“Can It Be That God Does Not Remember Me”: A Qualitative Study on the Psychological Distress, Suffering, and Coping of Dominican Women With Chronic Filarial Lymphedema and Elephantiasis of the Leg

Abstract

The psychological states of Dominican women with chronic lymphedema and elephantiasis of the leg and the coping strategies they used to ameliorate the negative psychological effects of this condition were explored using modified precepts of grounded theory method. Qualitative data were gathered through in-depth interviewing and focus group discussions held in the Dominican Republic. Thematic results found that compounding their physical disfigurement, functional limitations, and social losses were feelings of depression, embarrassment, social isolation, and despair. Adaptive problem solving and emotion-focused coping strategies that emerged during analysis also are discussed. It is recommended that management of psychological distress should be a significant component of lymphedema management programs in developing countries.

Funding for this study was provided by Grant #401R103 from the Office of Minority and Women's Health in the National Center for Infectious Diseases, at the Centers for Disease Control and Prevention. We thank Meredith Hickson for her ongoing support throughout the study. We thank Kelly Holton and Laurie Dieterich for critical reading and editorial support of this manuscript. We thank Professor Onofre de La Rosa for his interviewing assistance, and Dr. Paulino, Dr. Polibio, and all who contributed to this study. We thank the Emory University Lymphatic Filariasis Support Center for the assistance they provided. We also thank all the women who participated in this study for their cooperation and support for the study.

The opinions or assertions contained in this manuscript are the private ones of the authors and are not to be construed as official or reflecting the view of the U.S. Public Health Service or Department of Health and Human Services. Use of trade names is for identification only and does not imply endorsement by the U.S. Public Health Service or Department of Health and Human Services.