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Mental and behavioral health problems among displaced Myanmar adults exhibiting suboptimal adherence to chronic disease medication treatment in Thailand 在泰国流离失所的缅甸成年人中存在的心理和行为健康问题,他们对慢性病药物治疗的依从性不够理想
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100279
Judith K Bass , Amanda Nguyen , Kittipong Sornlorm , Ye Htut Oo , Jarntrah Sappayabanphot , Catherine Lee , Wongsa Laohasiriwong
<div><h3>Background</h3><div>People living with non-communicable diseases (NCDs) such as hypertension and diabetes are at high risk for mental health and psychosocial problems. These problems, in turn, can lead to social isolation, lower quality of life, greater health needs, and poorer health outcomes. The prevalence of NCDs is rising in humanitarian settings, where residents are already at an increased risk of mental health problems due to trauma and stressful living conditions. Yet there has been limited focus on understanding experiences and intersections between these often-co-occurring health conditions in humanitarian settings. Improving this understanding holds promise for supporting integrated care and better patient health outcomes.</div></div><div><h3>Objective</h3><div>To describe mental health problems of displaced Myanmar adults with current poor medication adherence for hypertension and/or type 2 diabetes mellitus and identify factors associated with poor mental health among this population.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis of 224 adults with poor medication adherence (<70 %) for diabetes and/or hypertension treatment. Medication adherence was assessed using pill count. Demographic and physical health characteristics were collected; mental and behavioral health outcomes included a mental health symptom severity score generated based on symptoms of depression, anxiety and posttraumatic stress as well indicators of substance use. Data on sleep quality and self-efficacy for managing chronic disease were also collected. Multiple linear regression was used to identify factors associated with more severe mental health symptoms.</div></div><div><h3>Findings</h3><div>Among the 224 participants, 63.84 % were taking medication for hypertension, 17.86 % for diabetes mellitus, and 18.30 % for both. The sample was 70.98 % female and more than a third (37.5 %) were overweight or obese. Among the total sample, 29.91 % and 65.63 % reported ever using tobacco and betel nuts, respectively. In bivariate analyses, reported religious affiliation, financial situation, hypertension and diabetes comorbidity and more sleep problems were all significantly associated with poorer mental health; all of these factors other than religious affiliation remained significant in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>More than one-third of the displaced Myanmar adults who had suboptimal adherence to their chronic illness medications are living with moderate to severe mental health problems. The factors associated with more severe mental health problems were identified as having debt along with poor financial situation, having comorbid hypertension and diabetes, and having the worse scoring on the sleep problems scale. Integrating mental health support programs into chronic disease care systems is needed to help improve the overall health of this vulnerable population. Holistic approaches to improve economic
背景患有高血压和糖尿病等非传染性疾病(NCDs)的人很容易出现精神健康和社会心理问题。这些问题反过来又会导致社会隔离、生活质量下降、健康需求增加以及健康结果变差。在人道主义环境中,非传染性疾病的发病率正在上升,由于创伤和紧张的生活条件,那里的居民出现心理健康问题的风险已经增加。然而,人们对人道主义环境中这些经常并发的健康问题的经历和交叉点的了解却很有限。方法 对 224 名糖尿病和/或高血压治疗用药依从性差(70%)的成年人进行横断面分析。采用药片计数法评估服药依从性。收集了人口统计学和身体健康特征;心理和行为健康结果包括根据抑郁、焦虑和创伤后应激症状生成的心理健康症状严重程度评分以及药物使用指标。此外,还收集了有关睡眠质量和慢性病自我管理能力的数据。研究采用多元线性回归法来确定与更严重的心理健康症状相关的因素。 研究结果在 224 名参与者中,63.84% 的人服用高血压药物,17.86% 的人服用糖尿病药物,18.30% 的人同时服用两种药物。样本中有 70.98% 为女性,超过三分之一(37.5%)的人超重或肥胖。在所有样本中,分别有 29.91% 和 65.63% 的人表示曾使用烟草和槟榔。在二元分析中,报告的宗教信仰、经济状况、高血压和糖尿病合并症以及更多睡眠问题都与较差的心理健康状况显著相关;除宗教信仰外,所有这些因素在多元分析中仍然显著。与更严重的心理健康问题相关的因素包括:欠债且经济状况不佳、合并高血压和糖尿病以及睡眠问题量表得分较低。需要将心理健康支持计划纳入慢性病护理系统,以帮助改善这一弱势群体的整体健康状况。对于人道主义环境中的慢性病患者,应考虑采取综合方法来改善他们的经济和健康状况。
