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1.
PLoS One ; 14(12): e0226342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851709

RESUMO

BACKGROUND: Older women perform consistently poorer on physical performance tests compared to men. Risk groups for this "female disadvantage" in physical performance and it's development over successive birth cohorts are unknown. This is important information for preventive strategies aimed to enhance healthy aging in all older women. This study aims to longitudinal investigate whether there are risk groups for a more apparent female disadvantage and study its trend over successive birth cohorts. METHODS: Data of the Longitudinal Aging Study Amsterdam (LASA) were used. All participants were aged 55-65 years at baseline. Longitudinal data of two birth cohorts with baseline measurements in 1992/1993 (n = 966, 24 year follow-up) and 2002/2003 (n = 1002, 12 year follow-up) were included. Follow-up measurements were repeated every three/four years. Cross-sectional data of two additional cohorts were included to compare ethnic groups: a Dutch cohort (2012/2013, n = 1023) and a Migration cohort (2013/2014, n = 478) consisting of migrants with a Turkish/Moroccan ethnicity. RESULTS: Mixed model analysis showed that women aged 55 years and older had a lower age- and height-adjusted gait speed (-0.03 m/s; -0.063-0.001), chair stand speed (-0.05 stand/s; -0.071--0.033), handgrip strength (-14,8 kg; -15.69--13.84) and balance (OR = 0.71; 0.547-0.916) compared to men. The sex difference in handgrip strength diminished with increasing age, but remained stable for gait speed, chair stand speed and balance. In general, results were consistent across different, educational levels and Turkish/Moroccan ethnic groups and birth cohorts. CONCLUSIONS: There is a consistent "female disadvantage" in physical performance among older adults, which remains stable with increasing age (except for handgrip strength) and is consistent across different educational levels, ethnic groups and successive birth cohorts. So, no specific risk groups for the female disadvantage in physical performance were identified. Preventive strategies aimed to enhance healthy aging in older women are needed and should target all older women.


Assuntos
Envelhecimento , Escolaridade , Desempenho Físico Funcional , Caracteres Sexuais , Idoso , Envelhecimento/etnologia , Estatura , Estudos de Coortes , Grupos Étnicos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , Países Baixos , Turquia/etnologia
2.
Fortschr Neurol Psychiatr ; 87(9): 504-510, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519026

RESUMO

BACKGROUND: Neuropsychological dementia diagnosis of migrants are limited regarding the testing of cognitive abilities as well as the recording of everyday activities (Activities of Daily Living, ADL) such as linguistic, educational, lifestyle and cultural-religious factors have not been taken into account in psychometric instruments. AIM OF THE STUDY: We aimed to develop a culturally sensitive ADL scale, which is suitable for both German people and Turkish migrants that takes into consideration gender, cultural-religious and lifestyle aspects. A further aim was to determine the quality criteria for the newly proposed ADL scale. METHODS: After the initial phase, including qualitative interviews (N = 15) with cognitively unimpaired German participants and Turkish migrants, a first version of the ADL instrument was developed. This version was then completed by cognitively unimpaired Germans (n = 197) and Turkish participants (n = 53) and the shortened ADL scale was generated based on an item analysis. It consisted of the three subscales 'cognition', 'Basic Activities of Daily Living (BADL)' and 'Instrumental Activities of Daily Living (IADL)'. For Turkish participants, questions about Islamic prayers were added. Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS) were applied to rule out cognitive impairment and depression. The 'Bayer-ADL' was used to measure the validity of the scale. RESULTS: The everyday life of Germans and Turkish migrants differs in aspects of religious practice and in terms of sociocultural activities, which are taken into account in the CC-ADL. The reliability of the new ADL scale in terms of internal consistency (Cronbach's alpha) were regarding 'cognition' α = .43 for Germans and α = .80 for Turkish migrants; 'BADL' α = .55 for Germans and α = -.04 for Turkish migrants; 'IADL' α = .91 for Germans and α = .83 for Turkish migrants and α = .73 for Turkish migrants under the 'prayer items'. The correlation of the ADL total score with the Bayer ADL for Germans was ρ = .347 (p < .00) and for the Turkish sample ρ = .520 (p < .01). CONCLUSION: The development of a final version of the CC-ADL scale requires further data from healthy participants and patients (Mild Cognitive Impairment and dementia).


