ƒ Appendix D. Key questions for the focus group interviews

APPENDICCES

ƒ Appendix A. Letter of approval from BFmF to carry out the study

ƒ Appendix B. Photos of few premises at the BFmF center

ƒ Appendix C. Geographical retrofitting map for users of the center in Cologne

ƒ Appendix D. Key questions for the focus group interviews

ƒ Appendix E. Key questions for the key informant interviews

ƒ Appendix F. The questionnaire including the SCL-90-R

instrument

Appendix A

Letter of approval from BFmF to carry out the study

Appendix B Photos of few premises at the BFmF center

Computer room Seminar and meeting room

Nursery and playing room for children

Free time activity room

Interview room Teaching room

Appendix C Map of cologne with geographical retrofitting

10/24/2005 16

Cologne Region City District and Parts

Office for city development and statistics Statistical and Information System

The

center is

in this

area

Appendix D

Key questions for the focus group interviews

Focus group number:

Place:

Date:

Number of participants:

o What is health in your opinion?

o What makes a woman healthy? Probe: what should a woman do to stay healthy?

o What are the major health problems that you or your family members have experienced or health problems you heard about from other Arab families in Cologne?

o What are the difficulties you face when you seek health care?

o Where do you get health information? What is the best method to inform Arab migrant women about health?

o What types of screening examinations do/did you perform? If you do not perform

screening, what are the reasons for that?

Appendix E

Guideline for the key informant interviews

Key informant number:

Place:

Date:

Nationality:

o What are the available data on health indicators among Arab migrants, health education materials, services to Arab speaking migrants and previous studies on them?

o What is the proportion of Arab migrants among care seekers?

o What are the main observed health problems among Arab migrants in general and women in specific in comparison to other nationalities?

o What is the level of compliance of Arab migrants with treatment, check-ups, self care and inclination to follow advice and screening exams?

o What is the best method to inform Arab migrants about health? What health education materials are available in Arabic?

o What are the main barriers for seeking health care?

o What methods do Arab migrant women use to express their stress?

Appendix F

Questionnaire

Date of filling the questionnaire: ………..

Code of the questionnaire: ………

PART ONE

I. Demographic Data

ƒ Age

ƒ Place of Birth: ……….

ƒ Level of education:

o Uneducated

o Elementary (from 1 ^st to 6 ^th class) o Preparatory (from 7 ^th to 10 ^th class) o Secondary (from 11 ^th to 12 ^th class) o Diploma

o Bachelor

o Higher (Master, PhD, …)

o Other, define:………..

ƒ Marital status:

o Single o Married o Divorced

o Widow

o Engaged

ƒ How many children do you have?

II. Social situation

ƒ How many months/years have you been living in Germany?

ƒ What do you work?

o A housewife

o A worker in ………

o A student

o Other, define: ……….

III. Health status

ƒ Have you ever had diseases that you had to go to the physician since you migrated to Germany?

Dear Madam,

This questionnaire aims to assess your psychological status. All provided information will be treated with high privacy and confidentiality and will only be used for scientific purposes and your name is not required to be filled out.

The first part is related to general information and in the second part, you only need to choose the suitable number that reflects your psychological status as given in the example in that section.

Many thanks for your cooperation.

o Yes o No

ƒ Do you suffer currently from any diseases?

o Yes, what is the disease? …...

o No

ƒ To what level are you satisfied with the health care in Germany?

Very satisfied Satisfied Moderate Unsatisfied Completely unsatisfied

4 3 2 1 0

ƒ What is the level of difference that you feel when health personnel deal with you in comparison to patients from other nationalities?

No difference Very little Little Much Very much

0 1 2 3 4

ƒ How many times a week do you perform physical exercise (which lasts at least 20 minutes)?

……… time/s.

IV. Psychological status

ƒ Do you feel that being a migrant living in Germany negatively affects your psychological status?

o Yes o No

ƒ What are the main stressors that negatively affect your psychological status? “you can choose more than one answer”

o Family problems o Language incompetence

o Feeling lonely as no family, relatives or friends o Not participating in social activities

o Inability to adapt with the environment here o Other, define: ……….

ƒ In case you are under psychological stress, how many persons –including the family- provide you with support?

………. person/s.

ƒ In case you are under psychological stress, do you ask any help/support from others?

o Yes o No

ƒ If yes, from whom?

o Family o Friends o Physician

o Psychological counseling

o Others, define: ………..

ƒ In case you are under psychological stress, how do you react? “you can choose more than one answer”

o Crying

o Talking to others o Leaving the house

o Dealing badly with my children o Smash what I find in front of me o Smoking

o Worship to God

o Others, define: ………

ƒ Do you feel that your nutrition is affected by your psychological status?

o Yes

o No

ƒ Do you visit your home country during holidays?

o Yes.

o No

ƒ If yes, do you feel any positive effect on your psychological status after the visit?

o Yes o No

ƒ What are the activities that you usually do in your fee time? “you can choose more than one answer”

o Visiting or meeting family members o Visiting or meeting friends

o Reading o Walking o Swimming o Watching TV

o Working on the computer o Gymnastic

o Religious/worship activities

o Others, define: ………

PART TWO: SCL-90-R Dear Madam,

“Below is a list of problems and complaints that people sometimes have. Read each one carefully and select one of the numbered descriptors that best describe how much discomfort that problem has caused to you during the past 7 days INCLUDING TODAY. Place that number in the open block. Do not skip any items, and print your number clearly. If you change your mind, erase your first number completely.”