{"title":"Mental and behavioral health problems among displaced Myanmar adults exhibiting suboptimal adherence to chronic disease medication treatment in Thailand","authors":"Judith K Bass ,&nbsp;Amanda Nguyen ,&nbsp;Kittipong Sornlorm ,&nbsp;Ye Htut Oo ,&nbsp;Jarntrah Sappayabanphot ,&nbsp;Catherine Lee ,&nbsp;Wongsa Laohasiriwong","doi":"10.1016/j.jmh.2024.100279","DOIUrl":"10.1016/j.jmh.2024.100279","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;People living with non-communicable diseases (NCDs) such as hypertension and diabetes are at high risk for mental health and psychosocial problems. These problems, in turn, can lead to social isolation, lower quality of life, greater health needs, and poorer health outcomes. The prevalence of NCDs is rising in humanitarian settings, where residents are already at an increased risk of mental health problems due to trauma and stressful living conditions. Yet there has been limited focus on understanding experiences and intersections between these often-co-occurring health conditions in humanitarian settings. Improving this understanding holds promise for supporting integrated care and better patient health outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To describe mental health problems of displaced Myanmar adults with current poor medication adherence for hypertension and/or type 2 diabetes mellitus and identify factors associated with poor mental health among this population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Cross-sectional analysis of 224 adults with poor medication adherence (&lt;70 %) for diabetes and/or hypertension treatment. Medication adherence was assessed using pill count. Demographic and physical health characteristics were collected; mental and behavioral health outcomes included a mental health symptom severity score generated based on symptoms of depression, anxiety and posttraumatic stress as well indicators of substance use. Data on sleep quality and self-efficacy for managing chronic disease were also collected. Multiple linear regression was used to identify factors associated with more severe mental health symptoms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Among the 224 participants, 63.84 % were taking medication for hypertension, 17.86 % for diabetes mellitus, and 18.30 % for both. The sample was 70.98 % female and more than a third (37.5 %) were overweight or obese. Among the total sample, 29.91 % and 65.63 % reported ever using tobacco and betel nuts, respectively. In bivariate analyses, reported religious affiliation, financial situation, hypertension and diabetes comorbidity and more sleep problems were all significantly associated with poorer mental health; all of these factors other than religious affiliation remained significant in the multivariate analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;More than one-third of the displaced Myanmar adults who had suboptimal adherence to their chronic illness medications are living with moderate to severe mental health problems. The factors associated with more severe mental health problems were identified as having debt along with poor financial situation, having comorbid hypertension and diabetes, and having the worse scoring on the sleep problems scale. Integrating mental health support programs into chronic disease care systems is needed to help improve the overall health of this vulnerable population. Holistic approaches to improve economic","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100279"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breastfeeding practices among immigrants living in Finland: Results from the FinChildren survey 芬兰移民的母乳喂养习惯:芬兰儿童调查的结果
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100283
I Muhumed , J Meinilä , R Klemetti , FA Adebayo , SM Virtanen , M Erkkola

