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1.
Turkiye Parazitol Derg ; 46(3): 184-188, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36094118

RESUMO

Objective: This study aimed to evaluate the distribution of intestinal parasites in refugee and native patients who applied to a territory hospital in Turkey. Methods: A total of 17911 patients who were admitted to our hospital between January 2018 and January 2019 were evaluated retrospectively in terms of intestinal parasites. The patients' stool samples were investigated for the existence of intestinal parasites by direct wet mount preparation, formalin ether concentration technique and cellophane tape method. The data obtained were compared between patient groups according to the examination method. Results: The overall prevalence of E. vermicularis in refugee children was found twice higher than that in native patients and the most common symptom was abdominal pain in these patients. Intestinal parasite detection rates were significantly higher in the stool concentration method than in the direct wet mount examination. Cutaneous complaints and protein energy malnutrition/growth retardation were the most common clinical conditions besides gastrointestinal symptoms in patients with intestinal parasitosis. Conclusion: In our study, the prevalence of Blastocystis sp. in refugees was found to be higher than in the normal population. Intestinal parasitic infections should be investigated with proper diagnostic methods especially in children with PEM/GR and cutaneous symptoms in addition to gastrointestinal problems.


Assuntos
Enteropatias Parasitárias , Parasitos , Refugiados , Animais , Criança , Hospitais , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Estudos Retrospectivos , Turquia/epidemiologia
2.
PLoS One ; 17(9): e0274316, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36112570

RESUMO

BACKGROUND: Turkey hosts an estimated 3.7 million Syrian refugees. Syrian refugees have access to free primary care provided through Refugee Health Centers(RHC). We aimed to determine factors that influence patient satisfaction in refugee health centers. METHODS: The study was a cross-sectional quantitative study. A patient survey was administered among 4548 patients attending services in selected 16 provinces in Turkey. A quantitative questionnaire was used to collect information on patient satisfaction and experience in the healthcare facility. Information on "overall satisfaction with health services" was collected on a 5-point Likert scale and dichotomized for analysis. Logistic regression was conducted to identify factors that influenced patient satisfaction. RESULTS: We found that 78.2% of the participants were satisfied with the health services they received. Factors related to service quality and communication were significant determinants of patient satisfaction. The strongest predictors of satisfaction were having a sufficient consultation time (AOR: 2.37; 95% CI: 1.76-3.21; p< 0.0001), receiving a comprehensive examination (AOR: 2.01; 95% CI: 1.49-2.70; p < 0.0001) and being treated with respect by the nurse (AOR: 2.08; 95% CI: 1.52-2.85; p< 0.0001). CONCLUSION: Providing integrated, culturally and linguistically sensitive health services is important in refugee settings. The quality of service and communication with patients influence patient satisfaction in refugee health centers. As such, improvements in aspects such as consultation time and the quality of physician-patient interaction are recommended for patient satisfaction.


Assuntos
Satisfação do Paciente , Refugiados , Estudos Transversais , Serviços de Saúde , Humanos , Turquia
3.
BMC Health Serv Res ; 22(1): 1165, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114536

RESUMO

BACKGROUND: The vast majority of refugees are hosted in low and middle income countries (LMICs), which are already struggling to finance and achieve universal health coverage for their own populations. While there is mounting evidence of barriers to health care access facing refugees, there is more limited evidence on equity in access to and affordability of care across refugee and host populations. The objective of this study was to examine equity in terms of health needs, service utilisation, and health care payments both within and between South Sudanese refugees and hosts communities (Ugandan nationals), in two districts of Uganda. METHODS: Participants were recruited from host and refugee villages from Arua and Kiryandongo districts. Twenty host villages and 20 refugee villages were randomly selected from each district, and 30 households were sampled from each village, with a target sample size of 2400 households. The survey measured condition incidence, health care seeking and health care expenditure outcomes related to acute and chronic illness and maternal care. Equity was assessed descriptively in relation to household consumption expenditure quintiles, and using concentration indices and Kakwani indices (for expenditure outcomes). We also measured the incidence of catastrophic health expenditure- payments for healthcare and impoverishment effects of expenditure across wealth quintiles. RESULTS: There was higher health need for acute and chronic conditions in wealthier groups, while maternal care need was greater among poorer groups for refugees and hosts. Service coverage for acute, chronic and antenatal care was similar among hosts and refugee communities. However, lower levels of delivery care access for hosts remain. Although maternal care services are now largely affordable in Uganda among the studied communities, and service access is generally pro-poor, the costs of acute and chronic care can be substantial and regressive and are largely responsible for catastrophic expenditures, with service access benefiting wealthier groups. CONCLUSIONS: Efforts are needed to enhance access among the poorest for acute and chronic care and reduce associated out-of-pocket payments and their impoverishing effects. Further research examining cost drivers and potential financing arrangements to offset these will be important.


