Selecting instruments for assessing psychological wellbeing in Afghan and Kurdish refugee groups

Cheryl Mr Sulaiman-Hill, Sandra C Thompson, Cheryl Mr Sulaiman-Hill, Sandra C Thompson

Abstract

Background: Afghan and Iraqi refugees comprise nearly half of all those currently under United Nations protection. As many of them will eventually be resettled in countries outside the region of origin, their long term health and settlement concerns are of relevance to host societies, and will be a likely focus for future research. Since Australia and New Zealand have both accepted refugees for many years and have dedicated, but different settlement and immigration policies, a study comparing the resettlement of two different refugee groups in these countries was undertaken. The purpose of this article is to describe the instrument selection for this study assessing mental health and psychological well being with Afghan and Kurdish former refugees, in particular to address linguistic considerations and translated instrument availability. A summary of instruments previously used with refugee and migrant groups from the Middle East region is presented to assist other researchers, before describing the three instruments ultimately selected for the quantitative component of our study.

Findings: The Kessler-10 Psychological Distress Scale (K10), General Perceived Self-Efficacy Scale (GPSE), and Personal Well-Being Index (PWI) all showed good reliability (Cronbach's alphas of 0.86, 0.89 and 0.83 respectively for combined language versions) and ease of use even for pre-literate participants, with the sample of 193 refugees, although some concepts in the GPSE proved problematic for a small number of respondents. Farsi was the language of choice for the majority of Afghan participants, while most of the Kurds chose to complete English versions in addition to Farsi. No one used Arabic or Turkish translations. Participants settled less than ten years were more likely to complete questionnaires in Farsi. Descriptive summary statistics are presented for each instrument with results split by gender, refugee group and language version completed.

Conclusion: This paper discusses instrument selection for Farsi and Arabic speaking refugee participants from the Middle East and Afghanistan, concluding that the Kessler-10, GPSE scale and PWI were suitable for use with these groups. Suitable language translations are freely available. Our experience with these instruments may help inform other studies with these vulnerable groups.