Background

Breastfeeding is a cornerstone of child health and survival as it provides crucial, non-replaceable nourishment necessary for infant's growth and development. Immigration has been shown to influence breastfeeding particularly among immigrants from low- and middle-income countries. Our aim was to examine breastfeeding practices and sociodemographic characteristics of Somali-, Arabic-, and Russian-speaking in comparison with Finnish-speaking mothers.

Methods

We analyzed data from 5348 mothers with infants who participated in FinChildren survey conducted in 2020. Univariate and multivariate analysis were used to estimate the association between maternal origin and breastfeeding practices by comparing immigrant mothers with native-born mothers.

Results

Somali-/Arabic-speaking mothers were younger, less educated and had higher BMI than Russian- and native Finnish-speaking mothers. Proportions of exclusive breastfeeding at 4–5 months of age were lowest among Somali-/Arabic-speaking mothers (21 %) compared to native-born (49 %) and to Russian-speaking mothers (52 %). Again, Somali-/Arabic-speaking mothers had the highest proportions of mixed feeding (66 %) compared to native Finnish-speaking (38 %) and Russian-speaking mothers (32 %). Being a Somali-/Arabic-speaking mother decreased the odds of exclusive breastfeeding five times (OR 0.20, 95 % CI 0.10–0.45) and quadrupled (OR 4.0, 95 % CI 2.18–7.37) the odds of mixed feeding at 4–5 months of age.

Conclusion

Even though the number of immigrant mothers was low, this study suggests that maternal origin is a significant predictor of suboptimal breastfeeding independent of sociodemographic and antenatal characteristics. There is a need for culturally sensitive interventions to promote breastfeeding among these groups.
背景母乳喂养是儿童健康和生存的基石,因为它为婴儿的成长和发育提供了不可替代的重要营养。研究表明,移民会影响母乳喂养,尤其是来自中低收入国家的移民。我们的目的是研究讲索马里语、阿拉伯语和俄语的母亲与讲芬兰语的母亲的母乳喂养习惯和社会人口特征。结果讲索马里语/阿拉伯语的母亲比讲俄语和芬兰语的母亲更年轻、受教育程度更低、体重指数(BMI)更高。与本地出生的母亲(49%)和讲俄语的母亲(52%)相比,讲索马里语/阿拉伯语的母亲在婴儿4-5个月大时进行纯母乳喂养的比例最低(21%)。同样,讲索马里语/阿拉伯语的母亲混合喂养的比例最高(66%),而讲芬兰语和俄语的母亲混合喂养的比例分别为38%和32%。作为索马里语/阿拉伯语母亲,纯母乳喂养的几率降低了五倍(OR 0.20,95 % CI 0.10-0.45),4-5个月大时混合喂养的几率增加了四倍(OR 4.0,95 % CI 2.18-7.37)。有必要采取文化敏感性干预措施来促进这些群体的母乳喂养。
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引用次数: 0
Strategies for seeking care in the host country among asylum-seeking women who have been victims of sexual violence: A French qualitative study 寻求庇护的性暴力受害妇女在东道国寻求护理的策略:法国定性研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100254
Khouani Jeremy , Anne Desrues , Constance Decloitre-Amiard , Marion Landrin , Rachel Cohen Boulakia , Didier Thery , Gaëtan Gentile , Pascal Auquier , Maeva Jego

Background

Incidence of sexual violence among recently arrived asylum-seeking women in France (INCIDAVI) is a French study which found a past year incidence of 26 % for postarrival sexual violence (SV) among asylum-seeking women (ASW). It reported that fewer than 1 out of 10 victims consulted a healthcare professional when SV occurred. These findings raise the question of how ASW who have been victims of SV get involved in care. We aimed to explore the mechanisms and obstacles to seeking care in the host country among this population.

Methods

This qualitative phase of INCIDAVI was based on a grounded theory approach. Twenty semi structured interviews were conducted between February 1, 2022, and July 29, 2022. The interviews explored the conditions under which women talk about SV, the care pathway in France and the perceived consequences of care. We performed an inductive analysis using NVivo® 14 software.

Findings

Life paths of ASW are traversed by SV which influence their health and safety behaviour and can re-expose them to SV. Talking about SV is a rare choice focused on seeking protection. When appropriate care is used, it is perceived as beneficial and leads to a change in the perception of a possible recovery.