Assuntos
Atividades Cotidianas , Competência Cultural , Demência/diagnóstico , Demência/psicologia , Emigrantes e Imigrantes/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Alemanha , Humanos , Estilo de Vida/etnologia , Masculino , Testes Neuropsicológicos , Religião e Psicologia , Reprodutibilidade dos Testes , Turquia/etnologia
3.
BMC Public Health ; 19(1): 1228, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488086

RESUMO

BACKGROUND: The few previous studies investigating acculturation and self-management have suggested that increased participation in (or adaptation to) the host culture is associated with better health and disease management. However, research on the relationship between acculturation strategies (attachment to the Dutch and Turkish cultures) and broader self-management abilities among older Turkish immigrants in the Netherlands is lacking. This study aimed to investigate this relationship in this population. METHODS: Turkish immigrants aged > 65 years and residing in Rotterdam, the Netherlands (n = 2350), were identified using the municipal register. In total, 680 respondents completed the questionnaire (32% response rate). RESULTS: The average age of the respondents was 72.90 (standard deviation, 5.02; range, 66-95) years and 47.6% of respondents were women. The majority (80.3%) of respondents reported having low educational levels. Women, single individuals, less-educated respondents, and those with multimorbidity experienced lower levels of attachment to the Dutch culture and reported poorer self-management abilities. Slightly stronger relationships were found between self-management and attachment to the Dutch culture than attachment to the Turkish culture. Multimorbidity negatively affected the self-management abilities of older Turkish people living in the Netherlands. CONCLUSIONS: The study findings indicate that especially attachment to the Dutch culture matters for the self-management abilities of older Turkish immigrants in the Netherlands. Given the high prevalence of multimorbidity in this population, investment in their self-management abilities is expected to be beneficial. Special attention is needed for women, single individuals, less-educated people, and those with multimorbidity. Interventions aiming to better integrate these groups into Dutch society are also expected to be beneficial for their self-management abilities.


Assuntos
Aculturação , Emigrantes e Imigrantes/psicologia , Autogestão , Idoso , Idoso de 80 Anos ou mais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Masculino , Países Baixos , Inquéritos e Questionários , Turquia/etnologia
4.
Work ; 63(3): 457-467, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31322585

RESUMO

BACKGROUND: Given that shift work spreads across many different business sectors, studies of its adverse effects are very topical. Much research has been done on the negative impact of shift work, but many researchers have not focused on its impact in a multicultural environment. OBJECTIVE: The aim of this study was to map out how shift work is perceived by workers in two different shift regimes and two national groups. METHODS: The research was carried out on Czech manufacturing workers and Turkish airport ground personnel using a questionnaire. The impact of shift work was studied from physical, mental, social and health aspects with connection to family status and gender. For statistical evaluation, Pearson's chi-squared test of independence was used. The effect of shift work on workers' performance and scrap rate was analysed only on the sample of the manufacturing workers. RESULTS: Fifty-five Czech male workers, 49 Turkish male workers and 60 Turkish female workers participated in the survey. The dependence between sexes was confirmed for mental aspects and sleeping routines. The main difference between nationalities is in work attitude, social aspects and sleeping routines. According to the family status, the difference was confirmed in all areas except social aspects. The lowest values of productivity and the highest scrap rate were observed on night shifts and the maximum productivity and lowest scrap rates were observed on afternoon shifts. CONCLUSIONS: Some of the basic assumptions were confirmed which suggests that a multicultural environment has an influence on the perception of shift work by the nations and gende.


