Health of the “Poto Mitan:” Women’s Experiences of Stress, Trauma and Mental Health Outcomes in Léogâne, Haiti Open Access
Paige, Olivia (Spring 2018)
Abstract
OBJECTIVES: There is a lack of data on mental health outcomes and coping strategies in Haiti. The primary objective of this study was to determine coping strategies and supports that ameliorate the mental health impacts of stressors and traumatic events among women living in Léogâne Commune. A comparison of quantitative and qualitative data was utilized to investigate the presence and use of specific coping strategies and stressors among women. Qualitative results were compared to quantitative results to evaluate the extent to which results were comparable.
METHODS: A mixed methods study was conducted to determine the experience of stressors and traumatic events among women and to explore coping strategies and supports used by women. Data collection followed a triangulation design while analysis followed a sequential explanatory design. In the quantitative phase, a survey was administered to Haitian women living in Léogâne Commune (N=198). This survey included various scales assessing women’s experience of stressors and traumatic events, mental health outcomes, and use of coping strategies. Quantitative data were entered into SAS 9.4 (Cary, North Carolina) software for data analysis. Multivariable linear regression analyses were conducted to identify associations between experiences of stressors and traumatic events with mental health outcomes and coping strategies. In the qualitative phase, in-depth interviews were conducted among eight (N=8) women to better understand the nuances of women’s experience of stress and use of coping strategies and supports. Qualitative data were transcribed into English and transcripts were entered into MaxQDA software for data analysis. A thematic analysis approach was used to summarize themes within the data.
RESULTS: A total of 198 female participants were surveyed for this study. Participants were approximately equally surveyed from the four indicated regions of Léogâne Commune. A model assessing the relationship between the number of traumatic events experienced, the number of stressors experienced, and the number of coping mechanisms used on an individual’s score on the ZDLSI (Depression) Index, while controlling for age and educational attainment was conducted. This model was also conducted on an individual’s score of the BAI (Anxiety) Index. There was no presence of interaction on either model. Qualitative results showed that child-related stressors, male-related stressors, economic stressors, and experiences of reproductive health were related to adverse mental health outcomes among women. In addition, results showed that community support and coping/self-support were effective in mediating the negative impacts of traumatic events and stressors among women.
CONCLUSIONS: This study illustrates how coping strategies and supports can ameliorate the impacts of mental health outcomes associated with stressors and experience of trauma. This study provides both qualitative and quantitative evidence that women experience a variety of stressors due to their complex role within Haitian society. Stressors surrounding women’s roles in intimate partner relationships and providing for children were qualitatively shown to cause an increase in negative mental health outcomes. Traumatic events such as house fire, losing one’s whole harvest and car accident were also related to negative mental health outcomes as shown in the quantitative data. Quantitative results showed that primary education was protective against negative mental health outcomes. Qualitative data produced the results of social support and education positive forms of coping for women.
Table of Contents
Table of Contents
CHAPTER 1: Introduction……………………………………………………………………10
1.1 Background
1.2 Scope of the Problem
1.3 Purpose of the Study
1.4 Research Questions
1.5 Significance of the Study
CHAPTER 2: Comprehensive Review of the Literature…………………………………….13
2.1 Global Burden of Mental Illness
2.2 Anxiety and Depression Disorders
2.3 Haitian Context
2.4 Mental Health in Haiti
2.5 Disasters and Mental Health in Haiti
2.6 Female Gender Roles and Mental Health in Haiti
CHAPTER 3: Methods…………………………………………………………………………32
3.1 Introduction
3.2 Research Design
3.3 Study Setting
3.4 Population and Sample
3.5 Instruments
3.6 Data collection
3.7 Data Entry and Analysis
3.8 Data Management and Ethics
CHAPTER 4: Results…………………………………………………………………………..45
4.1 Quantitative Results
4.2 Qualitative Results
4.3 Qualitative and Quantitative Analysis
CHAPTER 5: Discussion……………………………………………………………………….67
5.1 Strengths and Limitations
5.2 Areas of Further Study
5.3 Recommendations
5.4 Conclusion
CHAPTER 6: References………………………………………………………………………77
CHAPTER 7: Appendix..………………………………………………………………………85
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