Interpretation

The failure of ASW to seek care for SV is shaped by the fact that SV is initially perceived as ordinary. A proactive attitude on the part of carers towards detecting such violence leads to positive experiences of care, which in turn influence women's initial perceptions of SV, enabling them to envisage health recovery.

背景法国新近抵达的寻求庇护妇女的性暴力发生率(INCIDAVI)是一项法国研究,该研究发现,过去一年中,寻求庇护妇女(ASW)在抵达后遭受性暴力(SV)的发生率为 26%。该研究报告称,在发生性暴力时,每 10 名受害者中只有不到 1 人咨询过医疗专业人员。这些发现提出了一个问题,即遭受性暴力侵害的寻求庇护妇女如何参与护理。我们的目标是探索这一人群在东道国寻求医疗服务的机制和障碍。方法 INCIDAVI 的这一定性阶段基于基础理论方法。我们在 2022 年 2 月 1 日至 2022 年 7 月 29 日期间进行了 20 次半结构式访谈。访谈探讨了妇女谈论 SV 的条件、法国的护理途径以及护理的预期后果。我们使用 NVivo® 14 软件进行了归纳分析。研究结果 ASW 的生活轨迹受到 SV 的影响,这影响了她们的健康和安全行为,并可能使她们再次接触 SV。谈论 SV 是一种罕见的选择,主要是为了寻求保护。当采取适当的护理措施时,人们会认为这样做是有益的,并会改变对可能康复的看法。照护者对发现这种暴力行为所持的积极态度会带来积极的照护体验,进而影响妇女对 SV 的最初看法,使她们能够设想健康的恢复。
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引用次数: 0
Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the COVID-19 pandemic 圣地亚哥边境地区吸毒者在 COVID-19 大流行之前和期间的特征以及与密切接触者的互动差异
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100267
Lara K Marquez, Natasha K Martin, Steffanie A Strathdee, Britt Skaathun

Background

Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.

Methods

Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: n = 206; San Diego PWID [SD-PWID]: n = 203; Tijuana PWID [TJ-PWID]: n = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.

Results

Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (psex=0.71;pdrug/alcohol=0.15;pclose=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.

Conclusions

Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.
背景2020-2021年期间,为减少SARS-CoV-2的传播而实施的旅行限制措施降低了许多普通人群的流动性,减少了他们的身体接触。本分析探讨了圣地亚哥边境地区(SDBR)注射吸毒者(PWID)在 COVID-19 时代之前和期间通过跨境流动性进行网络联系的变化情况。方法利用 2020 年 10 月至 2021 年 10 月期间收集的圣地亚哥边境地区注射吸毒者队列研究基线数据,回顾性地描述不同跨境注射吸毒者群体(跨境注射吸毒者 [CB-PWID]:n = 206;圣地亚哥注射吸毒者 [SD-PWID]:n = 203;蒂华纳注射吸毒者 [TJ-PWID]:n = 202)的基线特征差异。卡方检验和费雪精确检验对社会人口学、注射风险行为、减低伤害服务史、监禁史、非致命性用药过量、HCV、HIV 进行了评估。使用 Kruskal-Wallis 检验法评估了大流行前和大流行期间所有注射吸毒者以及跨境注射吸毒者在性、吸毒/酗酒和亲密伴侣方面的中位数差异。结果在 611 名吸毒者中,大流行前和大流行期间的性伴侣、吸毒/酗酒相关伴侣和密切接触者人数保持相对稳定(psex=0.71;pdrug/alcohol=0.15;pclose=0.09)。圣地亚哥的吸毒者在与毒品/酒精有关的伴侣方面的差异最大(中位数[IQR]:-1[-6,0]),而跨境吸毒者报告的密切接触者与大流行前相比变化最小(中位数[IQR]:0[0,1])。结论与大流行前相比,SDBR 地区的吸毒者中性伴侣、毒品/酒精相关伴侣和密切接触者的中位数保持稳定。未来的研究应探讨这些网络接触是如何随时间演变的。
{"title":"Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the COVID-19 pandemic","authors":"Lara K Marquez,&nbsp;Natasha K Martin,&nbsp;Steffanie A Strathdee,&nbsp;Britt Skaathun","doi":"10.1016/j.jmh.2024.100267","DOIUrl":"10.1016/j.jmh.2024.100267","url":null,"abstract":"<div><h3>Background</h3><div>Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.</div></div><div><h3>Methods</h3><div>Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: <em>n</em> = 206; San Diego PWID [SD-PWID]: <em>n</em> = 203; Tijuana PWID [TJ-PWID]: <em>n</em> = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.</div></div><div><h3>Results</h3><div>Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (p<sub>sex</sub>=0.71;p<sub>drug/alcohol</sub>=0.15;p<sub>close</sub>=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.</div></div><div><h3>Conclusions</h3><div>Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100267"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Building a healthy migrant workforce in Singapore – A cross-sectional study to understand health-seeking behaviours of male migrant workers 在新加坡建立一支健康的移民劳动力队伍--了解男性移民工人寻求健康行为的横断面研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100266
Nurul Amanina Binte Hussain , Sheena Ramazanu , Priscilla Ang , Halina Talib , Si Ying Tan , Hui Xiang Chia , Sharon Tan , Jeremy Fung Yen Lim , Jason CH Yap

