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1.
MMWR Morb Mortal Wkly Rep ; 70(5): 162-166, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33539336

RESUMO

In 2019, approximately 51 million U.S. adults aged ≥18 years reported any mental illness,* and 7.7% reported a past-year substance use disorder† (1). Although reported prevalence estimates of certain mental disorders, substance use, or substance use disorders are not generally higher among racial and ethnic minority groups, persons in these groups are often less likely to receive treatment services (1). Persistent systemic social inequities and discrimination related to living conditions and work environments, which contribute to disparities in underlying medical conditions, can further compound health problems faced by members of racial and ethnic minority groups during the coronavirus disease 2019 (COVID-19) pandemic and worsen stress and associated mental health concerns (2,3). In April and May 2020, opt-in Internet panel surveys of English-speaking U.S. adults aged ≥18 years were conducted to assess the prevalence of self-reported mental health conditions and initiation of or increases in substance use to cope with stress, psychosocial stressors, and social determinants of health. Combined prevalence estimates of current depression, initiating or increasing substance use, and suicidal thoughts/ideation were 28.6%, 18.2%, and 8.4%, respectively. Hispanic/Latino (Hispanic) adults reported a higher prevalence of psychosocial stress related to not having enough food or stable housing than did adults in other racial and ethnic groups. These estimates highlight the importance of population-level and tailored interventions for mental health promotion and mental illness prevention, substance use prevention, screening and treatment services, and increased provision of resources to address social determinants of health. How Right Now (Qué Hacer Ahora) is an evidence-based and culturally appropriate communications campaign designed to promote and strengthen the emotional well-being and resiliency of populations adversely affected by COVID-19-related stress, grief, and loss (4).


Assuntos
Ansiedade/etnologia , Grupos de Populações Continentais/psicologia , Grupos Étnicos/psicologia , Disparidades nos Níveis de Saúde , Transtornos Mentais/etnologia , Estresse Psicológico/etnologia , Adulto , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Prevalência , Transtornos Relacionados ao Uso de Substâncias/etnologia , Estados Unidos/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33480484

RESUMO

Objective: There are multiple studies indicating that the Indian expat population working in the Middle East is at a significantly high risk for developing anxiety, depression, and suicidal thoughts. The coronavirus disease 2019 (COVID-19) pandemic can precipitate or exacerbate psychological distress among the expat population. The objective of this study was to evaluate psychological distress and coping mechanisms among Indian expats working in the Middle East during the COVID-19 pandemic. Methods: An online survey was conducted with a semistructured questionnaire using a nonprobability snowball sampling technique. In addition to demographic data, a list of COVID-19 pandemic-related questions, the Brief COPE, the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) were also utilized. Results: A total of 94 responses were received. Of the respondents, 52% reported clinically significant anxiety levels, and 41% reported clinically significant depression levels. Both the PHQ-9 and GAD-7 scores were significantly associated with the level of concern with air traffic restriction (P < .05). Conclusions: Our findings show that governments of both Indian and Middle Eastern countries should pay more attention to the mental health of the expat population while combating COVID-19.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/etnologia , Transtorno Depressivo/etnologia , Angústia Psicológica , Estresse Psicológico/etnologia , Adulto , Transtornos de Ansiedade/etiologia , Estudos Transversais , Transtorno Depressivo/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Estresse Psicológico/etiologia , Adulto Jovem
4.
Soins Pediatr Pueric ; 41(315): 20-22, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32951691

RESUMO

What place should be given to puberty? In France, it is an intimate act that belongs only to the young girl. In Sri Lanka, it is a family and collective act that is ritualized and celebrated. Young girls born into Tamil families living in France have to make these very different logics cohabit. Analyse of a young girl's great suffering at puberty and its methods of reconstruction, which take into account the ways of doing and thinking about puberty here and there.


