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      Solving Tension coping among Bhutanese refugees in Nepal

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          Abstract

          Purpose

          The Bhutanese refugee camps of eastern Nepal are home to a mass resettlement operation over half the population has been relocated within the past five years. While recent research suggests Bhutanese refugees are experiencing degradation of social networks and rising suicide rates, little is known about ethnocultural pathways to coping and resilience in this population.

          Designmethodologyapproach

          A common coping measure Brief COPE was adapted to the linguistic and cultural context of the refugee camps and administered to a representative sample of 193 Bhutanese refugees as part of a broader tenmonth ethnographic study of resilience.

          Findings

          Active coping, planning, and positive reframing were the most frequently utilized strategies, followed by acceptance, religion, and seeking emotional support. Exploratory factor analysis resulted in five factors humor, denial, behavioral disengagement positive reframing, planning, active coping emotional support, instrumental support interpersonal a new subscale, acceptance, selfblame and venting, religion.

          Research implications

          Data support the relevance of some dimensions of coping while revealing particularities of this population.

          Practical implications

          Findings can inform future research and intervention efforts aimed at reducing suicide and promoting mental health across the Bhutanese refugee diaspora.

          Originalityvalue

          This is the first mixedmethods study of coping in the Bhutanese refugee camp population since the start of a mass resettlement exercise. Qualitative data and ethnography were used to illuminate measured trends in local coping behavior.

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          Most cited references16

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          Preparing Instruments for Transcultural Research: Use of the Translation Monitoring Form with Nepali-Speaking Bhutanese Refugees

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            Nepali concepts of psychological trauma: the role of idioms of distress, ethnopsychology and ethnophysiology in alleviating suffering and preventing stigma.

            In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry.
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              Coping, mood, and aspects of personality in Spanish translation and evidence of convergence with English versions.

              Research on stress and its influence on health and well-being has flourished for several decades, examining as predictors such psychosocial variables as personality and coping. This work now often targets multiethnic samples. Because many potential participants lack facility in English, a need exists for translations of measures into other languages. We translated 6 instruments into Spanish and studied their characteristics. Of these, 3 were measures of personality qualities: the Life Orientation Test--Revised (Scheier, Carver, & Bridges, 1994), the Behavioral Inhibition/Behavioral Activation Scales (Carver & White, 1994), and the Measure of Body Apperception (Carver et al., 1998). The others were the Brief COPE (Carver, 1997), the Center for Epidemiological Studies--Depression Scale (Radloff, 1977), and an abbreviated version of the Profile of Mood States (McNair, Lorr, & Droppelman, 1971). Correlations between English and Spanish versions in bilingual samples were all above. 72, except for the COPE's Behavioral Disengagement scale. Alpha reliabilities of the Spanish versions were comparable to those of the English versions. Correlations among measures in a sample of cancer patients were similar across languages.
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                Author and article information

                Contributors
                Journal
                ijmhsc
                10.1108/ijmhsc
                International Journal of Migration, Health and Social Care
                Emerald Publishing
                1747-9894
                14 June 2013
                : 9
                : 2
                : 71-83
                Affiliations
                MSc Candidate, Division of Social and Transcultural Psychiatry, McGill University, Montral, Canada
                Assistant Professor, Graduate School of Professional Psychology, University of Denver, Denver, Colorado, USA
                Program Coordinator and Clinical Supervisor, Jhapa Branch, Transcultural Psychosocial OrganizationNepal, Damak, Nepal
                Article
                5480090202.pdf 5480090202
                10.1108/IJMHSC-05-2013-0001
                7d7a02ce-d387-4dd9-bcd7-8b09f00aefb0
                © Emerald Group Publishing Limited
                History
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                cat-VG, Vulnerable groups
                cat-IDMG, Inequalities & diverse/minority groups
                cat-SOCY, Sociology
                cat-RES, Race & ethnic studies
                cat-MIN, Minorities
                cat-MLT, Multiculturalism
                cat-RIL, Racial identity
                cat-WEO, Work, economy & organizations
                cat-INQ, Inequality
                cat-LMOV, Labour movements
                cat-POV, Poverty
                Custom metadata
                no
                yes
                included

                Coping,Individual behaviour,Forced migrants,Resilience,Mixedmethods,Mental health,Bhutanese refugees,Nepal

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