Emotional distress, anxiety, and depression in South Asians with long-term conditions: a qualitative systematic review

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Hassan Awan¹  Faraz Mughal²  Tom Kingstone³  Carolyn A Chew-Graham⁴  Nadia Corp¹ 

[1] School of Medicine, Keele University;School of Medicine, Keele University, Keele, honorary clinical research fellow, Unit of Academic Primary Care, University of Warwick;School of Medicine, Keele University, Keele, Research and Innovation Department, St George’s Hospital;School of Medicine, Keele University, Keele, honorary professor of primary care mental health, Midlands Partnership NHS Foundation Trust, St George’s Hospital

关键词: distress;    general practice;    health inequality;    long-term conditions;    mental health;    systematic review;   

DOI  :  10.3399/bjgp.2021.0345

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background People with physical–mental comorbidity have a poorer quality of life, worse clinical outcomes, and increased mortality compared with people with physical conditions alone. People of South Asian (SA) origin are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. People of SA origin are less likely to recognise symptoms that may represent mental health problems.Aim To explore how people of SA origin with LTCs understand, experience, and seek help for emotional distress, depression, and anxiety.Design and setting Systematic review of qualitative studies exploring emotional distress in people of SA origin with diabetes or coronary heart disease, within primary and community care settings worldwide.Method Comprehensive searches of eight electronic databases from inception to 1 September 2021 were undertaken. Data extracted included study characteristics, and understanding, experience, and help-seeking behaviour for emotional distress. Thematic synthesis was undertaken. The Critical Appraisal Skills Programme (CASP) checklist for qualitative studies was used to assess quality of articles, and Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) used to determine the overall strength of evidence.Results Twenty-one studies from 3165 unique citations were included. Three main themes were identified. Understanding of emotional distress: non-medical terminology used, such as ‘tension’, and a complex relationship between emotional and physical illness. Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and sex differences. Help-seeking behaviour: self-management, support from family, friends, and faith, and inadequate clinical support.Conclusion This review provides a greater understanding of the conceptualisation of emotional distress in the context of LTCs by people of SA origin, to support improvement in its recognition and management.

【 授权许可】

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