Assuntos
Comportamento Ritualístico , Grupo com Ancestrais do Continente Europeu/psicologia , Puberdade/etnologia , Estresse Psicológico/etnologia , Adolescente , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , França , Humanos , Psicopatologia , Puberdade/psicologia
5.
Med Sci Monit ; 26: e926602, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32966271

RESUMO

BACKGROUND This study aimed to use online questionnaires to evaluate the factors associated with anxiety and depression in Chinese visiting scholars in the United States during the COVID-19 pandemic. MATERIAL AND METHODS Using a cross-sectional design, 311 Chinese scholars visiting 41 states in the United States were interviewed on 20 and 21 April 2020 through WeChat using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. RESULTS Of these 311 visiting scholars, 69 (22.2%) reported no symptoms of anxiety or depression, whereas 63 (20.3%) reported severe anxiety and 67 (21.5%) reported severe depression. Risk of anxiety was 93% higher in visiting scholars with than without accompanying parents in the US (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.01-3.68) and was 1.72-fold (95% CI, 1.04-2.84) higher in those experiencing stress about family members with COVID-19. Stresses about personal security and return to China on schedule were associated with 1.73-fold (95% CI, 1.03-2.92) and 3.00-fold (95% CI, 1.51-5.95) higher risks of anxiety, respectively. Risks of depression were 1.86-fold (95% CI, 1.14-3.05), 1.84-fold (95% CI, 1.10-3.07), and 3.45-fold (95% CI, 1.72-6.92) higher in visiting Chinese scholars who were than were not experiencing stresses about financial support, personal security and return to China on schedule, respectively. CONCLUSIONS Chinese scholars visiting the United States during the COVID-19 pandemic experienced severe psychological distress. Surveys that include larger numbers of visiting scholars are warranted.


Assuntos
Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/etiologia , Intercâmbio Educacional Internacional , Pandemias , Pneumonia Viral/psicologia , Estresse Psicológico/etiologia , Adulto , Ansiedade/etnologia , China/etnologia , Estudos Transversais , Depressão/etnologia , Feminino , Humanos , Masculino , Casamento , Pais , Testes Psicológicos , Risco , Estresse Psicológico/etnologia , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-32916996

RESUMO

This study aimed to explore changes in psychological responses (perceived stress, traumatic stress, stigma, coping) over time in residents, as well as their predictors. The level of perceived stress, traumatic stress, stigma, and coping responses were assessed using the Perceived Stress Scale, Impact of Event-Revised, Healthcare Workers Stigma Scale, and Brief Coping Orientation to Problems Experienced (COPE) Inventory, respectively. We collected responses from 274 residents at baseline and 221 residents at 3 months follow-up (timepoint 2) from the National Healthcare Group (NHG) residency programs in Singapore. All residents reported lower perceived stress and lower perceived stigma compared to baseline. Use of avoidance coping was associated with all three psychological responses (perceived stress, traumatic stress, and stigma) across the two timepoints. Compared to baseline, specific factors associated with perceived stress and traumatic stress at timepoint 2 were living alone, less problem solving, and seeking social support. Residency programs should encourage active coping strategies (e.g., seeking social support, positive thinking, problem solving) among residents, and proactively identify residents who may be at higher risk of psychological sequelae due to circumstances that contribute to isolation.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/psicologia , Internato e Residência/estatística & dados numéricos , Médicos/psicologia , Pneumonia Viral/psicologia , Estigma Social , Transtornos de Estresse Traumático/psicologia , Estresse Psicológico/psicologia , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Estudos Longitudinais , Pandemias , Pneumonia Viral/epidemiologia , Singapura , Estresse Psicológico/etnologia
7.
J Natl Black Nurses Assoc ; 31(1): 26-31, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32853493

RESUMO

Chronic stress and depressive symptoms in midlife southern rural African-American women were examined because little is known about the intersections among them in this population. The research used Vitaliano's model of chronic stress to guide a secondary analysis of a convenience sample 206 (N = 206) midlife (40-65 years) African-American women from a southern rural community in Florida. Data were obtained from a larger study that focused on menopausal health and well-being among women. It also included brief comments from the women during focus group meetings, indicating that they experienced stress and were feeling "down." Statistical data showed that although the women reported relatively low levels of chronic stress and depressive symptoms, associations with certain personal vulnerabilities and social resources emerged as significant. The results from this secondary analysis will help to inform healthcare professionals about the role of personal vulnerability and social resources.