Assuntos
Diversidade Cultural , Jornada de Trabalho em Turnos/efeitos adversos , Adolescente , Adulto , República Tcheca/epidemiologia , República Tcheca/etnologia , Humanos , Masculino , Indústria Manufatureira/métodos , Indústria Manufatureira/normas , Pessoa de Meia-Idade , Jornada de Trabalho em Turnos/psicologia , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Transtornos do Sono do Ritmo Circadiano/etnologia , Transtornos do Sono do Ritmo Circadiano/etiologia , Inquéritos e Questionários , Turquia/epidemiologia , Turquia/etnologia , Tolerância ao Trabalho Programado/psicologia , Local de Trabalho/psicologia , Local de Trabalho/normas
5.
BMC Public Health ; 19(1): 701, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170950

RESUMO

BACKGROUND: Parental support is an important element in overweight prevention programs for children. The purpose of this study was to examine everyday life situations in which mothers encounter difficulties encouraging healthy energy balance-related behavior in their school-age children. METHODS: We formed four focus groups containing 6-9 participants each. The participants were mothers of Dutch, Turkish, or Moroccan descent with a child 8-13 years of age. All focus group sessions were recorded, transcribed, and coded. Content was analyzed conventionally using ATLAS.ti 6. RESULTS: Twenty-seven difficult everyday life situations were identified in 14 settings. The five most frequently reported situations were a daily struggle regarding eating vegetables, eating breakfast on time before going to school, eating candy and snacks between meals, and spending excessive time watching television and using the computer. A perceived loss of parental control, the inability to establish rules and the failure to consistently enforce those rules were the most commonly cited reasons for why the mothers experience these situations as being difficult. CONCLUSIONS: We identified five difficult everyday life situations related to healthy energy balance-related behavior. These five difficult situations were used as the input for developing a web-based parenting program designed to prevent children from becoming overweight. We reasoned that if we use these situations and the underlying reasons, many parents would recognize these situations and are willing to learn how to deal with them and complete the e-learning.


Assuntos
Comportamento Infantil/psicologia , Comportamentos Relacionados com a Saúde , Mães/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Adolescente , Adulto , Atitude Frente a Saúde , Criança , Comportamento Infantil/etnologia , Ingestão de Alimentos/psicologia , Feminino , Grupos Focais , Humanos , Masculino , Refeições/psicologia , Marrocos/etnologia , Países Baixos/etnologia , Sobrepeso/prevenção & controle , Sobrepeso/psicologia , Poder Familiar/etnologia , Percepção , Turquia/etnologia
6.
Medicine (Baltimore) ; 98(18): e15412, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045797

RESUMO

BACKGROUND: Hepatitis B virus (HBV) infection is an important public health problem in the Turkish population, that is, one of the largest migrant populations in Europe. With the introduction of cost-effective antiviral treatments in the past decade, there is a need to identify HBV-infected patients who may benefit from treatment. This study describes the design of a study to assess the HBV prevalence in the Turkish population living in Belgium. Additionally, we will determine the risk factors of HBV infection and the uptake of screening, vaccination, and antiviral treatment in this hard-to-reach Turkish population. METHODS: A longitudinal, epidemiological study will be conducted in the region Middle Limburg Belgium, where the Turkish adult population, 18 years of age and older, will be screened for hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), and antibodies against hepatitis B core antigen (anti-HBc). Educational meetings concerning viral hepatitis B will be organized and there will be 3 ways to be screened for HBV: immediately after the educational meetings, at the Outpatient Hepatology Department of Ziekenhuis Oost-Limburg, and at home visits. Subsequently, participants will be asked to fill in a questionnaire regarding sociodemographic factors, migration history, risk factors for HBV infection (e.g., sharing toothbrushes, HBV-infected family member), and HBV vaccination status. Six months after screening, HBsAg-positive patients will be assessed whether they are under follow-up at the general practitioner or hepatologist. We will also gather information regarding the uptake of vaccination in nonimmunized subjects. DISCUSSION: This study will provide information about the HBV prevalence and distribution of the stages of liver disease in the Turkish population in Belgium. By determining the risk factors for HBV infection, subgroups with an increased prevalence of HBV infection can be identified. CLINICAL TRIAL NUMBER: This clinical trial is registered at clinicaltrials.gov (NCT03396458).