Assuntos
Refugiados , Estudos Transversais , Feminino , Gastos em Saúde , Acesso aos Serviços de Saúde , Humanos , Gravidez , Uganda/epidemiologia
4.
Tijdschr Psychiatr ; 64(8): 513-516, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-36117483

RESUMO

Background  Of the total Dutch population, 25.7% has a migration background. The countries of origin, migration motives and time in the Netherlands are very diverse. Aim  To provide an overview of the cultural diversity within the psychiatry of different groups of people with a migration background, and to address the challenges and mental health care to these groups and the position of transcultural psychiatry in the Netherlands. Method  Based on integration of a narrative literature review (without a systematic search), own experiences and a fictitious case, we discuss the most important groups. This concerns the so-called guest workers as a specific group of first-generation migrants, second-generation migrants with their specific problems, and finally refugees and undocumented migrants with an accumulation of risk-increasing factors. Results  In addition to predisposition and migration factors, insufficient understanding of cultural context contributes to the psychiatric problems of first- and second-generation migrants. Refugees and undocumented migrants also have limited access to care. There is a reimbursement system in the Netherlands for undocumented migrants, through which they can also rely on care. By understanding cultural backgrounds, professionals can further improve their skills and communication in the field of intercultural psychiatry. Conclusion  Cultural diversity of patient groups demands additional attention to diagnosis and therapy.


Assuntos
Refugiados , Migrantes , Diversidade Cultural , Etnopsicologia , Humanos , Saúde Mental
5.
Tijdschr Psychiatr ; 64(8): 524-528, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-36117486

RESUMO

Background  Despite high prevalence of psychopathology, the use of mental health services by asylum seekers seems low. Barriers to care may play an important role in this. Aim  To explore the barriers in mental health care for adult and adolescent asylum seekers and their care providers in high-income countries. Method  A narrative literature review, based on a systematic evaluation of the current scientific literature. Results  In a narrative synthesis of the results, we identified the following six categories of barriers: lack of knowledge of the healthcare system, language barriers, discrepant beliefs and expectations of mental healthcare, lack of trust towards authority, and structural difficulties. Conclusion  Six thematic barriers were retained. Different interventions are possible to address these barriers. Further research into needs and interventions is recommended, with specific attention to the Belgian and Dutch context.


Assuntos
Serviços de Saúde Mental , Refugiados , Adolescente , Adulto , Acesso aos Serviços de Saúde , Humanos , Idioma , Saúde Mental , Refugiados/psicologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-36078371

RESUMO

BACKGROUND: After the invasion of Ukraine, neighbouring countries were forced to find systemic solutions to provide medical care to those fleeing the war, including children, as soon as possible. In order to do this, it is necessary to know the communication problems with refugee minors and find proposals for their solutions. METHODS: A systematic review of the literature from 2016 to 2022 was conducted according to PRISMA criteria. RESULTS: Linguistic diversity and lack of professional readiness of teachers are the main constraints hindering the assistance of refugee children in schools. Problems during hospitalization include lack of continuity of medical care and lack of retained medical records. Solutions include the use of the 3C model (Communication, Continuity of care, Confidence) and the concept of a group psychological support program. CONCLUSIONS: In order to provide effective assistance to refugee minors, it is necessary to create a multidisciplinary system of care. It is hoped that the lessons learned from previous experiences will provide a resource to help refugee host countries prepare for a situation in which they are forced to provide emergency assistance to children fleeing war.