Assuntos
Afro-Americanos/psicologia , Depressão/etnologia , Estresse Psicológico/etnologia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Feminino , Florida , Grupos Focais , Humanos , Menopausa , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos
8.
Artigo em Inglês | MEDLINE | ID: mdl-32365883

RESUMO

Symptom relief is fundamental to palliative care. Aboriginal and Torres Strait Islander (Indigenous) Australians are known to experience inequities in health care delivery and outcomes, but large-scale studies of end-of-life symptoms in this population are lacking. We compared symptom-related distress among Indigenous and non-Indigenous Australian patients in specialist palliative care using the multi-jurisdictional Palliative Care Outcomes Collaboration dataset. Based on patient-reported rating scale responses, adjusted relative risks (aRRs) stratified by care setting were calculated for occurrence of (i) symptom-related moderate-to-severe distress and worsening distress during a first episode of care and (ii) symptom-related moderate-to-severe distress at the final pre-death assessment. The p-value significance threshold was corrected for multiple comparisons. First-episode frequencies of symptom-related distress were similar among Indigenous (n = 1180) and non-Indigenous (n = 107,952) patients in both inpatient and community settings. In final pre-death assessments (681 Indigenous and 67,339 non-Indigenous patients), both groups had similar occurrence of moderate-to-severe distress when care was provided in hospital. In community settings, Indigenous compared with non-Indigenous patients had lower pre-death risks of moderate-to-severe distress from overall symptom occurrence (aRR 0.78; p = 0.001; confidence interval [CI] 0.67-0.91). These findings provide reassurance of reasonable equivalence of end-of-life outcomes for Indigenous patients who have been accepted for specialist palliative care.


Assuntos
Disparidades em Assistência à Saúde , Cuidados Paliativos , Estresse Psicológico , Assistência Terminal , Adulto , Idoso , Austrália , Assistência à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos , Estresse Psicológico/etnologia
9.
Aust N Z J Public Health ; 44(3): 186-192, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32459387

RESUMO

OBJECTIVE: To examine whether baseline measures of stress, life satisfaction, depression and alcohol use predict making or sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. METHODS: We analysed data from the nationally representative quota sample of 1,549 Aboriginal and Torres Strait Islander adults who reported smoking at least weekly in the Talking About The Smokes baseline survey (April 2012-October 2013) and the 759 who completed a follow-up survey a year later (August 2013-August 2014). RESULTS: More smokers who reported negative life satisfaction, feeling depressed, higher stress or drinking heavily less often than once a week at baseline made a quit attempt between the baseline and follow-up surveys. In contrast, of these smokers who had made quit attempts between surveys, more who reported higher stress were able to sustain abstinence for at least one month; other associations were inconclusive. Conclusions and implications for public health: Health staff and Aboriginal and Torres Strait Islander smokers need not see being more stressed as an obstacle to quitting among Aboriginal and Torres Strait Islander people. Health staff should emphasise the benefits to mental health that come with successfully quitting smoking.


Assuntos
Alcoolismo/psicologia , Depressão/psicologia , Satisfação Pessoal , Fumantes/psicologia , Fumar/efeitos adversos , Estresse Psicológico/psicologia , Adulto , Alcoolismo/etnologia , Austrália/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Depressão/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Fumar/epidemiologia , Fumar/etnologia , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Estresse Psicológico/etnologia
10.
BMC Public Health ; 20(1): 566, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345300

RESUMO

BACKGROUND: Racial disparities in cardiovascular disease (CVD) have been attributed in part to negative psychosocial factors. Prior studies have demonstrated associations between individual psychosocial factors and CVD risk factors, but little is known about their cumulative effects. METHODS: Using the Jackson Heart Study, we examined the cross-sectional associations of cumulative psychosocial factors with CVD risk factors among 5306 African Americans. We utilized multivariable Poisson regression to estimate sex-stratified prevalence ratios (PR 95% confidence interval-CI) of obesity, hypertension and diabetes prevalence and hypertension and diabetes control with negative affect (cynicism, anger-in, anger-out, depressive symptoms and cumulative negative affect) and stress (global stress, weekly stress, major life events-MLEs and cumulative stress), adjusting for demographics, socioeconomic status, and behaviors. RESULTS: After full adjustment, high (vs. low) cumulative negative affect was associated with prevalent obesity among men (PR 1.36 95% CI 1.16-1.60), while high (vs. low) cumulative stress was similarly associated with obesity among men and women (PR 1.24 95% CI 1.01-1.52 and PR 1.13 95% CI 1.03-1.23, respectively). Psychosocial factors were more strongly associated with prevalent hypertension and diabetes among men than women. For example, men who reported high cynicism had a 12% increased prevalence of hypertension (PR 1.12, 95% CI 1.03-1.23). Psychosocial factors were more strongly associated with lower hypertension and diabetes control for women than men. Women who reported high (vs. low) cynicism had a 38% lower prevalence of hypertension control (PR 0.62, 95% CI 0.46-0.84). CONCLUSIONS: Cumulative psychosocial factors were associated with CVD risk factors and disease management among African Americans. The joint accumulation of psychosocial factors was more associated with risk factors for men than women.