Assuntos
Emigrantes e Imigrantes , Hepatite B/diagnóstico , Hepatite B/etnologia , Programas de Rastreamento/organização & administração , Adolescente , Adulto , Idoso , Antivirais/uso terapêutico , Bélgica/epidemiologia , Métodos Epidemiológicos , Feminino , Educação em Saúde/organização & administração , Hepatite B/tratamento farmacológico , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Turquia/etnologia , Vacinas contra Hepatite Viral/administração & dosagem , Adulto Jovem
7.
Psychiatry Res ; 275: 71-77, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30878859

RESUMO

More suicidal ideation and higher rates of attempted suicide are found in Turkish people when compared with the general population in Europe. Acculturation processes and related distress may explain an elevated risk of suicide. The current study investigates the association between acculturation and suicidal ideation among Turkish migrants in the Netherlands. The mediating effect of hopelessness and moderating effect of secure attachment are also examined. A total of 185 Turkish migrants living in the Netherlands were recruited through social media and through liaison with community groups. They completed an online survey including validated measures of suicidal ideation, hopelessness, acculturation and attachment style. Mediation and moderation analyses were tested using bootstrapping. Higher participation was associated with less hopelessness and less suicidal ideation. Greater maintenance of one's ethnic culture was associated with higher hopelessness and higher suicidal ideation. Greater participation was associated with less suicidal ideation particularly amongst those with less secure attachment styles. Turkish migrants who participate in the host culture may have a lower risk of developing suicidal thinking. Participation may protect against suicidal thinking, particularly among those with less secure attachment styles.


Assuntos
Aculturação , Ideação Suicida , Tentativa de Suicídio/psicologia , Migrantes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Negociação/psicologia , Países Baixos/etnologia , Autoimagem , Tentativa de Suicídio/etnologia , Tentativa de Suicídio/prevenção & controle , Inquéritos e Questionários , Turquia/etnologia , Adulto Jovem
8.
BMC Nephrol ; 20(1): 45, 2019 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-30732569

RESUMO

BACKGROUND: Nephrotic syndrome (NS) is one of the most frequent occurring chronic kidney diseases in childhood, despite its rarely occurrence in the general population. Detailed information about clinical data of NS (e.g. average length of stay, complications) as well as of secondary nephrotic syndrome (SNS) is not well known. METHODS: A nationwide ESPED follow-up study presenting the clinical course and management of children with NS in Germany. RESULTS: In course of 2 years, 347 children developed the first onset of NS, hereof 326 patients (93.9%) had a primary NS, and 19 patients had a SNS (missing data in 2 cases), the majority due to a Henoch-Schönlein Purpura. Patients with steroid-resistant NS (SRNS) stayed significantly longer in hospital than children with steroid-sensitive NS (25.2 vs. 13.3 d, p <  0.001). Patients with bacterial/viral infections stayed longer in hospital (24.9 d/19.5d) than children without an infection (14.2 d/14.9 d; p <  0.001; p = 0.016). Additionally, children with urinary tract infections (UTI) (p < 0,001), arterial hypertension (AH) (p < 0.001) and acute renal failure (ARF) (p < 0,001) stayed significantly longer in hospital. Patients with SRNS had frequent complications (p = 0.004), such as bacterial infections (p = 0.013), AH (p < 0.001), UTI (p < 0.001) and ARF (p = 0.007). Children with a focal segmental glomerulosclerosis (FSGS) had significantly more complications (p = 0.04); specifically bacterial infections (p = 0.01), UTI (p = 0.003) and AH (p < 0,001). Steroid-resistance was more common in patients with UTI (p < 0.001) and in patients with ARF (p = 0.007). Furthermore, steroid-resistance (p < 0.001) and FSGS (p < 0.001) were more common in patients with AH. CONCLUSIONS: This nationwide, largest German study presents results on the clinical course of children with NS considering a diverse range of complications that can occur with NS. The establishment of a region-wide and international pediatric NS register would be useful to conduct further diagnostic and therapy studies with the aim to reduce the complication rate and to improve the prognosis of NS, and to compare the data with international cohorts.