Background

The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.

Methods

A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).

Results

The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).

Conclusion

This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.
背景新加坡的外来务工人员医疗保健政策传统上侧重于改善职业健康和预防工伤。COVID-19 大流行导致为外来务工人员提供医疗保健服务的模式迅速转变,当务之急是改善初级和预防性医疗保健服务的可及性和可负担性,并加强公共卫生监测。本研究的目的是确定需要改进的领域,以便政策制定者能够提高外来务工人员医疗保健政策的实施效果。为此,我们对以下方面进行了基线了解:(a)新加坡外来务工人员的求医行为;(b)他们如何使用初级和预防性医疗服务;以及(c)在提供服务方面存在的系统性差距。方法2022年8月至11月期间,我们在新加坡的五个外来务工人员宿舍和两个社区空间进行了横断面研究。1101 名男性外来务工人员参与了调查,对 1089 份有效答卷进行了分析。采用多变量逻辑回归法确定了与医疗服务利用率和对为外来务工人员推出的新医疗融资计划(即初级保健计划(PCP))的认知度相关的社会人口学因素。大多数参与者为印度或孟加拉国国籍。至少 82% 的参与者表示,他们可以在新加坡获得各种医疗服务,73% 的参与者对医疗费用表示满意。然而,看医生的参与者比例较低(54%),主要是看呼吸道、发烧或肌肉骨骼方面的疾病,只有 7%的人一年至少看一次牙医。这是因为他们认为看医生(91%)或看牙医(71%)的需求很低。虽然参与者中慢性病的发病率(4%)较低,但约有三分之一的参与者吸烟(26%)、饮酒(32%)或采用自我治疗或药物治疗(39%)。虽然参与者认为新加坡的医疗保健服务方便且价格低廉,但只有有限的证据表明预防性医疗保健被列为优先事项。这表明目前的推广计划可能存在不足,需要进一步开发新的有针对性的计划,以提高新加坡外来务工人员的健康知识水平和对初级预防保健服务的认识。
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引用次数: 0
Young people with migration experience and their (non) encounters with Swedish sexual and reproductive health services and information: An explorative study 有移民经历的年轻人及其(非)接触瑞典性与生殖健康服务和信息的情况:一项探索性研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100270
Nada Amroussia , Malin Lindroth , Catrine Andersson
Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach.
Three themes were generated during the analysis. The first SRH services: dual perceptions and experiences shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second Sexuality education: an eye-opener or a joke? reflects participants’ both positive and negative experiences and attitudes when receiving sexuality education in schools. The third SRH information: beyond formal services and education captures participants’ ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.
尽管越来越多的文献关注有移民经历的年轻人在瑞典性与生殖健康(SRH)服务方面的经历,但缺乏深入的定性探讨。本研究旨在探讨有移民经历的年轻人在性与生殖健康服务方面的遭遇,以及他们对影响其使用这些服务的因素的理解。研究结果来自 2021 年 10 月至 2023 年 5 月期间在瑞典南部进行的 18 次访谈。研究采用了方便取样和滚雪球取样相结合的策略。本研究的参与者自我认同为中东人,移民至瑞典,年龄在 17 岁至 26 岁之间。研究采用反思性主题分析方法对数据进行了分析。第一个主题是 "性健康和生殖健康服务:双重认知和体验",它表明了参与者对性健康和生殖健康服务(主要是青年诊所)的矛盾认知。一些人认为青年诊所是一个被污名化的地方,与羞耻感和性健康与生殖健康问题(如意外怀孕和性传播感染)有关,而另一些人则认为青年诊所是一个安全的空间。这些负面的看法以及前往青年诊所的困难导致了服务使用率低。第二项 "性教育:大开眼界还是笑话?"反映了参与者在学校接受性教育时的正反两方面经历和态度。第三项 "性健康和生殖健康信息:正规服务和教育之外 "反映了参与者获取性健康和生殖健康信息的途径,这些途径超出了传统的性健康和生殖健康服务以及学校性教育所提供的信息。这些信息来源包括家庭、朋友和互联网。研究指出,有必要采取多要素战略来改善性健康和生殖健康服务的可及性,并提请注意在性教育中挑战瑞典人相关规范的重要性,以促进青年参与移民经历并确保他们的性公民身份。
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引用次数: 0
Fertility intentions and perceived health status: A study of Polish migrants and non-migrants 生育意愿与健康状况:对波兰移民和非移民的研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100264
Nasim Ahamed Mondal