Assuntos
Reabilitação Psiquiátrica , Refugiados , Criança , Humanos , Menores de Idade , Refugiados/psicologia , Instituições Acadêmicas , Ucrânia
7.
Artigo em Inglês | MEDLINE | ID: mdl-36078608

RESUMO

Due to pre-, peri- and post-migratory stress factors, refugees often experience higher levels of psychological stress than the general population. Post-traumatic stress disorder, in particular, has an increased prevalence in the refugee population. However, living conditions in the early post-migratory phase are characterized by many challenges. In the present qualitative study, 14 refugees with symptoms of PTSD from temporary accommodations in Germany were interviewed in semi-structured interviews about their individual experiences of the impact of their trauma sequelae symptoms on their current living conditions and interactions. Participants reported dealing with post-traumatic symptoms primarily through distraction strategies, such as working or learning the language or social interaction. Many reported a sense of mistrust as a result of traumatic experiences. Current stress factors cited included uncertain asylum status, worry about family members and lack of ability to influence living situations. The interactions between the post-traumatic symptoms and the living conditions of the refugees were highlighted. The effects of the symptomatology of trauma sequelae and the framework conditions under which refugees live can lead to aggravated psychological distress. Therefore, special attention must be paid to refugee mental health care.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Adaptação Psicológica , Alemanha/epidemiologia , Humanos , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-36078636

RESUMO

Social connections are foundational to the human condition and are inherently disrupted when people are forcibly displaced from their home countries. At a time of record high global forced migration, there is value in better understanding how refugee-background individuals engage theirsocial supports or ties in resettlement contexts. A mixed methods research design aimed to understand the complexities of how 104 refugee-background women experienced their social networks in the first few months of resettlement in Australia. One of the research activities involved participants completing a survey with both quantitative and qualitative components. The quantitative analyses identified the impact of post-migration living difficulties that represented social stressors (worry about family, loneliness and boredom, feeling isolated, and racial discrimination) on the women's mental health outcomes in the months following resettlement. The qualitative data highlighted the complexities of social relationships serving as both stressors and sources of support, and the importance of recognizing extended families and supports around the globe. The findings point to the need for nuanced accounts of the social contexts surrounding refugee resettlement as important influences able to promote trauma-informed and gender sensitive practices to support mental health and well-being in new settings.


Assuntos
Refugiados , Ansiedade , Austrália , Feminino , Humanos , Saúde Mental , Refugiados/psicologia , Inquéritos e Questionários
9.
Artigo em Inglês | MEDLINE | ID: mdl-36078814

RESUMO

Mental health and social resilience play a significant role in refugees' adaptation during the resettlement process in the host country. Maintaining good mental wellbeing helps the refugees to respond to stressful experiences with healthy life choices. This study aimed to explore the mental wellbeing and social resilience of Eritrean refugees living in Germany and to identify social conditions and enablers to foster adaptation. This study employs a qualitative approach with a semi-structured, in-depth interview data collection method. Informants were identified among mostly young adult refugees living in Heidelberg, Germany, with a migration history of 3-6 years. In total, 15 informants were recruited through snowball sampling. Data were sorted and analyzed using the five pillars of the Adaptation and Development after Persecution and Trauma (ADAPT) model. The findings suggest that Eritrean refugees experienced psychological distress after resettlement in Germany; however, with time, their mental health improved. The study revealed conditions that were experienced as hindrances, as well as ones that were considered to be resources of positive mental wellbeing and social resilience for resettled refugees. Resettlement challenges described by the participants were the language barrier, discrimination, unemployment, insecure residence status, loss of family and friends, conflict within the diaspora community, and isolation. The main sources of mental wellbeing and social resilience include the feeling of being welcomed by local communities, access to social services, adopting new relationships, and educational opportunities. These experiences encouraged refugees to have a favorable view of their lives and futures and were also found to facilitate better integration and adaptation. Understanding refugee mental wellbeing and social resilience requires a multidimensional perspective. Eritrean refugees living in Germany have experienced and are still experiencing resettlement challenges, such as, for example, loss of family and friends, negative perception of the German system, loss of past achievements, or unemployment. However, they have developed adaptive and resilience mechanisms, as well, such as seeing an opportunity for a better life, adopting new roles, and accepting Germany as a "second home". In addressing those issues reported by the refugees as hindrances, these could be turned into sources of mental wellbeing and resilience.