Assuntos
Afeto , Afro-Americanos/psicologia , Doenças Cardiovasculares/psicologia , Adulto , Idoso , Ira , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Depressão/etnologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Diabetes Mellitus/psicologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etnologia , Hipertensão/psicologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etnologia , Obesidade/psicologia , Distribuição de Poisson , Prevalência , Análise de Regressão , Fatores de Risco , Fatores Sexuais , Classe Social , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Estresse Psicológico/etnologia
11.
PLoS Med ; 17(3): e1003066, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32208416

RESUMO

BACKGROUND: According to the United Nations High Commissioner for Refugees, 44,000 people are forced to flee their homes every day due to conflict or persecution. Although refugee camps are designed to provide a safe temporary location for displaced persons, increasing evidence demonstrates that the camps themselves have become stressful and dangerous long-term places-especially for women. However, there is limited literature focused on refugee women's perspectives on their insecurity. This qualitative study sought to better understand the ways in which women experienced insecurity at a refugee camp in Kenya. METHODS AND FINDINGS: Between May 2017 and June 2017, ethnographic semi-structured interviews accompanied by observation were conducted with a snowball sampling of 20 Somali (n = 10) and Ethiopian Oromo (n = 10) women, 18 years and older, who had had at least 1 pregnancy while living in Kakuma Refugee Camp. The interviews were orally translated, transcribed, entered into Dedoose software for coding, and analyzed utilizing an ethnographic approach. Four sources of insecurity became evident: tension between refugees and the host community, intra- or intercultural conflicts, direct abuse and/or neglect by camp staff and security personnel, and unsafe situations in accessing healthcare-both in traveling to healthcare facilities and in the facilities themselves. Potential limitations include nonrandom sampling, the focus on a specific population, the inability to record interviews, and possible subtle errors in translation. CONCLUSIONS: In this study, we observed that women felt insecure in almost every area of the camp, with there being no place in the camp where the women felt safe. As it is well documented that insecure and stressful settings may have deleterious effects on health, understanding the sources of insecurity for women in refugee camps can help to guide services for healthcare in displaced settings. By creating a safer environment for these women in private, in public, and in the process of accessing care in refugee camps, we can improve health for them and their babies.


Assuntos
Conflito Psicológico , Características Culturais , Medo , Acesso aos Serviços de Saúde , Paridade , Campos de Refugiados , Refugiados/psicologia , Estresse Psicológico/psicologia , Violência/psicologia , Adulto , Etiópia , Feminino , Humanos , Entrevistas como Assunto , Gravidez , Pesquisa Qualitativa , Fatores de Risco , Medidas de Segurança , Somália , Estresse Psicológico/diagnóstico , Estresse Psicológico/etnologia , Viagem , Violência/etnologia , Adulto Jovem
12.
PLoS Med ; 17(3): e1003011, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32126076

