Investigating the Physical and Mental Health Nexus: a Network Analysis of Depression, Cardiometabolic Health, Bone Mass, and Perceived Health Status Among Filipino Domestic Workers.

BACKGROUND: Migrant domestic workers are vulnerable to physical and mental health problems given the many challenges they experience while working abroad. Using network analysis, this study examined the structure of depression, cardiometabolic health indicators (BMI, waist-hip ratio (WHR), blood pressure, and heart rate), bone mass, and perceived health status in this population. The network model allowed for an examination of central symptoms or symptoms with the most direct connections with other symptoms; bridge symptoms, or symptoms that link two or more communities; and edges, or relationships among symptoms. METHOD: Cross-sectional data were gathered from 1375 Filipino domestic workers in Macao (SAR), China. Data from a subsample of 510 participants who met a cutoff indicating depression were analyzed. Anthropometric measurements and surveys were used to collect data, which was analyzed using R statistical software. RESULTS: Results showed four community clusters: three communities consisted of at least two depression symptoms each and the fourth community included physical health indicators. Strong edges were formed between BMI-bone mass, psychomotor-concentration, BMI-WHR, and sad mood-anhedonia. The node with the highest expected influence was BMI. There were three bridges: worthlessness, psychomotor difficulties, and concentration difficulties. CONCLUSION: The link between depression, cardiometabolic indicators, bone mass, and poor perceived health reinforces the need to address multimorbidity within migrant populations. Health promotion interventions that address mental and physical health may improve the health of this population.

A network analysis investigation of the comorbidity between sleep dysfunction and PTSD symptomatology among Filipino domestic workers in Macao (SAR) China.

Posttraumatic stress disorder (PTSD) is highly comorbid with sleep dysfunction. This association was previously explained based on cognitive and emotional dysfunction. The current study extends this literature by investigating the symptom level comorbidity of sleep dysfunction and DSM-5 PTSD utilizing a network approach. Participants were trauma-exposed female Filipino domestic workers (N = 1241). Network analysis was applied to 23 items: 18 items from PCL-5 measuring PTSD (Community 1) and 5 items from PSQI assessing sleep dysfunction (Community 2). The results showed that the symptoms within each community had the strongest correlations. Bridge connections were identified between the sleep dysfunction and PTSD symptom communities. Symptoms with the highest bridge strength were concentration difficulties, recklessness, irritability, and sleep disturbance. This is among the first studies investigating the comorbidity between PTSD and sleep dysfunction from the network approach. Future interventions may be developed that emphasize the bridge symptoms to address comorbidity among trauma exposed migrants.

Acculturative stress and coping among migrant workers: A global mixed-methods systematic review.

No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers' experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.

Understanding seasonal mobilities, health and wellbeing to Sanya, China.

Both the ageing of the Chinese population and elderly mobility impact on the Chinese social infrastructure, triggering challenges to maintain elderly wellbeing. This paper reflects on the notion that seasonal mobility promotes wellbeing, and explores how two crucial factors, namely, forced migration and health conditions, influence the relations between seasonal retirement mobility and wellbeing. This study analyses amenity-led seasonal retired mobilities to Sanya as a case study, and adopts and develops a conceptual framework for relations between mobility and wellbeing in terms of daily activity, sociality, and context through seasonal mobility. Qualitative methods including participant observation, non-participant observation, in-depth interviews, and mobile ethnography were used to collect data. This revealed the heterogeneity of health conditions, and the constrained mobilities of seasonal retirees. Health and willingness for mobility are shown as significant factors in influencing the relations between mobility and wellbeing, which are in turn complicated and dynamic. Seasonal mobilities bring about difficulties for retirees particularly in terms of their efforts to reconstruct their previous life and self-continuities. However, it is argued that these retirees can merely maintain temporary and superficial wellbeing due to constant health concerns and uncertainties over potential temporary or permanent return to their places of origin. Those with serious health problems have more limitations, sacrificing other aspects of wellbeing for physical health. Practical implications from state, destination, and individual levels to better facilitate seasonal mobility and promote wellbeing are provided.