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1.
Recurso na Internet em Inglês, Espanhol, Francês, Português, Árabe, Russo, Chinês | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47088

RESUMO

Organização Mundial da Saúde apresenta dicas para enfrentar consequências psicológicas e mentais do novo coronavírus; doença está gerando estresse na população afetada pelo risco de contaminação, incerteza, isolamento social e desemprego entre outros motivos; guia contempla profissionais de saúde, crianças e idosos, líderes de equipes e pessoas em quarentena.


Assuntos
Saúde Mental/etnologia , Pandemias/prevenção & controle , Surtos de Doenças/prevenção & controle , Coronavirus , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Isolamento Social/psicologia
2.
Am J Public Health ; 110(1): 112-118, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31725330

RESUMO

Objectives. To examine if exposure to victimization (e.g., homicide, violence, sexual assault, arson, kidnapping) is related to health problems, health care access and barriers, and health needs-beyond the effects of female genital mutilation or cutting (FGM/C)-among Somali women and adolescent girls.Methods. We collected original survey data in 2017 from 879 female Somalis in Arizona.Results. Compared with nonvictims, victims experienced significantly more health problems, were significantly less likely to have a designated place to receive health care, and identified significantly more health care needs and barriers to health care. Victims were 4 times more likely to experience depression or trauma and more than twice as likely to experience sexual intercourse problems, pregnancy problems, and gynecological problems. Among Somalis with FGM/C, victims had a 15% higher predicted probability of pregnancy-related health problems and a 19% higher predicted probability of gynecological health problems compared with nonvictimized Somalis with FGM/C.Conclusions. Somalis exposed to victimization have more health problems, needs, and health care barriers.Public Health Implications. Although more than 98% of Somali women and adolescent girls have undergone FGM/C, crime victimization affects health more than FGM/C alone.


Assuntos
Circuncisão Feminina/etnologia , Vítimas de Crime/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Violência/etnologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Saúde Mental/etnologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Somália/etnologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/etnologia , Adulto Jovem
3.
BMC Public Health ; 19(1): 1521, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727039

RESUMO

BACKGROUND: Improving the rates of, and instruments used in, screening for perinatal depression and anxiety among Aboriginal and Torres Strait Islander women are important public health priorities. The Kimberley Mum's Mood Scale (KMMS) was developed and later validated as an effective and acceptable perinatal depression and anxiety screening tool for the Kimberley region under research conditions. Other regions have expressed interest in using the KMMS with perinatal Aboriginal and Torres Strait Islander women. It is, however, important to re-evaluate the KMMS in a larger Kimberley sample via a real world implementation study, and to test for applicability in other remote and regional environments before recommendations for wider use can be made. This paper outlines the protocol for evaluating the process of implementation and establishing the 'real world' validity and acceptability of the KMMS in the Kimberley, Pilbara and Far North Queensland in northern Australia. METHODS: The study will use a range of quantitative and qualitative methods across all sites. KMMS validation/revalidation internal consistency of Part 1 will be determined using Cronbach's alpha. Equivalence for identifying risk of depression and anxiety compared to a standard reference assessment will be determined from receiver operating characteristic curves. Sensitivity and specificity will be determined based on these cut-points. Qualitative methods of phenomenology will be used to explore concepts of KMMS user acceptability (women and health professionals). Additional process evaluation methods will collate, assess and report on KMMS quality review data, consultations with health service administrators and management, field notes, and other documentation from the research team. This information will be reported on using the Dynamic Sustainability Framework. DISCUSSION: This project is contributing to the important public health priority of screening Aboriginal and Torres Strait Islander women for perinatal depression and anxiety with tools that are meaningful and responsive to cultural and clinical needs. Identifying and addressing barriers to implementation contributes to our understanding of the complexity of improving routine clinical practie. TRIAL REGISTRATION: The study was registered retrospectively on 15/05/2019 with the Australian and New Zealand Clinical Trial registry (ACTRN12619000580178).