Assuntos
Refugiados , Emprego/psicologia , Eritreia , Nível de Saúde , Humanos , Saúde Mental , Refugiados/psicologia , Adulto Jovem
10.
AIDS ; 36(13): 1887-1890, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36172872

RESUMO

The ECEE Network Group investigated early provision of HIV care to war refugees migrating from Ukraine in Central and Eastern Europe (CEE) through an online survey. Fourteen countries admitting war refugees from Ukraine on March 31, 2022, completed the survey. Most centers (86%) organized provision of same day antiretroviral therapy (ART) for at least 30 days (77%), but indicated that it may affect the local HIV care. CEE countries put effective emergency mechanisms, which need continuation with international support.


Assuntos
Infecções por HIV , Refugiados , Europa (Continente) , Europa Oriental , Infecções por HIV/tratamento farmacológico , Humanos , Ucrânia/epidemiologia
11.
PLoS One ; 17(9): e0273650, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36084096

RESUMO

BACKGROUND: The purpose of this cross-sectional study was to determine the extent to which Congolese refugees seek health information, to identify and assess the resources used while exercising Health Information-Seeking Behavior (HISB), and to identify individual determinants that affect their HISB. METHODOLOGY: Building Bridges program participants who resided in Texas between 2017-2020, reported country of origin as Democratic Republic of Congo, and responded to HISB questions were included in this study. Four HISB questions asked about frequency seeking health information, preferred source and perceived trustworthiness of source, and frequency worrying about their health. Associations between HISB and sociodemographic factors (age, gender, education years, years in US, proficiency speaking English, marital status) were tested using Pearson chi-square or Fisher's exact tests (α≤0.05). RESULTS: Most participants (59%) reported seeking health information sometimes. Less than half (44%) of participants identified doctors as their preferred source of health information, Twenty-five percent relied on family, friends, and community leaders, and 23% used media sources. Doctors were identified as the most trustworthy source (71%), family and friends were the second highest trusted source (25%), whereas media sources were the least trusted (4%). Sociodemographic factors age (p = .02), gender (p < .01), and education years (p < .01) were the only significant predictors of preferred information sources. Conversely, those residing in US <5 years were more likely to seek health information more frequently (p = .01). The majority of participants did not worry about their health, and it was not significantly associated with source or frequency of seeking health information. CONCLUSIONS: The high trust in doctors represents an opportunity for healthcare professionals to educate and address individual barriers contributing to refugees' underutilization of preventive care services such as routine immunizations and preventive health screenings.


Assuntos
Comportamento de Busca de Informação , Refugiados , Estudos Transversais , Comportamentos Relacionados com a Saúde , Humanos , Inquéritos e Questionários , Confiança
12.
BMC Pediatr ; 22(1): 518, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050745

RESUMO

IMPORTANCE: Surgery is a foundational aspect to high functioning health care systems. In the wake of the Lancet Commission on Global Surgery, previous research has focused on defining the burden of surgical conditions among a pediatric population, however these studies often fail to include forced migrant or refugees. The goal of this study was to estimate the prevalence of pediatric surgical conditions among refugees in east Africa. METHODS: We used the previously validated Surgeons OverSeas Assessment of Surgical Need (SOSAS) that utilizes cross-sectional design with random cluster sampling to assess prevalence of surgical disease among participants aged 0 to 18 years in Nyarugusu refugee camp, Tanzania. We used descriptive and multivariable analyses including an average marginal effects model. RESULTS: A total of 1,658 participants were included in the study. The mean age of our sample was 8.3 ± 5.8 years. A total of 841 participants (50.7%) were male and 817 participants (49.3%) were female. A total of 513 (n = 30.9%) reported a history or presence of a problem that may be surgical in nature, and 280 (54.6%) of them reported the problem was ongoing or untreated. Overall, 16.9% had an ongoing problem that may be amenable to surgery. We found that increasing age and recent illness were associated with having a surgical problem on both our multivariable analyses. CONCLUSION: To our knowledge, this is the first and largest study of prevalence of surgical conditions among refugee children in sub-Saharan Africa. We found that over 16% (one-in-six) of refugee children have a problem that may be amenable to surgery. Our results provide a benchmark upon which other studies in conflict or post-conflict zones with refugee or forced migrant populations may be compared.