References

    1. UNHCR. UNHCR Statistical Online Population Database. United Nations High Commissioner for Refugees. 2009.
    1. Boufous S, Silove D, Bauman A, Steel Z. Disability and Health Service Utilization Associated with Psychological Distress: The Influence of Ethnicity. Mental Health Services Research. 2005;7(3):171–179. doi: 10.1007/s11020-005-5785-2.
    1. National Health Survey: Summary of Results.
    1. A Portrait of Health: Key results of the 2006/07 New Zealand Health Survey.
    1. Fassaert T, De Wit MAS, Tuinebreijer WC, Wouters H, Verhoeff AP, Beekman ATF, Dekker J. Psychometric properties of an interviewer-administered version of the Kessler Psychological Distress scale (K10) among Dutch, Moroccan and Turkish respondents. International Journal of Methods in Psychiatric Research. 2009;18(3):159–168. doi: 10.1002/mpr.288.
    1. Andrews G, Slade T. Interpreting scores on the Kessler Psychological Distress Scale (K10) Australian and New Zealand Journal of Public Health. 2001;25(6):494–497. doi: 10.1111/j.1467-842X.2001.tb00310.x.
    1. Bandura A. Self-Efficacy: The Exercise of Control. New York: W.H Freeman; 1997.
    1. Scholz U, Dona BG, Sud S, Schwarzer R. Is General Self-Efficacy a Universal Construct? Psychometric Findings from 25 Countries. European Journal of Psychological Assessment. 2002;18(3):242–251. doi: 10.1027//1015-5759.18.3.242.
    1. Chen G, Gully S, Eden D. General self-efficacy and self-esteem: towards theoretical and empirical distinction between correlated self-evaluations. Journal of Organizational Behavior. 2004;25(3):375–395. doi: 10.1002/job.251.
    1. Cummins R, Eckersley R, Pallant J, Van Vugt J, Misajon R. Developing a National Index of Subjective Wellbeing: The Australian Unity Wellbeing Index. Social Indicators Research. 2003;64(2):159–190. doi: 10.1023/A:1024704320683.
    1. Tiliouine H. Measuring Satisfaction with Religiosity and Its Contribution to the Personal Well-Being Index in a Muslim Sample. Applied Research Quality of Life. 2009;4:91–108. doi: 10.1007/s11482-009-9074-x.
    1. Jacobsen K, Landau L. New Issues in Refugee Research - Working Paper No 90. Geneva: Evaluation and Policy Unit, UNHCR; 2003. Researching refugees: some methodological and ethical considerations in social science and forced migration.
    1. Orb A, Eisenhauer L, Wynaden D. Ethics in Qualitative Research. Journal of Nursing Scholarship. 2001;33(1):93–96. doi: 10.1111/j.1547-5069.2001.00093.x.
    1. Hollifield MMD, Warner TDP, Lian NDOM, Krakow BMD, Jenkins JHP, Kesler JMD, Stevenson JMD, Westermeyer JMDP. Measuring Trauma and Health Status in Refugees: A Critical Review. JAMA. 2002;288(5):611–621. doi: 10.1001/jama.288.5.611.
    1. Karasz A. Cultural differences in conceptual models of depression. Social Science & Medicine. 2005;60(7):1625. doi: 10.1016/j.socscimed.2004.08.011.
    1. McCabe R, Priebe S. Explanatory models of illness in schizophrenia: comparision of four ethnic groups. British Journal of Psychiatry. 2004;185:25–30. doi: 10.1192/bjp.185.1.25.
    1. Van Ommeren M. Validity issues in transcultural epidemiology. Br J Psychiatry. 2003;182(5):376–378. doi: 10.1192/bjp.182.5.376.
    1. Maneesriwongul W, Dixon J. Instrument translation process: a methods review. Journal of Advanced Nursing. 2004;48(2):175–186. doi: 10.1111/j.1365-2648.2004.03185.x.
    1. Smith P. Acquiescent Response Bias as an Aspect of Cultural Communication Style. Journal of Cross-Cultural Psychology. 2004;35(1):50–61. doi: 10.1177/0022022103260380.
    1. Fischer R. Standardization to Account for Cross-Cultural Response Bias: A Classification of Score Adjustment Procedures and Review of Research in JCCP. Journal of Cross-Cultural Psychology. 2004;35(3):263–282. doi: 10.1177/0022022104264122.
    1. Ventevogel P, De Vries G, Scholte W, Shinwari N, Faiz H, Nassery H, van den Brink W, Olff M. Properties of the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Soc Psychiatry Psychiatr Epidemiol. 2007;42(4):328–335. doi: 10.1007/s00127-007-0161-8.
    1. Ahmad A, Sundelin-Wahlsten V, Sofi M, Qahar J, von Knorring A. Reliability and validity of a child-specific cross-cultural instrument for assessing posttraumatic stress disorder. European Child and Adolescent Psychiatry. 2000;9(4):285–294. doi: 10.1007/s007870070032.
    1. Casimiro S, Hancock P, Northcote J. Isolation and Insecurity: Resettlement Issues Among Muslim Refugee Women in Perth, Western Australia. Australian Journal of Social Issues. 2007;42(1):55.
    1. Gerritsen A, Bramsen I, Deville W, van Willigen L, Hovens J, van der Ploeg H. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Social Psychiatry and Psychiatric Epidemiology. 2006;41(1):18–26. doi: 10.1007/s00127-005-0003-5.
    1. Ghazinour M, Richter J, Eisemann M. Quality of Life Among Iranian Refugees Resettled in Sweden. Journal of Immigrant Health. 2004;6(2):71–81. doi: 10.1023/B:JOIH.0000019167.04252.58.
    1. Gilgen D, Maeusezahl D, Salis Gross C, Battegay E, Flubacher P, Tanner M, Weiss MG, Hatz C. Impact of migration on illness experience and help-seeking strategies of patients from Turkey and Bosnia in primary health care in Basel. Health & Place. 2005;11(3):261–273. doi: 10.1016/j.healthplace.2004.04.002.
    1. Hafshejani A. In: Asylum Seekers and Refugees in Australia: Issues of Mental Health and Wellbeing. Barnes D, editor. Sydney: Transcultural Mental Health Centre; 2003. Relationship between meaning in life and post-traumatic stress disorder among Iranians and Afghans.
    1. Hosin A, Moore S, Gaitanou C. The Relationship Between Psychological Well-Being and Adjustment of Both Parents and Children of Exiled and Traumatized Iraqi Refugees. Journal of Muslim Mental Health. 2006;1:123–136. doi: 10.1080/15564900600980616.
    1. Husni M, Cernovsky ZZ, Koye N, Haggarty J. Sociodemographic correlates of assimilation of refugees from Kurdistan. Psychol Rep. 2002;90(1):67–70. doi: 10.2466/PR0.90.1.67-70.
    1. Ichikawa M, Nakahara S, Wakai S. Effect of post-migration detention on mental health among Afghan asylum seekers in Japan. Australian and New Zealand Journal of Psychiatry. 2006;40:341–346.
    1. Koehn PH. Medical Encounters in Finnish Reception Centres: Asylum-Seeker and Clinician Perspectives. Journal of Refugee Studies. 2005;18(1):47–75. doi: 10.1093/jrs/18.1.47.
    1. Omeri A, Lennings C, Raymond L. Beyond asylum: implications for nursing and health care delivery for afghan refugees in Australia. J Transcult Nurs. 2006;17(1):30–39. doi: 10.1177/1043659605281973.
    1. Ross-Sheriff F. Afghan Women in Exile and Repatriation - Passive Victims or Social Actors? Affilia: Journal of Women and Social Work. 2006;21(2):206–219. doi: 10.1177/0886109905285782.
    1. Sondergaard HP, Ekblad S, Theorell T. Self-reported life event patterns and their relation to health among recently resettled Iraqi and Kurdish refugees in Sweden. J Nerv Ment Dis. 2001;189(12):838–845. doi: 10.1097/00005053-200112000-00005.
    1. Taloyan M, Johansson LM, Johansson S-E, Sundquist J, Kocturk TO. Poor Self-reported Health and Sleeping Difficulties among Kurdish Immigrant Men in Sweden. Transcultural Psychiatry. 2006;43(3):445–461. doi: 10.1177/1363461506066988.

Source: PubMed

3
Subscribe