Assuntos
Afeto , Ansiedade/diagnóstico , Depressão/diagnóstico , Programas de Rastreamento/métodos , Saúde Mental/etnologia , Grupo com Ancestrais Oceânicos/psicologia , Assistência Perinatal/métodos , Adolescente , Adulto , Ansiedade/etnologia , Depressão/etnologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etnologia , Feminino , Humanos , Lactente , Recém-Nascido , Ilhas , Programas de Rastreamento/normas , Mães/psicologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/etnologia , Gestantes/etnologia , Gestantes/psicologia , Psicometria , Queensland , Projetos de Pesquisa , Estudos Retrospectivos , Adulto Jovem
4.
Med Care ; 57(12): 960-967, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31730568

RESUMO

OBJECTIVES: Our objectives were to assess rates of perceived stigma in health care (clinical) settings reported by racially diverse New York City residents and to examine if this perceived stigma is associated with poorer physical and mental health outcomes. METHODS: We analyzed data from the 2016 New York City Community Health Survey. We applied bivariable and multivariable methods to assess rates of perceived stigma, and perceived stigma's statistical relationship with health care access, physical health status, and mental health status controlling for sociodemographics and health insurance status. RESULTS: Perceived stigma was associated with poorer health care access [odds ratio (OR)=7.07, confidence interval (CI)=5.32-9.41), depression (OR=3.80, CI=2.66-5.43), diabetes (OR=1.86, CI=1.36-2.54), and poor overall general health (OR=0.43, CI=0.33-0.57). Hispanic respondents reported the highest rate of perceived stigma among racial and ethnic minority groups (mean=0.07, CI=0.05-0.08). CONCLUSIONS: We found that perceived stigma in health care settings was a potential barrier to good health. Prior studies have illustrated that negative health outcomes are common for patients who avoid or delay care; thus, the unfortunate conclusion is that even in a diverse, heterogeneous community, stigma persists and may negatively affect well-being. Therefore, eliminating stigma in clinical settings should be a top priority for health care providers and public health professionals seeking to improve health equity.


Assuntos
Grupos de Populações Continentais/psicologia , Acesso aos Serviços de Saúde , Nível de Saúde , Saúde Mental/etnologia , Estigma Social , Adolescente , Adulto , Idoso , Atitude do Pessoal de Saúde , Depressão/etnologia , Diabetes Mellitus/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Fatores Socioeconômicos , Adulto Jovem
5.
PLoS Med ; 16(9): e1002908, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31539373

RESUMO

BACKGROUND: Mental illness stigma is a fundamental barrier to improving mental health worldwide, but little is known about how to durably reduce it. Understanding of mental illness as a treatable medical condition may influence stigmatizing beliefs, but available evidence to inform this hypothesis has been derived solely from high-income countries. We embedded a randomized survey experiment within a whole-population cohort study in rural southwestern Uganda to assess the extent to which portrayals of mental illness treatment effectiveness influence personal beliefs and perceived norms about mental illness and about persons with mental illness. METHODS AND FINDINGS: Study participants were randomly assigned to receive a vignette describing a typical woman (control condition) or one of nine variants describing a different symptom presentation (suggestive of schizophrenia, bipolar, or major depression) and treatment course (no treatment, treatment with remission, or treatment with remission followed by subsequent relapse). Participants then answered questions about personal beliefs and perceived norms in three domains of stigma: willingness to have the woman marry into their family, belief that she is receiving divine punishment, and belief that she brings shame on her family. We used multivariable Poisson and ordered logit regression models to estimate the causal effect of vignette treatment assignment on each stigma-related outcome. Of the participants randomized, 1,355 were successfully interviewed (76%) from November 2016 to June 2018. Roughly half of respondents were women (56%), half had completed primary school (57%), and two-thirds were married or cohabiting (64%). The mean age was 42 years. Across all types of mental illness and treatment scenarios, relative to the control vignette (22%-30%), substantially more study participants believed the woman in the vignette was receiving divine punishment (31%-54%) or believed she brought shame on her family (51%-73%), and most were unwilling to have her marry into their families (80%-88%). In multivariable Poisson regression models, vignette portrayals of untreated mental illness, relative to the control condition, increased the risk that study participants endorsed stigmatizing personal beliefs about mental illness and about persons with mental illness, irrespective of mental illness type (adjusted risk ratios [ARRs] varied from 1.7-3.1, all p < 0.001). Portrayals of effectively treated mental illness or treatment followed by subsequent relapse also increased the risk of responses indicating stigmatizing personal beliefs relative to control (ARRs varied from 1.5-3.0, all p < 0.001). The magnitudes of the estimates suggested that portrayals of initially effective treatment (whether followed by relapse or not) had little moderating influence on stigmatizing responses relative to vignettes portraying untreated mental illness. Responses to questions about perceived norms followed similar patterns. The primary limitations of this study are that the vignettes may have omitted context that could have influenced stigma and that generalizability beyond rural Uganda may be limited. CONCLUSIONS: In a population-based, randomized survey experiment conducted in rural southwestern Uganda, portrayals of effectively treated mental illness did not appear to reduce endorsement of stigmatizing beliefs about mental illness or about persons with mental illness. These findings run counter to evidence from the United States. Further research is necessary to understand the relationship between mental illness treatment and stigmatizing attitudes in Uganda and other countries worldwide. TRIAL REGISTRATION: The experimental procedures for this study were registered with ClinicalTrials.gov as "Measuring Beliefs and Norms About Persons With Mental Illness" (NCT03656770).