Assuntos
Refugiados , Migrantes , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Tanzânia/epidemiologia
13.
BMC Public Health ; 22(1): 1688, 2022 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068557

RESUMO

BACKGROUND: The World Health Organization (WHO) considers that the heterogeneity of concepts and definitions of migrants is an obstacle to obtaining evidence to inform public health policies. There is no recent data on the health status of only asylum seekers who have recently arrived in their Western host country. The purpose of this study was to determine the health status of asylum seekers and search for explanatory factors for this health status. METHODS: This cross-sectional observational study screened the mental and somatic health of adult asylum seekers who had arrived in France within the past 21 days and went to the Marseille single center between March 1 and August 31, 2021. In order to study the explanatory factors of the asylum seekers' health status, a multivariate analysis was performed using a logistic regression model to predict the health status. Factors taken into account were those significantly associated with outcome (level < 0.05) in univariate analysis. RESULTS: In total, 419 asylum seekers were included and 96% CI95%[93;97.3] had at least one health disorder. Concerning mental health, 89% CI95% [85.1;91.4] had a mental disorder and in terms of somatic health exclusively, 66% CI95% [61.4;70.6] had at least one somatic disorder. Women were more likely to have a somatic disease OR = 1.80 [1.07; 3.05]. We found a statistically significant association between the presence of at least one disorder and sleeping in a public space OR = 3.4 [1.02;11.28] p = 0.046. This association is also found for mental disorders OR = 2.36 [1.16;4.84], p = 0.018. CONCLUSIONS: Due to the high prevalence of health disorders our study found, asylum seekers are a population with many care needs when they arrive in their host country. The main factors linked to a poor health status seem to be related to a person's sex, geographical origin and sleeping in a public space.


Assuntos
Transtornos Mentais , Refugiados , Adulto , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Saúde Mental , Refugiados/psicologia
14.
BMC Public Health ; 22(1): 1732, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096788

RESUMO

BACKGROUND: Physical inactivity is one of the major risk factors for non-communicable diseases. Few studies about physical activity have been conducted among refugees from neighbouring countries. Given changes in the situation of Syrians, assessment of physical activity among Syrian refugees is required to understand their situation. This study aimed to evaluate the degree of self-reported physical activity and to identify perceived facilitators of and barriers to physical activity among Syrian refugees living in Amman, Jordan, in 2017. METHODS: This community-based cross-sectional study was conducted using a structured questionnaire and the short form of the International Physical Activity Questionnaire. Participants were eligible for the study if they were Syrian refugees aged 18-64 years, living in Amman city, and were either registered with the United Nations High Commissioner for Refugees, waiting for their registration, or had a service card issued by the Jordanian Ministry of Interior. The relationship between physical activity level and sex was assessed using the chi-square test and Cochran-Armitage tests. The Mann-Whitney U test was performed to assess the relationship between the median metabolic equivalent scores of physical activity and gender. Backward stepwise logistic regression analysis was used to analyse the association between predictors of physical inactivity and physical activity level. RESULTS: Among the 173 participants, the majority (91.9%) reported moderate to a high level of physical activity, and 8.1% were physically inactive. The metabolic equivalent scores for the walking activity of males (median: 1039.5, IQR: 0, 2772) was significantly higher than that of females (median: 396, IQR: 0, 1188) (p < 0.01). "Perceived change in the amount of physical activity" was a significant predictor of physical inactivity (adjusted OR = 3.00; 95%CI: 1.27-7.26). Common facilitators of physical activity were "psychological wellbeing"(49.7%) and "prevent diseases"(46.8%). The greatest barriers to physical activity were "time limitation"(43.4%) and "high cost"(57.8%). CONCLUSION: This study revealed the physical activity level among Syrian refugees in Amman. The perceived facilitators and barriers to physical activity identified among Syrian refugees were similar to those in previous studies conducted among non-refugees. These results provide a valuable baseline for future examinations of physical activity level and to verify its possible facilitators and barriers.


Assuntos
Refugiados , Estudos Transversais , Exercício Físico , Feminino , Humanos , Jordânia , Masculino , Síria
15.
BMC Public Health ; 22(1): 1739, 2022 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100895

