Conceptualisation, Appraisal, and Response to Adverse Events through an Intercultural Lens, Qualitative study among Ecuadorians Abroad

Culturally sensitive mental health represents a complex theoretical framework that recognises and promotes an intercultural approach to understanding the diverse conceptualisation of health, illness, and well-being (Bautista-Valarezo et al., 2020). Based on that, this framework recognises that individual, social, economic, political, and environmental factors interact to influence the conceptualisations and responses to adversity among individuals and communities (American Psychiatric Association, 2022; Clausen & Barrantes, 2022; Guédez Mujica et al., 2023). Understanding cultural impact becomes particularly crucial in intercultural societies, as is the case in Ecuador. Given the exploratory nature of this research, a qualitative methodology was applied. Semi-structured interviews with open-ended questions of narrative and episodic nature were designed and administered in Spanish, exploring participants' migration experiences, cultural differences, perceptions, reactions and appraisal of adverse life events. The sample comprised twenty Ecuadorians living abroad from various regions, genders, ages, and occupations, representing the country's diversity. Recruitment occurred through word of mouth, and written and oral informed consent were obtained. Three different qualitative analyses were conducted: word clouds, co-occurrence stability, and thematic network analysis. The results showed important dimensions and the relationships across them. Social difficulties, family, and adaptation to contextual differences are described as adverse and challenging events; on the other hand, social support and self-management are described as strategies to address them. Also, there is recognition for medical healthcare services, natural medicine, self-education in mental health skills, and exploring one's own spirituality as strategies to improve health and well-being. In addition, most participants recalled the event as a learning experience, even though the situation was traumatic. Their appraisals were modified through experience, predominantly from negative to positive perspectives, as opportunities for learning, personal growth, and resilience. Most of them emphasised the individualisation of their story and background.