Assessing psychological stress among Arab migrant women in the City of Cologne/Germany using the Community Oriented Primary Care (COPC) approach.

Migrants suffer from various health problems including psychological stress. This study is the first to use the Community Oriented Primary Care methodology to address a health problem among Arab migrant women in Germany. In partnership with the Muslim Women's Educational Center in Cologne, we defined a community, identified an important health problem through focus groups, key informant interviews and a community discussion group, and studied psychological stress in a sample of Arab migrant women (N = 116) using a questionnaire that included the Symptom Checklist-90-Revised (SCL-90-R) instrument. Almost 90% of participating women were psychologically stressed. About half of the women cited "feeling lonely" as a main source of stress and another third cited religious, moral and personal factors as sources of stress. While the majority of women reacted to stressful situations with crying, 23% coped by talking to others and 20% through worship. Higher stress scores were associated with older age, lower level of education, having more children, coming from a North African rather than Middle Eastern or European country, having lived in Germany for <15 years, having had a disease since migrating to Germany, being ill at the time of the study, and feeling negatively about being a migrant. To date, this study provides the most comprehensive study of psychological distress among Arab migrants in Germany, and provides important information for future studies and interventions.