RESUMO

BACKGROUND: Forced migration can lead to loss of social support and increased vulnerability to psychological distress of displaced individuals. The aims were to ascertain the associations of sociodemographic characteristics and social support received by resettled adult humanitarian migrants in Australia; determine the relationship between social support and mental health at different intervals following humanitarian migration; and examine the modification effects of gender, age and migration pathway on that relationship. METHODS: A secondary analysis was conducted of data generated in Waves One (three to six months after resettlement), Three (three years after resettlement) and Five (five years after resettlement) of the Building a New Life in Australia prospective cohort study. The association between sociodemographic characteristics and mental health were examined at each timepoint using a multivariate regression model. Exploratory factor analysis was used to develop a two-factor social support scale (emotional/instrumental and informational support) from a larger set of items collected in the BNLA. Psychological distress was measured by the Kessler-6 scale. Path analysis was used to analyse the relationships between social support and psychological distress among the three time points considering socio-demographic characteristics simultaneously. RESULTS: A total of 2264 participants were included in the analyses. Age, gender, birth region, migration pathway, education level and English proficiency were significantly associated with both social support types. Main source of income was only significantly associated with informational support. Remoteness area was only significantly associated with emotional/instrumental support. As emotional/instrumental support increased by one standard deviation (SD) at Wave One, psychological distress at Wave Three decreased by 0.34 score [95% CI (- 0.61; - 0.08)]. As informational support at Wave Three increased by one SD, psychological distress at Wave Five decreased by 0.35 score [95% CI (- 0.69; - 0.01)]. The relationships between social support and psychological distress varied between genders, age groups and migration pathways. CONCLUSION: Findings demonstrate the importance of emotional/instrumental support and informational support for the medium and long-term mental health of humanitarian migrants. This study also highlights the important of extending current social support provisions and tailoring programs to enhance support received by humanitarian migrant subgroups years after resettlement to improve mental health.


Assuntos
Refugiados , Migrantes , Adulto , Austrália , Feminino , Humanos , Masculino , Saúde Mental , Estudos Prospectivos , Refugiados/psicologia , Apoio Social , Estresse Psicológico/psicologia
16.
BMJ Paediatr Open ; 6(1)2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-36053652

RESUMO

OBJECTIVE: To assess variation in current practice of initial health assessments (IHAs) for unaccompanied asylum-seeking children (UASC) across England. DESIGN: Cross-sectional survey. MAIN OUTCOMES MEASURES: Type of routine assessment carried out, threshold to specialist referrals and facilities available to complete IHA. RESULTS: Eighty-six health professionals responded across England; 47% had received training in UASC IHA and 33% in UASC mental health issues. The majority (80%) of IHAs were conducted with translator support and 7% of participants reported Child and Adolescent Mental Health Services (CAMHS) input. Around half of clinicians (53%) performed tuberculosis and bloodborne virus screening for all UASC, while other infectious diseases (IDs) screening was symptom and risk factor dependent. Overall, 14% of clinicians routinely comment on age assessment and 76% share the IHA report and health plan with UASC. The time allocated for assessment range between 30 and 90 min. CONCLUSION: There is significant variation in practice around UASC IHAs across England, notably around CAMHS input, time allocated, translation facilities and ID screening. The results suggest that, an increase in resources available for UASC teams, improved access to specialist services and further training on UASC health are all needed. Guidance that aims to set a best practice framework for UASC IHA delivery such as a 'one-stop shop' model would help to standardise UASC IHA across the country.


Assuntos
Refugiados , Adolescente , Criança , Estudos Transversais , Inglaterra/epidemiologia , Hospitais Psiquiátricos , Humanos , Programas de Rastreamento , Refugiados/psicologia
18.
Health Promot Int ; 37(4)2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36102477

RESUMO

To investigate a health promotion strategy to improve oral health among former refugees in New Zealand. Former refugees were recruited (n = 63) and answered a questionnaire about their oral home care, smoking, sugar consumption and use of dental services. Participants then joined either focus group sessions to co-design oral health educational material (n = 39) or to be dentally examined for oral hygiene, periodontal health, gingivitis and dental caries and receive motivational instructions to improve their oral health habits (n = 20). Health messages using dual-language leaflets (covering oral home care, smoking, diet and access to services) were subsequently individually delivered monthly to all participants via a mobile phone application. After 6 months, follow-up questionnaires were sent to all participants and those who had been dentally examined were re-examined. Half of those who did not brush twice daily at baseline (54.1%) had increased brushing to at least twice daily by follow-up; 76.9% of those who consumed sugary drinks at least twice daily, reduced their sugar intake. No smokers quit smoking, however, 52.4% reported reducing the number of cigarettes or engaging in smoking cessation activities. Among those who had been dentally examined, plaque scores, gingivitis and periodontal pocketing all decreased significantly. Culturally and linguistically tailored oral health promotion interventions led to improved oral health behaviours for this group of former refugees over a 6 months follow-up period. We expect this to not only improve the oral health quality of life for this population, but also reduce the burden on the health system.