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Preconceito/etnologia , Opinião Pública , População Rural , Estereotipagem , Adolescente , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/etnologia , Saúde Mental/etnologia , Pessoa de Meia-Idade , Recidiva , Religião e Medicina , Vergonha , Resultado do Tratamento , Uganda , Adulto Jovem
6.
Med Care ; 57(10): 773-780, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415338

RESUMO

INTRODUCTION: Colorectal cancer (CRC) is a common but largely preventable malignancy. Screening is recommended for all adults aged 50-75 years; however, screening rates are low nationally and vary by patient factors and across health care systems. It is currently unknown whether there are inequities in CRC screening rates by patient sociodemographic and/or clinical factors in the Veterans Health Administration (VA) where the majority of patients are CRC screening-eligible age and CRC is the third most commonly diagnosed cancer. METHODS: We performed a retrospective cohort study using VA national clinical performance and quality data to determine the overall CRC screening rate, rates by patient sociodemographic and clinical factors, and predictors of screening adjusting for patient and system factors. We also determined whether disparities in screening exist in VA. RESULTS: The overall CRC screening rate in VA was 81.5%. Screening rates were lowest among American Indians/Alaska Natives [75.3%; adjusted odds ratio (aOR)=0.77, 95% confidence interval (CI)=0.65-0.90], those with serious mental illness (75.8%; aOR=0.65, 95% CI=0.61-0.69), those with substance abuse (76.9%; aOR=0.76, 95% CI=0.72-0.80), and those in the lowest socioeconomic status quintile (79.5%; aOR=1.10-1.31 for quintiles 2-5 vs. lowest quintile 1). Increasing age, Hispanic ethnicity, black race, Asian race, and high comorbidity were significant predictors of screening uptake. CONCLUSIONS: Many racial/ethnic disparities in CRC screening documented in non-VA settings do not exist in VA. Nonetheless, overall high VA CRC screening rates have not reached American Indians/Alaska Natives, low socioeconomic status groups, and those with mental illness and substance abuse. These groups might benefit from additional targeted efforts to increase screening uptake.


Assuntos
Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Saúde dos Veteranos/estatística & dados numéricos , Idoso , Neoplasias Colorretais/etnologia , Neoplasias Colorretais/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Disparidades em Assistência à Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Saúde Mental/etnologia , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Pobreza/etnologia , Pobreza/estatística & dados numéricos , Estudos Retrospectivos , Fatores Socioeconômicos , Estados Unidos , United States Department of Veterans Affairs , Saúde dos Veteranos/etnologia
7.
Infant Ment Health J ; 40(5): 640-658, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31335984

RESUMO

Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision-making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18-64) of the International Latino Research Partnership (ILRP) study. We used descriptive and inferential statistics to compare immigrant mothers of minor children to those without, regarding their psychological and reproductive health, and correlates of past exposure to sexual trauma. Over one third (38%) of ILRP participants had minor children, and 58% had citizenship in their host country. The rate for sexual assault was 30 and 61%, respectively, for physical assault; these rates were similarly high for women with and without minor children. Women who reported sexual assault scored significantly higher for depression, posttraumatic stress disorder, and substance-abuse screens. Odds of experiencing sexual assault was highest for women who experienced physical assault (odds ratio = 10.74), and for those from the Northern Triangle (odds ratio = 8.41). Subgroups of Latina migrant mothers are vulnerable to traumatic stress and related sexual and mental health risks. Given these findings, we frame the implications in a reproductive justice framework and consider consequences for caregiver-child well-being.