RESUMO

BACKGROUND: Despite recognition that palliative care is an essential component of any humanitarian response, serious illness-related suffering continues to be pervasive in these settings. There is very limited evidence about the need for palliative care and symptom relief to guide the implementation of programs to alleviate the burden of serious illness-related suffering in these settings. A basic package of essential medications and supplies can provide pain relief and palliative care; however, the practical availability of these items has not been assessed. This study aimed to describe the illness-related suffering and need for palliative care in Rohingya refugees and caregivers in Bangladesh. METHODS AND FINDINGS: Between November 20 and 24, 2017, we conducted a cross-sectional study of individuals with serious health problems (n = 156, 53% male) and caregivers (n = 155, 69% female) living in Rohingya refugee camps in Bangladesh, using convenience sampling to recruit participants at the community level (i.e., going house to house to identify eligible individuals). The serious health problems, recent healthcare experiences, need for medications and medical supplies, and basic needs of participants were explored through interviews with trained Rohingya community members, using an interview guide that had been piloted with Rohingya individuals to ensure it reflected the specificities of their refugee experience and culture. The most common diagnoses were significant physical disabilities (n = 100, 64.1%), treatment-resistant tuberculosis (TB) (n = 32, 20.5%), cancer (n = 15, 9.6%), and HIV infection (n = 3, 1.9%). Many individuals with serious health problems were experiencing significant pain (62%, n = 96), and pain treatments were largely ineffective (70%, n = 58). The average age was 44.8 years (range 2-100 years) for those with serious health problems and 34.9 years (range 8-75 years) for caregivers. Caregivers reported providing an average of 13.8 hours of care per day. Sleep difficulties (87.1%, n = 108), lack of appetite (58.1%, n = 72), and lack of pleasure in life (53.2%, n = 66) were the most commonly reported problems related to the caregiving role. The main limitations of this study were the use of convenience sampling and closed-ended interview questioning. CONCLUSIONS: In this study we found that many individuals with serious health problems experienced significant physical, emotional, and social suffering due to a lack of access to pain and symptom relief and other essential components of palliative care. Humanitarian responses should develop and incorporate palliative care and symptom relief strategies that address the needs of all people with serious illness-related suffering and their caregivers.


Assuntos
Cuidadores/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Cuidados Paliativos/psicologia , Campos de Refugiados , Refugiados/psicologia , Socorro em Desastres , Estresse Psicológico/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/provisão & distribução , Bangladesh , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Estudos Transversais , Assistência à Saúde Culturalmente Competente , Feminino , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estresse Psicológico/diagnóstico , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Adulto Jovem
13.
J Cross Cult Gerontol ; 35(2): 217-234, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32112183

RESUMO

Family members provide the majority of caregiving to individuals living with Alzheimer's disease (AD) and related dementias. Asian American families are disproportionately impacted by the burden of caregiving due to limited knowledge about the disease in this community. This study explored how Vietnamese American caregivers understand AD and provide care to family members with AD. Twenty caregivers who have provided care to a family member with AD participated in a semi-structured qualitative interview. Data were analyzed using thematic analysis. Several themes were identified in the caregivers' understanding of AD: (a) "Now I know:" the disruptions, shocks and surprises leading up to the initial diagnosis; (b) The frustrations of managing family members' cognitive impairments; (c)"Going with the flow:" challenges in managing personality and behavioral changes; (d) The exhaustion of around-the-clock caregiving; (e)"Taking it day by day" in the face of progressively worsening symptoms. Underlining the participants' descriptions of AD was a shared understanding of the progressively worsening, complex and unpredictable nature of the disease that makes it challenging for family caregivers on a daily basis. Findings provide important implications for healthcare workers' outreach to Vietnamese American families to ease the caregiving experience through culturally-responsive education, thereby enhancing the families' ability to recognize the early symptoms and seek appropriate help.


Assuntos
Doença de Alzheimer/enfermagem , Americanos Asiáticos/psicologia , Cuidadores/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estresse Psicológico/etnologia , Estados Unidos/etnologia , Vietnã
14.
Public Health ; 181: 151-157, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32036172