Assuntos
Síndrome Nefrótica/terapia , Adolescente , Corticosteroides/uso terapêutico , Fatores Etários , Criança , Criança Hospitalizada/estatística & dados numéricos , Pré-Escolar , Comorbidade , Resistência a Medicamentos , Feminino , Seguimentos , Alemanha/epidemiologia , Glomerulosclerose Segmentar e Focal/epidemiologia , Glomerulosclerose Segmentar e Focal/terapia , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Lactente , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Masculino , Síndrome Nefrótica/epidemiologia , Turquia/etnologia
9.
BMC Public Health ; 19(1): 181, 2019 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-30755186

RESUMO

BACKGROUND: The "Latina paradox" describes the unexpected association between immigrant status, which is often correlated to low socioeconomic status, and low prevalence of unfavourable birth outcomes. Social (e.g. culture, religion) and/or non-social factors related to country of origin are potentially responsible for this paradox. METHODS: Questionnaire survey of 6413 women delivering in three large obstetric hospitals in Berlin (Germany) covering socioeconomic and migration status, country of origin (Turkey, Lebanon), and acculturation. Data was linked with routine obstetric data. Logistic regressions were performed to assess the effect of acculturation, affinity to religion and country of origin on preterm birth and small-for-gestational-age (SGA). RESULTS: Immigrant women with a low level of acculturation (reference) were less likely to have a preterm birth than those who were highly acculturated (aOR: 1.62, 95%CI: 1.01-2.59), as were women from Turkey compared to non-immigrants (aOR: 0.49, 95%CI: 0.33-0.73). For SGA, we found no epidemiologic paradox; conversely, women from Lebanon had a higher chance (aOR: 1.72, 95%CI: 1.27-2.34) of SGA. Affinity to religion had no influence on birth outcomes. CONCLUSIONS: There is evidence that low acculturation (but not affinity to religion) contributes towards explaining the epidemiologic paradox with regard to preterm birth, emphasising the influence of socioeconomic characteristics on birth outcomes. The influence of Turkish origin on preterm birth and Lebanese origin on SGA suggests that non-social factors relating to the country of origin are also at play in explaining birth outcome differences, and that the direction of the effect varies depending on the country of origin and the outcome.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Recém-Nascido Pequeno para a Idade Gestacional , Nascimento Prematuro/epidemiologia , Aculturação , Adolescente , Adulto , Feminino , Alemanha/epidemiologia , Maternidades , Humanos , Recém-Nascido , Líbano/etnologia , Gravidez , Fatores Socioeconômicos , Inquéritos e Questionários , Turquia/etnologia , Adulto Jovem
10.
Soc Psychiatry Psychiatr Epidemiol ; 54(3): 343-353, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30643926

RESUMO

PURPOSE: Research shows that the prevalence of psychiatric problems is higher in ethnic minority youth compared to native youth. This school-based screening study of early adolescents' mental health in the Netherlands examined differences in prevalence of psychotic experiences in ethnic minority youth compared to their Dutch peers. Moreover, we investigated the association between psychotic experiences, ethnic identity, and perceived discrimination. METHODS: A cohort of 1194 ethnic majority and minority adolescents (mean age 13.72, SD 0.63) filled-out questionnaires on psychotic experiences (including delusional and hallucinatory experiences), perceived group and personal discrimination, and ethnic identity. RESULTS: Apart from lower levels of hallucinatory experiences in Turkish-Dutch adolescents, prevalence of psychotic experiences did not differ between ethnic minority and majority adolescents. Perceived personal discrimination was associated with the presence of psychotic experiences (including delusional and hallucinatory experiences) (OR 2.30, 95% CI 1.22-4.34). This association was stronger for delusional experiences (OR 2.94, 95% CI 1.43-6.06) than for hallucinatory experiences (OR 1.65, 95% CI 0.73-3.72). No significant associations were found between perceived group discrimination and psychotic experiences. A weak ethnic identity was associated with higher risk for reporting psychotic experiences (OR 2.04, 95% CI 1.14-3.66), particularly hallucinatory experiences (OR 3.15, 95% CI 1.54-6.44). When looking at specific ethnic identity categories, marginalization, compared to separation, was associated with a threefold risk for reporting psychotic experiences (OR 3.26, 95% CI 1.33-8.03). Both marginalisation (OR 3.17, 95% CI 1.04-9.63) and assimilation (OR 3.25, 95% CI 1.30-8.13) were associated with a higher risk for hallucinatory experiences. CONCLUSIONS: These results underline the protective effect of ethnic identity against mental health problems. Future research should focus on interventions that focus on strengthen social identity.