Aims

This study aims, probably for the first time, to compare the fertility intentions of migrants and non-migrants of the same nationality at origin based on their self-rated health, wellbeing, and gender.

Methods

The study utilized data from the Families of Poles in the Netherlands (FPN) survey and the Generations and Gender Survey (GGS). This study used Blinder-Oaxaca decomposition models and generalized ordered logit models (gologit).

Results

The findings reveal that both migrants and non-migrants who have good self-rated health and wellbeing are more likely to express a desire to have children in the short-term. The impact of perceived health on the intention to have children is significant for both female and male irrespective of their migration status. Additionally, the average fertility intentions score is higher for Polish migrants residing in the Netherlands compared to Polish non-migrants residing in Poland across the models. The study emphasizes the role good perceived health plays in shaping fertility intentions.

目的本研究可能是首次根据原籍国同一国籍的移民和非移民的自评健康、福祉和性别,对他们的生育意愿进行比较。方法本研究利用了荷兰波兰人家庭(FPN)调查和代际与性别调查(GGS)的数据。结果研究结果表明,无论是移民还是非移民,如果他们对自己的健康状况和幸福感评价良好,就更有可能在短期内表达生育意愿。无论移民身份如何,女性和男性的健康感知对生育意愿的影响都是显著的。此外,与居住在波兰的非移民相比,居住在荷兰的波兰移民在各种模型中的平均生育意愿得分更高。这项研究强调了良好的健康感知对生育意愿的影响。
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引用次数: 0
Psychosocial etiology of post-traumatic stress disorder caused by war trauma among Iran–Iraq war immigrants in Mehran, Iran 伊朗迈赫兰的两伊战争移民因战争创伤导致的创伤后应激障碍的社会心理病因分析
IF 4.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100225
Ebrahim Masoudnia, Fatemeh Rahmati Farmani

Background

Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.

Method

The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.

Results

The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01).

Conclusion

Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.