Refugees have high rates of oral health problems and face hardships in accessing available dental services. This project intended to promote better oral health knowledge and self-care in a group of Syrian refugees that are resettled in Dunedin, New Zealand. We recruited 63 Syrian former refugees who answered a questionnaire on their oral home care, smoking, sugar consumption and use of dental services. A group of 39 people took part in focus group meetings to help design oral health educational material in both the Arabic and English languages. The remaining 20 were dentally examined for periodontal health, dental caries, gingivitis and oral hygiene. All participants received individual monthly oral health messages taken from the leaflets designed with the focus group participants. After 6 months, the same people answered follow-up questionnaires and those who had been dentally examined were re-examined. Participants reported significantly more favourable oral health attitudes and behaviours at follow-up, and oral health among those who had been clinically examined was greatly improved. Oral health education resources tailored to the language and culture of former refugees may help to improve oral self-care and health.


Assuntos
Cárie Dentária , Gengivite , Promoção da Saúde , Refugiados , Disparidades em Assistência à Saúde , Humanos , Nova Zelândia , Saúde Bucal , Higiene Bucal , Qualidade de Vida , Síria
19.
Int J Qual Stud Health Well-being ; 17(1): 2122151, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36071676

RESUMO

PURPOSE: Families arriving in Sweden after being forced to flee their home need health care. Communication is a key component to establishing good care relations and becomes difficult when there are language barriers between families and healthcare professionals. In the context of neonatal care, communication is carried out with parents. The aim of the study was to describe parents' experiences of communication with neonatal healthcare professionals and using pictorial support when language barriers exist. METHOD: The study takes a qualitative approach based on seventeen interviews with parents who had experienced neonatal ward. Qualitative content analysis was used. RESULTS: The parents needed to communicate through supports, which caused distress and misunderstanding. The relationship between parents and the healthcare professionals affected the communication. Pictorial support was used to different degrees. Four categories were identified from the data analysis: Communicating through supports, Facing barriers in communication, Facing external influences and The need for a good healthcare relationship. CONCLUSION: The present study is the first to describe parents' experience with using the pictorial support developed in the project KomHIT Refugee and therefore fulfils the function of being a first evaluation of the pictures from parents' perspective.


Assuntos
Barreiras de Comunicação , Refugiados , Comunicação , Atenção à Saúde , Humanos , Recém-Nascido , Pais
20.
Child Abuse Negl ; 133: 105865, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36095862

RESUMO

BACKGROUND: Nearly half of the refugee and asylum seeking population in Europe is under the age of 18, and many of these individuals are unaccompanied children and adolescents. OBJECTIVE: The aim of this systematic review is both to summarize findings regarding the prevalence of mental health disorders among unaccompanied refugee minors (URM) in European countries since the last available systematic review (October 2017), and to describe associated risk factors. METHODS: Five databases were systematically searched for articles published between October 1, 2017 and May 1, 2022. RESULTS: The findings from 23 studies conducted in 9 countries which examined 80,651 child and adolescent URM are explained. Afghanistan was the most common country of origin in the majority of studies and >75 % of the subjects were boys. Most of the studies (N = 13, 56.5 %) assessed posttraumatic stress disorder (PTSD) prevalence. We found a high prevalence of mental health disorders among URM children and adolescents, which varied considerably between studies, ranging from 4.6 % to 43 % for (PTSD), 2.9 % to 61.6 % for depression, 32.6 % to 38.2 % for anxiety and 4 to14.3 % for behavioral problems. Two studies looking at suicide attempts and deaths, also observed higher rates in URM compared to the host population of the same age. The studies looking at mental health risk factors suggest that levels of social support in the host country, rearing environment, and other factors are associated with psychopathology. Moreover, a meta-analysis of four studies regarding PTSD in URM and accompanied refugee minors (ARM) showed a lower prevalence among ARM: -1.14 (95%CI:-1.56-0.72). CONCLUSIONS: PTSD, depression and anxiety are the most prevalent problems among the URM population in Europe. Early intervention in host countries is needed in order to improve mental health outcomes for this vulnerable population and avoid possible neglect.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Adolescente , Criança , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Menores de Idade/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
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