Assuntos
Emigração e Imigração , Mães/psicologia , Saúde Sexual/etnologia , Transtornos Relacionados a Trauma e Fatores de Estresse , Adulto , Feminino , Hispano-Americanos/psicologia , Humanos , Lactente , Bem-Estar do Lactente , Saúde Mental/etnologia , Saúde Reprodutiva/etnologia , Fatores de Risco , Justiça Social , Transtornos Relacionados a Trauma e Fatores de Estresse/etnologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Estados Unidos , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologia
8.
Infant Ment Health J ; 40(5): 742-756, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31291015

RESUMO

Effecting a paradigm shift from "reproductive health" to "reproductive justice" within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient-provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.


Assuntos
Assistência à Saúde Culturalmente Competente , Pessoal de Saúde , Relações Profissional-Paciente/ética , Racismo/prevenção & controle , Encaminhamento e Consulta , Diversidade Cultural , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/organização & administração , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/normas , Humanos , Lactente , Saúde do Lactente/etnologia , Saúde Mental/etnologia , Pesquisa em Avaliação de Enfermagem , Gravidez , Encaminhamento e Consulta/ética , Encaminhamento e Consulta/normas , Estados Unidos , Populações Vulneráveis/etnologia
9.
Int J Soc Psychiatry ; 65(6): 496-506, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288604

RESUMO

BACKGROUND: Resilience, or an individual's positive response in managing life's adversities, is of increasing interest in addressing the mental health disparities in refugees. Although the link between stressful life events and poor mental health is established, research on the role of resilience on the mental health of refugees is limited. AIMS: This study assessed the association between resilience and anxiety or depression in resettled Bhutanese adults in Western Massachusetts. METHODS: A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 residing in Massachusetts. Resilience was measured with the 25-item Wagnild and Young's Resilience Scale including two constructs as follows: a 17-item 'personal competence' that measures self-reliance, independence, determination, resourcefulness, mastery and perseverance and an 8-item 'acceptance of self and life' that measures adaptability, flexibility and a balanced perspective of life. Higher total scores indicate greater resilience. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ⩾1.75 for moderate to severe symptoms. Associations of resilience with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses. RESULTS: The proportion of participants with above threshold anxiety and depression were 34.2% and 24%, respectively. Resilience was inversely associated with both anxiety (beta for 1 unit change in resilience scores: ß = -0.026; p = .037) and depression (ß = -0.036, p = .041). 'Personal competence' resilience was inversely associated with both anxiety (ß = -0.041 p = .017) and depression (ß = -0.058, p = .019), but 'acceptance of self and life' resilience was not. Participants with the highest tertile of resilience scores had a significantly decreased risk of anxiety (ORs (95% CI): 0.13 (0.04-0.40)) and depression (0.16 (0.04-0.60)). CONCLUSION: Higher resilience was associated with reduced anxiety and depression among Bhutanese with personal competence resilience accounting for most of the effects. These findings suggest the potential targets for mental-health intervention to improve resilience in refugees.


Assuntos
Ansiedade/etnologia , Depressão/etnologia , Saúde Mental/etnologia , Refugiados/psicologia , Resiliência Psicológica , Adulto , Butão/etnologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Escalas de Graduação Psiquiátrica , Apoio Social , Transtornos de Estresse Pós-Traumáticos/etnologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31174399

RESUMO

The healthy migrant effect and its impact on mental health has been reported in the general population of many countries. Information is limited about its impact on working populations. The aim of this study is to estimate the incidence of common mental disorders over a one-year follow-up period among a cohort of Colombian and Ecuadorian employees in Spain, taking into account the duration of residence and comparing with Spanish-born workers. Data was from the Longitudinal Studies on Immigrant Families Project (PELFI), a follow-up survey of immigrants and Spanish-born workers interviewed in 2015 and 2016. Mental health was assessed using the 12-item general health questionnaire (GHQ-12). Crude and adjusted odds ratios (ORas) for common mental disorders by sociodemographic and employment characteristics were created. There were differences for immigrants with time of residence less than or equal to 15 years (time of residence 11-15 years: ORa = 0.06, 95% CI = (0.26-0.01); time of residence 1-10 years: ORa = 0.06, 95% CI = (0.36-0.01)). There was evidence of a healthy immigrant worker effect, as newer arrivals from Ecuador and Columbia to Spain had a lower incidence of common mental disorders than either the Spanish-born or immigrant workers who had lived in Spain for more than 15 years.