背景创伤后应激障碍(PTSD)是由战争创伤引起的最重要、最常见的疾病之一。本研究旨在确定伊朗梅赫兰市饱受战争蹂躏的移民的社会心理因素与创伤后应激障碍之间的关系。数据收集对象为两伊战争期间从迈赫兰移民到伊拉姆的 245 名 45 岁及以上饱受战争蹂躏的移民(121 名女性和 124 名男性)。测量工具如下创伤后应激障碍量表、感知社会支持多维量表(MDPSS)、应对策略量表(CSS-R)、多维健康控制点量表。感知到的社会支持与创伤后应激障碍之间存在明显的负相关(p < .01)。包括寻求社会支持、重新评估/适应、以问题为中心的应对和积极应对在内的应对策略均与创伤后应激障碍呈显著负相关(p <.01)。相反,回避应对策略和自我控制与创伤后应激障碍之间存在明显的正相关(p <.01)。此外,外部控制力(相信偶然性)与创伤后应激障碍之间存在明显的正相关(P <0.01),而内部控制力与创伤后应激障碍之间存在明显的负相关(P <.01)。因此,建议采取社会和行为干预措施,以增加社会支持、传授解决问题的技能和加强受战争蹂躏的移民的个人控制力,从而降低患创伤后应激障碍的风险。
{"title":"Psychosocial etiology of post-traumatic stress disorder caused by war trauma among Iran–Iraq war immigrants in Mehran, Iran","authors":"Ebrahim Masoudnia,&nbsp;Fatemeh Rahmati Farmani","doi":"10.1016/j.jmh.2024.100225","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.</p></div><div><h3>Method</h3><p>The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.</p></div><div><h3>Results</h3><p>The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (<em>p</em> &lt; .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (<em>p</em> &lt; .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (<em>p</em> &lt; .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (<em>P</em> &lt; 0.01) and significant negative correlation between internal locus of control and PTSD (<em>P</em> &lt; .01).</p></div><div><h3>Conclusion</h3><p>Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"9 ","pages":"Article 100225"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000151/pdfft?md5=a8ce671d159a8d6443ca3720fd00dcb6&pid=1-s2.0-S2666623524000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with primary healthcare provider access among trans and non-binary immigrants, refugees, and newcomers in Canada 加拿大变性和非二元移民、难民及新移民获得初级医疗服务的相关因素
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100241
Monica A. Ghabrial , Tatiana Ferguson , Ayden I. Scheim , Noah J. Adams , Moomtaz Khatoon (Imptiaz Popat) , Greta R. Bauer

Objective

Trans and non-binary (TNB) immigrants, refugees, and newcomers (IRN) face intersecting challenges and barriers, including stigma and persecution in countries of origin, and others unique to the Canadian resettlement process. The present study aimed to investigate factors that are associated with having a primary healthcare provider among TNB IRN.

Design

Trans PULSE Canada was a community-based, national study of health and wellbeing among 2,873 TNB people residing in Canada, aged 14 and older, who were recruited using a multi-mode convenience sampling approach.. The survey asked questions about identity, community, service access, health – and IRN were asked questions specific to immigration/settlement.

Results

Of the 313 IRN participants who completed the full survey version (age M = 34.1, SE=0.75), 76.4 % had a primary healthcare provider. TNB IRN largely reported being Canadian citizens (59.8 %), gender non-binary or similar (46.9 %), currently living in Ontario (35.5 %), and having immigrated from the United States (32.1 %). Chi-square analyses revealed that having a primary healthcare provider was associated with age, gender identity, citizenship status, region of origin, current location in Canada, length of time since immigrating to Canada, status in gender affirming medical care, and having extended health insurance. With modified Poisson regression, we found that TNB IRN who were non-permanent residents, originating from European, African, and Oceania regions, or living in Quebec and the Prairie provinces were less likely to have a primary healthcare provider.

Conclusion

Results may inform settlement organizations of the unique needs and barriers of TNB IRN. Schools and LGBTQ+ organizations may better serve this population – especially those originating from highlighted regions, who live in Quebec or the Prairie provinces, and/or are non-permanent residents – by offering programs that connect them to primary healthcare providers who are competent in cross-cultural trans health.

