Definition, causes, and consequences of Hamm (idiom of distress in Arabic) in the Palestinian context: a qualitative study.

BACKGROUND: Hamm is an Arabic word that is used to express suffering. Idioms of distress are communicated differently in different contexts and cultures. Understanding idioms of distress and symptoms can help in diagnosis and lead to socioculturally sensitive health care.

METHODS: In this qualitative study, we did semi-structured interviews with men and women of all age groups. Questions focused on the definition, causes, and consequences of Hamm. Responses were analysed by reading and re-reading interview transcripts until themes and subthemes emerged. Oral informed consent was obtained from participants.

FINDINGS: 52 participants contributed to this study (26 women, 26 men; half of whom were aged 18-40 years, and the other half of whom were older than 40 years. Hamm was defined by participants as a feeling of discomfort, sadness, stress, anxiety, and fear of the future. Causes of Hamm included social, economic, and political factors and varied between the sexes: young men (aged 18-40 years) reported family obligations, conflicts, unsolved problems, and failure in studies, whereas young women (aged 18-40 years) reported gossip, social traditional restrictions, isolation, and gender-related problems. People older than 40 years reported fear of family separation, fear for children and their future, or the loss of loved ones. Political causes of Hamm included the Israeli occupation, Israeli checkpoints separating families and creating difficult living conditions, Palestinian authority measures, and the burden of colonialism. Young respondents reported that Hamm results in psychological problems apparent from facial expressions and body language, sleeplessness, miscommunication with others, rudeness and aggression, appetite changes, and mental illnesses. Respondents older than 40 years reported deterioration in psychosocial health, including feelings described as broken spirits, and emphasised the physical consequences of Hamm such as diabetes, heart attack, and hypertension.

INTERPRETATION: Hamm is precipitated by social, economic, and political factors that negatively affect life quality and human functioning. Hamm is embodied physically and in behaviour, and given that that stress through distress can lead to disease, Hamm could contribute to the occurrence of disease.

FUNDING: None.