Assuntos
Emigrantes e Imigrantes/psicologia , Transtornos Mentais/etnologia , Saúde Mental/etnologia , Adolescente , Adulto , Idoso , Colômbia/etnologia , Equador/etnologia , Emprego , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores Socioeconômicos , Espanha/epidemiologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
11.
Int J Circumpolar Health ; 78(1): 1629783, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31219779

RESUMO

The impacts of colonization have had significant impacts on the mental health and community wellness Indigenous peoples in the Northwest Territories (NWT). It is important that all communities in the NWT have access to key services in a culturally relevant way in achieving mental and community wellness. A scoping review was conducted to identify mental health services available in the NWT. To guide the understanding of the landscape of mental health services in the NWT, the information on health services gathered was organized using the First Nations Mental Wellness Continuum (FNMWC) Model's Continuum of Essential Services. Documents accessed included grey literature, consisting of government documents, practice guidelines, education materials, community wellness reports, internet searches and expert consult interviews to collect data on mental health and wellness services in the NWT. 68 mental health services were included in this review, from 23 different sources. Results were summarized and described the Continuum of Essential Services from the FNMWC Model. This guided approach was found to be useful for mapping mental health services for communities in the NWT. The findings highlight and catagorize existing mental health services and gaps in relation to a First Nation's perspective using the FNMWC Model. Specific areas examined included the Continuum of Essential Services, Key Partners, Culture as a Foundation, and Indigenous Social Determinants of Health. Findings can guide communities and health authorities in planning, implementing and coordinating a full range of optimized mental health services in the NWT.


Assuntos
Comportamento Aditivo/terapia , Competência Cultural/organização & administração , Serviços de Saúde do Indígena/organização & administração , Serviços de Saúde Mental/organização & administração , Saúde Mental/etnologia , Regiões Árticas , Comportamento Aditivo/etnologia , Comportamento Aditivo/reabilitação , Promoção da Saúde/organização & administração , Serviços de Saúde do Indígena/normas , Humanos , Inuítes , Territórios do Noroeste , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Saúde Pública , Resiliência Psicológica , Serviços de Saúde Rural
12.
Soc Psychiatry Psychiatr Epidemiol ; 54(10): 1199-1207, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31055631

RESUMO

OBJECTIVE: The aim of this study was to investigate the prevalence of serious psychological distress (SPD), depression, and suicidal ideation in an adult Indigenous population in Panamá. METHODS: Data were collected from 211 Kuna adults using a paper-based survey. Depression and suicidal ideation were measured using the Patient Health Questionnaire (PHQ-9), and SPD was measured using the Kessler-6. Univariate analyses were used to describe demographic variables, followed by chi2 tests to compare differences in demographic variables for each of the mental health outcomes (depression, serious psychological distress, suicidal ideation). A regression model, adjusted for all demographic variables, was then run for each mental health outcome to understand independent correlates. RESULTS: Within the sample surveyed, 6.2% (95% CI 3.4-10.4) reported serious psychological distress, 32.0% (95% CI 25.7-38.9) reported depression, and 22.9% (95% CI 17.4-29.1) reported suicidal ideation. Significant demographic differences existed with 14% of individuals between the age of 60-90 and 17% of individuals with no education reporting SPD. Women were nearly 5 times more likely to report depression than men (OR 4.90, 95% CI 1.27-19.00) and those with higher incomes were less likely to report depression (OR 0.32, 95% CI 0.13-0.78). CONCLUSION: High levels of depression, SPD, and suicidal ideation were present in an Indigenous Kuna community in Panamá. Women and individuals with low income were more likely to report depression, and SPD was more common in older individuals and those with low levels of education. Suicidal ideation was high across all demographic factors, suggesting that a community-wide program to address suicide may be warranted.