Possible answers are:

0: not present at all 1: present a little bit 2: present moderately 3: present in a big range 4: present extremely Example:

The item could be feeling lonely even if you are with others. If you extremely felt this statement then you put number 4. If you felt that this was not present at all, then you put number 0.

Not present at all

0

A little bit

1

Moderately

2

A big range (quite a bit)

3

Extremely

4

Item Symptom of somatization

1 Headaches

4 Faintness or dizziness

12 Pains in heart or chest 27 Pains in lower back 40 Nausea or upset stomach

42 Soreness of muscles

48 Trouble getting your breath 49 Hot or cold spells

52 Numbness or tingling in part of the body 53 Lump in your throat

56 Feeling weak in parts of your body 58 Heavy feeling in your arms or legs

Item Symptoms of the obsessive-compulsive dimension 3 Repeated unpleasant thoughts

9 Trouble remembering things

10 Worried about sloppiness or carelessness 28 Feeling blocked in getting things done 38 Having to do things very slowly to ensure

correctness

45 Having to check and double-check what you do

46 Difficulty making decisions

51 Your mind going blank

65 Having to repeat the same actions, such as touching, counting, washing

Item Symptom of the interpersonal sensitivity dimension

6 Feeling critical of others

21 Feeling shy or uneasy with the opposite sex

34 Your feelings being easily hurt 36 Feeling others do not understand you or

are unsympathetic

37 Feeling that people are unfriendly or dislike you

41 Feeling inferior to others

61 Feeling uneasy when people are watching or talking about you

69 Feeling very self-conscious with others 73 Feeling uncomfortable about eating or

drinking in public

Item Symptom of the depression dimension 5 Loss of sexual interest or pleasure 14 Feeling low in energy or slowed down 15 Thoughts of ending your life

20 Crying easily

22 Feelings of being trapped or caught 26 Blaming yourself for things

29 Feeling lonely

30 Feeling blue

31 Worrying too much about things 32 Feeling no interest in things 54 Feeling hopeless about the future 71 Feeling everything is an effort 79 Feelings of worthlessness

Item Symptom of the anxiety dimension 2 Nervousness or shaking inside

17 Trembling

23 Suddenly scared for no reason

33 Feeling fearful

39 Heart pounding or racing 57 Feeling tense or keyed up 72 Spells of terror or panic

78 Feeling so restless you couldn't sit still 80 The feeling that something bad is going to

happen to you

86 Thoughts or images of a frightening nature

Item Symptom of the hostility dimension 11 Feeling easily annoyed or irritated 24 Temper outbursts that you could not

control

63 Having urges to beat, injure or harm someone

67 Having urges to break or smash things 74 Getting into frequent arguments 81 Shouting or throwing things

Item Symptom of the phobic anxiety dimension 3 Feeling afraid in open spaces or on the

street

25 Feeling afraid to get out of your house alone

47 Feeling away to travel on buses, subways or trains

50 Having to avoid certain things, places or activities because they frighten you 70 Feeling uneasy in crowds, such as

shopping or at a movie

75 Feeling nervous when you are left alone 82 Feeling afraid you will faint in public Item Symptom paranoid ideation dimension 8 Feeling others are to blame for most of

your troubles

18 Feeling that most people cannot be trusted

43 Feeling you are watched or talked about by others

68 Having ideas or beliefs that others do not share

76 Others not giving you proper credit for your achievements

83 Feeling that people will take advantage of you if you let them

Item Symptom of the psychoticism dimension 7 The idea that someone else can control

your thoughts

16 Hearing voices that other people do not hear

35 Other people being aware of your private thoughts

62 Having thoughts that are not your own 77 Feeling lonely when you are with people 84 Having thoughts about sex that bother

you a lot

85 The idea that you should be punished for your sins

87 The idea that something serious is wrong with your body

88 Never feeling close to another person 90 The idea that something is wrong with

your mind

Item Symptom of Additional items 9 Poor appetite

44 Trouble falling asleep

59 Thoughts of death or dying

60 Overeating

64 Awakening in the early morning 66 Sleep that is restless or disturbed 89 Feelings of Guilt

Note: In case you would like to participate in an intervention program of this study, please provide a phone

number or an address where we can reach you (personal contact information will be dealt with high

privacy).

Erklärung

Ich versichere ausdrücklich, dass ich die Arbeit selbständig und ohne fremde Hilfe verfasst, andere als die von mir angegebenen Quellen und Hilfsmittel nicht benutzt und die aus den verwendeten Werken wörtlich oder inhaltlich übernommenen Stellen kenntlich gemacht habe und dass ich die Dissertation bisher nicht einem Fachvertreter an einer anderen Hochschule zur Überprüfung vorgelegt, oder mich anderweitig um Zulassung zur Promotion beworben habe.

Maesa Irfaeya

Bielefeld, January 2006