目标跨性别和非二元性(TNB)移民、难民和新移民(IRN)面临着相互交织的挑战和障碍,其中包括原籍国的污名化和迫害,以及加拿大重新安置过程中特有的其他障碍。本研究旨在调查 TNB IRN 拥有初级医疗保健提供者的相关因素。设计Trans PULSE Canada 是一项以社区为基础的全国性健康和福利调查,调查对象为居住在加拿大的 2873 名 14 岁及以上的 TNB 居民,调查采用了多模式便利抽样方法。调查询问了有关身份、社区、服务获取、健康等方面的问题,并询问了IRN有关移民/定居的具体问题。结果在完成完整调查版本的313名IRN参与者中(年龄M=34.1,SE=0.75),76.4%的人有初级医疗保健提供者。大多数 TNB IRN 表示自己是加拿大公民(59.8%)、性别非二元或类似(46.9%)、目前居住在安大略省(35.5%)以及从美国移民(32.1%)。卡方分析表明,是否拥有初级医疗保健提供者与年龄、性别认同、公民身份、原籍地区、目前在加拿大的居住地、移民到加拿大的时间长短、性别平权医疗保健状况以及是否拥有扩展医疗保险有关。通过修正泊松回归,我们发现非永久居民、来自欧洲、非洲和大洋洲地区或居住在魁北克省和草原省的 TNB IRN 不太可能拥有初级医疗保健提供者。学校和女同性恋、男同性恋、双性恋、变性者和跨性别者组织可以为这些人群提供更好的服务,尤其是那些来自重点地区、居住在魁北克省或草原省份和/或非永久居民的人群,为他们提供项目,将他们与能够提供跨文化变性健康服务的初级医疗保健提供者联系起来。
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引用次数: 0
Supporting organizations to improve migrants’ access to health services in New York City 支持各组织改善纽约市移民获得医疗服务的机会
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-01-01 DOI: 10.1016/j.jmh.2024.100249
Kathleen Cravero , L. Ansley Hobbs , Elisabeth Manipoud Figueroa , Diana Romero

Purpose

To survey community-based migrant-serving organizations (MSOs) in New York City (NYC) regarding their early experiences during the COVID-19 pandemic and perspectives on academic collaborations.

Methods

We developed and emailed a survey via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic's impact on service provision, type of MSO, and organizational capacity.

Results

Thirty-eight MSOs participated (RR=31%). COVID-19-related challenges included limited staff capacity, organizational funding, and technological and resource limitations of communities served. Organizational capacity correlated with types of services offered: smaller organizations offered health and social services, while larger organizations focused on education and employment. MSOs indicated interest in collaboration on migrant policy advocacy and communications, access to interns, and resources regarding best practices and policies.

Conclusions

MSOs in NYC have struggled with funding, staffing, and service provision. They specified fruitful areas for collaboration with academic research institutions.

Implications

Development of an academic-based migrant health resource hub will serve an identified need among MSOs in NYC.

目的调查纽约市(NYC)基于社区的移民服务组织(MSOs)在 COVID-19 大流行期间的早期经历以及对学术合作的看法。方法我们通过 Qualtrics 制定并向纽约市的 122 个 MSOs 发送了一份调查问卷(2020 年 12 月至 2021 年 1 月),收集有关组织、COVID-19 带来的挑战以及对潜在跨部门合作的兴趣等方面的数据。描述性分析的重点是大流行病对服务提供、MSO 类型和组织能力的影响。与 COVID-19 相关的挑战包括有限的人员能力、组织资金以及所服务社区的技术和资源限制。组织能力与提供的服务类型相关:规模较小的组织提供医疗和社会服务,而规模较大的组织则侧重于教育和就业。MSO 表示有兴趣在移民政策宣传和沟通、获得实习生以及有关最佳实践和政策的资源方面开展合作。他们指出了与学术研究机构合作的富有成效的领域。
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引用次数: 0
期刊
Journal of Migration and Health
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