Assuntos
Depressão/epidemiologia , Grupos Populacionais/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Ideação Suicida , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Depressão/etnologia , Depressão/psicologia , Feminino , Humanos , Renda , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Panamá/epidemiologia , Pobreza/etnologia , Prevalência , Fatores de Risco , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Suicídio/etnologia , Suicídio/psicologia , Inquéritos e Questionários
13.
J Gerontol Nurs ; 45(6): 44-56, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31135936

RESUMO

Lack of physical activity is particularly problematic among U.S. Latino older adults. There is substantial evidence linking physical activity and well-being. However, associations between physical activity and positive psychological well-being among this population have never been studied or measured. Physical activity was compared to five positive psychological well-being measures based on the PERMA model. Secondary data analysis was completed on a sample of 68 Latino American individuals, age 60 and older, compared to 72 non-Hispanic White older adults. Overall, physical activity was positively associated with positive psychological well-being despite race. Pain, functional limitations, and physical restrictions did not moderate the relationship between physical activity and positive psychological well-being among Latino and non-Hispanic White older adults. Further research is needed to clarify whether physical activity and psychological well-being are perceived similarly or differently within various cultures. [Journal of Gerontological Nursing, 45(6), 44-56.].


Assuntos
Exercício Físico , Nível de Saúde , Hispano-Americanos/psicologia , Saúde Mental/etnologia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estilo de Vida , Masculino , Fatores Socioeconômicos , Estados Unidos
14.
Medicine (Baltimore) ; 98(18): e15337, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045774

RESUMO

BACKGROUND: The prevalence of mental health problems in medical students has continuously increased and is higher than the prevalence of mental health problems in students with other majors, which could lead to undesirable consequences for the students and their future patients. In China, the current states of medical education and healthcare workplaces differ in certain areas from those in Western or other Asian countries. However, the mental health status of Chinese medical students has not been systematically analyzed. OBJECTIVES: The purpose of this meta-analysis was to summarize the prevalence of mental health problems in Chinese medical students. METHODS: All cross-sectional studies that investigated the prevalence of any mental health problem among Chinese medical students were retrieved from the following databases: EMBASE, PubMed, PsycINFO, OVID, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. We accepted each individual trial's inclusion and exclusion criteria for participants. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was adopted to appraise the methodological quality of each study. RevMan (version 5.3) was used to analyze the data. RESULTS: Ten cross-sectional studies involving a total of 30,817 Chinese medical students were included. The prevalence of depression, anxiety, suicidal ideation, and eating disorders were 29%, 21%, 11%, and 2%, respectively. Subgroup analysis revealed no significant differences in the prevalence of depression and suicidal ideation between genders and no significant difference in the prevalence of depression between individuals of different ages (20 years and older or younger than 20 years). CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Chinese medical students have relatively high prevalence of depression, anxiety, and suicidal ideation but a low prevalence of eating disorders. Mental health problems in Chinese medical students should be taken seriously, and timely screening of and proper intervention in these mental health problems are highly recommended.


Assuntos
Transtornos Mentais/epidemiologia , Saúde Mental/etnologia , Saúde Mental/estatística & dados numéricos , Estudantes de Medicina/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Educação Médica/normas , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Prevalência , Estudantes de Medicina/estatística & dados numéricos , Ideação Suicida , Local de Trabalho/normas , Adulto Jovem
15.
Issues Ment Health Nurs ; 40(8): 672-681, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31081707

RESUMO

The purpose of this research was to examine the psychometric properties of the Giscombe Superwoman Schema Questionnaire. Three separate studies conducted with 739 African American women provided preliminary evidence that the Questionnaire's factor structure aligns with the Superwoman Schema Conceptual Framework and has good reliability. In addition, it is positively associated with perceived stress, depressive symptoms, using food to cope with stress, poor sleep quality, and physical inactivity. This study provides preliminary evidence to suggest that the Giscombe Superwoman Schema Questionnaire is psychometrically sound; Superwoman Schema is associated with health behaviors and psychological states that may increase risk for illness.