RESUMO

OBJECTIVES: Depression has been associated with numerous adverse health conditions. This study sought to determine the frequency of significant depressive symptoms and whether or not acculturative stress, discrimination, and reproductive health conditions were risk factors for significant depressive symptoms in migrant working women in China. STUDY DESIGN: The design of this study is cross-sectional. METHODS: Data were derived from a survey of female migrant workers at three employment sites in Changsha, China. The associations between acculturative stress, discrimination, reproductive health, and risk for significant depressive symptoms were obtained using F-tests for mean differences, correlations, ordinary least squares regression, and logistic regression analysis. RESULTS: Between March and June 2017, 232 eligible female participants completed the survey among whom the median age was 34.36 years (standard error 0.43) and 25.58% reported significant depressive symptoms. Significant depressive symptoms were associated with higher education (F-test, P = .006), all four acculturative stress factors (r = 0.15 to r = 0.29), both institutional and interpersonal discrimination (r = 0.29, r = 0.35), age (r = - 0.13), and self-rated health (r = - 0.19). In multivariate regression analysis of depression scale scores, interpersonal discrimination was the strongest predictor (beta = 0.238, P = .002) among the nine factors identified in bivariate analysis. None of the other predictors (age, self-rated health, education, acculturative stress, and institutional discrimination) showed significant associations with the depression scale. Similar results were obtained for a multivariate logistic regression analysis of a clinically important threshold for depression (<10 versus ≥ 10 on the depression scale). Only interpersonal discrimination significantly distinguished between clinical depression categories (odds ratio = 2.607 per unit change in the index, P = .001). CONCLUSIONS: Migrant women workers in China appear to be at risk for significant depressive symptoms, and interpersonal discrimination appears to be an important risk factor in this setting. Acculturative stress and institutional discrimination may also be relevant risk factors, as suggested in our bivariate analysis, but in our sample, the correlations between the stress and discrimination factors are high enough to compromise identification of unique associations between acculturation stress and depression. Government, community and workplace education, and psychosocial services for migrant women are recommended.


Assuntos
Aculturação , Depressão/etnologia , Transtorno Depressivo/etnologia , Discriminação Psicológica , Saúde Reprodutiva/etnologia , Estresse Psicológico/etnologia , Migrantes/psicologia , Adulto , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Fatores de Risco , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
15.
Med Care ; 58(6): 541-548, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32011423

RESUMO

OBJECTIVES: We sought to determine the associations between maternal citizenship and health care access and utilization for US-born Latino youth and to determine whether maternal distress is a moderator of the associations. METHODS: Using 2010-2017 Integrated Public Use Microdata Series National Health Interview Survey data, multivariable logistic regressions were run to examine the associations among maternal citizenship and health care access and utilization for US-born Latino youth. Maternal citizenship and distress interactions were tested. RESULTS: Noncitizen mothers had higher odds of reporting uninsurance, lack of transportation for delaying care, and lower odds of health care utilization for their youth than citizen mothers. Compared with no distress, moderate and severe distress were positively associated with uninsurance, delayed medical care due to cost, lack of transportation, and having had an emergency department visit for their youth. Moderate distress was positively associated with youth having had a doctor's office visit. Noncitizen mothers with moderate distress were less likely to report their youth having had an emergency department visit than citizen mothers with moderate distress. Among severely distressed mothers, noncitizen mothers were more likely to report youth uninsurance and delayed care due to lack of transportation compared with citizen mothers. CONCLUSIONS: Health care access and utilization among US-born Latino youth are influenced by maternal citizenship and distress. Maternal distress moderates the associations among maternal citizenship and youth's health care access and use. Almost one-third of all US-born youth in the United States are Latino and current federal and state noninclusive immigration policies and anti-Latino immigrant rhetoric may exacerbate health care disparities.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Mães/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adolescente , Adulto , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Idioma , Modelos Logísticos , Masculino , Mães/psicologia , Fatores Socioeconômicos , Estresse Psicológico/etnologia , Imigrantes Indocumentados/psicologia , Imigrantes Indocumentados/estatística & dados numéricos , Estados Unidos
16.
Am J Orthopsychiatry ; 90(2): 267-282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32105125

RESUMO

Despite the proclamation of a "postracial" society, racism in the United States remains "alive and sick" (S. P. Harrell, 2000), negatively impacting the physical, psychological, and emotional well-being of Black Americans. Moreover, the complex impact of racism throughout the life span is inadequately understood. Coping with the insidiousness of racism in its myriad forms requires recognizing how it expresses across development. In this developmental overview, we apply a life-course perspective (Gee, Walsemann, & Brondolo, 2012) to investigate racism-related stress and coping over time. Within each period of development, we first explore how racism-related stress may present for Black Americans and then document what coping from this stress looks like, highlighting extant strategies and interventions where they exist. This work concludes with a set of definitional, methodological, and clinical future directions and recommendations for improving the field's ability to mitigate the deleterious impact of racism-related stress. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Afro-Americanos/psicologia , Desenvolvimento Humano , Racismo/psicologia , Estresse Psicológico/etnologia , Adulto , Idoso , Criança , Humanos , Estados Unidos/etnologia
17.
Complement Ther Med ; 48: 102277, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31987226

