public

Learning Objectives:
(1) Describe the five conceptualizations of mental health stressors that female Afghan refugees in the San Francisco Bay Area experienced during their migration trajectory. (2) Explain how these stressful encounters and sense making about them can exacerbate health, family relationship, and community reputation issues, leading to additional stressors. (3) Demonstrate enhanced culturally competent care towards refugees, particularly women, accounting for the traumatic mental health stressors they have experienced.

Keywords: Refugees, Mental Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an academic communication researcher focused on health and access barriers and strategies for Afghan refugees. I conducted all phases of this research as part of my dissertation. I have also facilitated the Afghan Health Leadership Consortium in the San Francisco East Bay for seven years and have volunteered extensively with Afghan refugees.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.