Assuntos
Afro-Americanos/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Saúde Mental/etnologia , Adaptação Psicológica , Adulto , Depressão/diagnóstico , Depressão/etnologia , Depressão/psicologia , Exercício Físico , Feminino , Grupos Focais , Humanos , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Sono , Estresse Psicológico/diagnóstico , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
16.
Int J Circumpolar Health ; 78(1): 1607502, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31023174

RESUMO

The North faces significant health disparities, especially among its many Indigenous peoples. In this article we discuss historical, environmental, and cultural variables that contribute to these disparities and propose a One Health approach to address them in a holistic and culturally appropriate manner. The One Health paradigm recognizes the interdependence among the health and well-being of people, animals and the environment. As such, the framework aligns well with many Indigenous world views. This proactive, interdisciplinary, constructivist, and collaborative approach promise earlier detection of risks and threats, as well as more effective responses, in part by engaging community level stakeholders in all stages of the process. In the far North, humans, especially Indigenous peoples, continue to live closely connected to their environment, in settings that exert significant impacts on health. In recent decades, rapid warming and elevated contaminant levels have heightened environmental risks and increased uncertainty, both of which threaten individual and community health and well-being. Under these circumstances especially, One Health's comprehensive approach may provide mitigating and adaptive strategies to enhance resilience. While many of the examples used in this manuscript focus on Alaska and Canada, the authors believe similar conditions exist among the indigenous and rural residents across the entire Circumpolar North.


Assuntos
Nativos do Alasca , Características Culturais , Meio Ambiente , Inuítes , Saúde Única , Alaska , Animais , Regiões Árticas , Canadá , Mudança Climática , Comportamento Cooperativo , Humanos , Saúde Mental/etnologia , Fatores de Risco , Meio Social , Fatores Socioeconômicos , Zoonoses/epidemiologia
17.
BMC Pregnancy Childbirth ; 19(1): 120, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31023259

RESUMO

BACKGROUND: Intimate partner violence (IPV) during pregnancy is associated with adverse maternal and child health outcomes, including poor mental health. Previous IPV research has largely focused on women's victimization experiences; however, evidence suggests young women may be more likely to engage in bilateral violence (report both victimization and perpetration) or perpetrate IPV (unilateral perpetration) during pregnancy than to report being victimized (unilateral victimization). This study examined prevalence of unilateral victimization, unilateral perpetration, and bilateral violence, and the association between these IPV profiles and mental health outcomes during pregnancy among young, low-income adolescents. METHODS: Survey data were collected from 930 adolescents (14-21 years; 95.4% Black and Latina) from fourteen Community Health Centers and hospitals in New York City during second and third trimester of pregnancy. Multivariable regression models tested the association between IPV profiles and prenatal depression, anxiety, and distress, adjusting for known predictors of psychological morbidity. RESULTS: Thirty-eight percent of adolescents experienced IPV during their third trimester of pregnancy. Of these, 13% were solely victims, 35% were solely perpetrators, and 52% were engaged in bilateral violence. All women with violent IPV profiles had significantly higher odds of having depression and anxiety compared to individuals reporting no IPV. Adolescents experiencing bilateral violence had nearly 4-fold higher odds of depression (OR = 3.52, 95% CI: 2.43, 5.09) and a nearly 5-fold increased likelihood of anxiety (OR = 4.98, 95% CI: 3.29, 7.55). Unilateral victims and unilateral perpetrators were also at risk for adverse mental health outcomes, with risk of depression and anxiety two- to three-fold higher, compared to pregnant adolescents who report no IPV. Prenatal distress was higher among adolescents who experienced bilateral violence (OR = 2.84, 95% CI: 1.94, 4.16) and those who were unilateral victims (OR = 2.21, 95% CI: 1.19, 4.12). CONCLUSIONS: All violent IPV profiles were associated with adverse mental health outcomes among pregnant adolescents, with bilateral violence having the most detrimental associations. Comprehensive IPV screening for both victimization and perpetration experiences during pregnancy is warranted. Clinical and community prevention efforts should target pregnant adolescents and their partners to reduce their vulnerability to violence and its adverse consequences. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00628771 . Registered 29 February 2008.