RESUMO

OBJECTIVE: Growing evidence demonstrates that perceived discrimination and racism are significant contributing factors to psychological distress, low-grade chronic inflammation, and cardiovascular health disparities among minorities, particularly among Black women. Despite this evidence, there are no evidence-based complementary therapy interventions available to ameliorate chronic stress associated with racism and discrimination. The purpose of this study was to examine the feasibility and effectiveness of a novel, 8-week, group-based stress reduction program, Resilience, Stress and Ethnicity (RiSE), designed to help Black women at risk for cardiovascular disease (CVD) develop effective coping skills for dealing with chronic stress uniquely associated with being a minority. METHODS: We conducted two semi-structured focus groups with Black women (N = 22) following their participation in the 8-week RiSE program. We analyzed the data using constant comparative qualitative methods. RESULTS: Attrition rate was low (13%) with all participants attending at least 6 of the 8 classes. Participants reported high levels of satisfaction with the program and the majority (81%) reported practicing the skills that they learned in real-life stressful situations. In describing the participants' response to the program, four key categories emerged from the data: (1) Increasing awareness of stressors associated with perceived discrimination and racism; (2) Coping with race-based stressors; (3) Coping with other sources of stress; and (4) Increasing sense of empowerment and emotion regulation. CONCLUSIONS: Findings suggest that RiSE is feasible and effective in helping Black women at risk for CVD cope with chronic stress associated with being a minority. Given evidence that perceived discrimination and racism are underlying factors in many inflammatory-based chronic diseases, this research may have broader implications for reducing health disparities across a wide-spectrum of chronic illnesses in which women minorities are disproportionately affected.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Doenças Cardiovasculares/etnologia , Racismo/psicologia , Resiliência Psicológica , Estresse Psicológico/etnologia , Estresse Psicológico/terapia , Idoso , Feminino , Grupos Focais , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa
18.
J Gerontol Soc Work ; 63(1-2): 41-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31948371

RESUMO

This qualitative study explores and describes the protective factors and processes that foster resilience and buffer psychosocial distress among later-life Egyptian immigrants post immigration to the US. Open-ended structured interviews were conducted with (30) later-life Egyptian immigrants who came to the United States after turning 60 years of age. Thematic analysis was used to analyze patterns within the data. The findings of this study reveal that the availability and utilization of psychosocial resources - due to opportunities embedded in their sociocultural context and coping strategies embedded in their individual strengths and cultural or religious beliefs - play a pivotal role in buffering the losses and acculturative stressors triggered by transitioning to a new environment. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs and services for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.


Assuntos
Emigrantes e Imigrantes/psicologia , Resiliência Psicológica , Estresse Psicológico/etnologia , Aculturação , Adaptação Psicológica , Idoso , Egito/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Pesquisa Qualitativa , Apoio Social , Estados Unidos
20.
Issues Ment Health Nurs ; 41(1): 3-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31900016

RESUMO

The synergistic influences of everyday life experiences, societal expectations, and cultural nuances affect a person's ability to successfully manage their life and remain mentally healthy. Persons from culturally and ethnically diverse populations may incur depression when societal expectations and cultural influences are in conflict with each other. Chronic stress, often-referred to as toxic stress, contributes to the development of depression as it is unrelenting, beginning in childhood and continuing into adulthood. This article discusses connections between societal expectations, persons' cultural perspectives as well as the role that these connections may contribute to in the development of toxic stress and depression. Beck's Cognitive Behavioral Theory provides a basis to describe the role that synergistic influences play in development of depression for culturally and ethnically diverse persons.


Assuntos
Depressão/etnologia , Transtorno Depressivo/etnologia , Grupos Étnicos/psicologia , Terapia Cognitivo-Comportamental , Humanos , Modelos Psicológicos , Estresse Psicológico/etnologia
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