Assuntos
Violência por Parceiro Íntimo , Saúde Mental , Gravidez/psicologia , Gestantes/psicologia , Adolescente , Feminino , Infecções por HIV/prevenção & controle , Humanos , Saúde Mental/etnologia , Cidade de Nova Iorque/epidemiologia , Gestantes/etnologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-30897849

RESUMO

Using data from a representative sample of Chinese adults who were surveyed in the Hong Kong Panel Study of Social Dynamics (HKPSSD), we estimate the effects of neighborhood discrimination towards immigrants from Mainland China on the mental health of Chinese residents in Hong Kong. Contrary to our expectations, discrimination towards immigrants from Mainland China measured at the neighborhood level is not associated with the poor mental health of post-1997 immigrants; instead, a higher level of immigrant discrimination is associated with a lower level of psychological distress for both post-1997 Mainland immigrants and other Chinese residents in Hong Kong. A functional family also appears to be a consistent predictor of better mental health for both groups. Our findings, therefore, suggest that immigrant discrimination can signify a prejudice that leads to social distance or avoidance and that the post-1997 Mainland immigrants do not have extensive contact with other local residents in Hong Kong. Although local residents' discriminatory attitudes may not result in aggressive behaviors that have a negative impact on newcomers' mental health, the social distance between the immigrants and the local residents is still an issue that requires further research and practical attention.


Assuntos
Emigrantes e Imigrantes/psicologia , Saúde Mental/etnologia , Preconceito/psicologia , Adulto , Agressão , Grupo com Ancestrais do Continente Asiático/psicologia , China , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
20.
Lancet Psychiatry ; 6(4): 305-317, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30846354

RESUMO

BACKGROUND: Evidence suggests that black, Asian and minority ethnic (BAME) groups have an increased risk of involuntary psychiatric care. However, to our knowledge, there is no published meta-analysis that brings together both international and UK literature and allows for comparison of the two. This study examined compulsory detention in BAME and migrant groups in the UK and internationally, and aimed to expand upon existing systematic reviews and meta-analyses of the rates of detention for BAME populations. METHODS: For this systematic review and meta-analysis, we searched five databases (PsychINFO, MEDLINE, Cochrane Controlled Register of Trials, Embase, and CINAHL) for quantitative studies comparing involuntary admission, readmission, and inpatient bed days between BAME or migrant groups and majority or native groups, published between inception and Dec 3, 2018. We extracted data on study characteristics, patient-level data on diagnosis, age, sex, ethnicity, marital status, and occupational status, and our outcomes of interest (involuntary admission to hospital, readmission to hospital, and inpatient bed days) for meta-analysis. We used a random-effects model to compare disparate outcome measures. We assessed explanations offered for the differences between minority and majority groups for the strength of the evidence supporting them. This study is prospectively registered with PROSPERO, number CRD42017078137. FINDINGS: Our search identified 9511 studies for title and abstract screening, from which we identified 296 potentially relevant full-text articles. Of these, 67 met the inclusion criteria and were reviewed in depth. We added four studies after reference and citation searches, meaning 71 studies in total were included. 1 953 135 participants were included in the studies. Black Caribbean patients were significantly more likely to be compulsorily admitted to hospital compared with those in white ethnic groups (odds ratio 2·53, 95% CI 2·03-3·16, p<0·0001). Black African patients also had significantly increased odds of being compulsorily admitted to hospital compared with white ethnic groups (2·27, 1·62-3·19, p<0·0001), as did, to a lesser extent, south Asian patients (1·33, 1·07-1·65, p=0·0091). Black Caribbean patients were also significantly more likely to be readmitted to hospital compared with white ethnic groups (2·30, 1·22-4·34, p=0·0102). Migrant groups were significantly more likely to be compulsorily admitted to hospital compared with native groups (1·50, 1·21-1·87, p=0·0003). The most common explanations for the increased risk of detainment in BAME populations included increased prevalence of psychosis, increased perceived risk of violence, increased police contact, absence of or mistrust of general practitioners, and ethnic disadvantages. INTERPRETATION: BAME and migrant groups are at a greater risk of psychiatric detention than are majority groups, although there is variation across ethnic groups. Attempts to explain increased detention in ethnic groups should avoid amalgamation and instead carry out culturally-specific, hypothesis-driven studies to examine the numerous contributors to varying rates of detention. FUNDING: University College London Hospitals National Institute for Health Research (NIHR) Biomedical Research Centre, NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, King's College London, and NIHR Collaboration for Leadership in Applied Health Research and Care North Thames at Bart's Health NHS Trust.


Assuntos
Política de Saúde , Disparidades em Assistência à Saúde/etnologia , Tratamento Psiquiátrico Involuntário/legislação & jurisprudência , Saúde Mental/etnologia , Grupos Étnicos , Humanos , Internacionalidade , Reino Unido
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