Assuntos
Delusões/etnologia , Transtornos Mentais/etnologia , Saúde Mental , Racismo , Identificação Social , Adolescente , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Grupos Minoritários/estatística & dados numéricos , Países Baixos/epidemiologia , Grupo Associado , Prevalência , Inquéritos e Questionários , Turquia/etnologia
11.
BMC Public Health ; 19(1): 119, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691420

RESUMO

BACKGROUND: Vitamin D levels may differ between migrant and non-migrant populations, especially among non-western immigrants living in a country with limited sun exposure such as Germany. This study examined serum vitamin D concentration and associated factors among Berliners with and without Turkish background. METHODS: Two samples (with and without Turkish roots) were recruited in the inner city of Berlin for a cross-sectional study assessing serum vitamin D concentration. Linear regression analyses were used to examine sociodemographic, lifestyle and medical factors associated with serum vitamin D levels. RESULTS: In the analyses, we included 537 subjects (39% men and 61% women, age 43.2 ± 12.5 (mean ± standard deviation) years) with and 112 without Turkish background (46% men and 54% women, age 46.7 ± 14.6 years). The Turkish sample had lower mean (95%-Confidence Interval) vitamin D levels than the non-Turkish sample: 22.7 nmol/L (21.5;23.9) vs 34.7 nmol/L (31.9;37.5), p < 0.001. In the Turkish female subgroup, veiled women had considerably lower levels than unveiled women: 14.4 nmol/L (11.5;17.3) vs 24.9 nmol/L (23.1;26.7), p < 0.001. Multivariable regression analysis revealed that among the Berliners of Turkish descent, being active less than 150 min per day, and being overweight/obese were independently associated with a lower vitamin D concentration. In the non-migrant sample besides being overweight and obese, female sex was associated with lower vitamin D concentrations. CONCLUSIONS: Serum vitamin D levels were considerably low in Berliners of Turkish descent, and especially in veiled women. Potentially modifiable factors of low vitamin D levels were high BMI and low physical activity. These findings should be considered in the development of future public health strategies for subpopulations with Turkish migration background.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Adulto , Berlim/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Migrantes/estatística & dados numéricos , Turquia/etnologia , Deficiência de Vitamina D/epidemiologia
12.
J Affect Disord ; 247: 134-155, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30665076

RESUMO

BACKGROUND: This study examined the state of the art relevant for clinical practice on symptom manifestation of depression or depression-related idioms of distress, the treatment effectiveness and obstacles and facilitators for therapeutic success in Turkish and Moroccan immigrant populations with depression in Europe. METHODS: We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases (1970- 31 July 2017). Peer-reviewed studies, with adult populations, and an instrument assessing depressive symptoms met inclusion criteria and were evaluated following quality guidelines. RESULTS: We included 13 studies on symptom manifestation, 6 on treatment effectiveness, and 17 on obstacles and facilitators, published between 2000 and 2017, from Germany, the Netherlands, Austria and Sweden (n Turkish individuals = 11,533; n Moroccan individuals = 5278; n native individuals = 303,212). Both ethnic groups more often reported combined mood and somatic symptoms (and anxiety in the case of Turkish groups) than natives, and had higher levels of symptoms. There was no report on effectiveness of pharmacotherapy and there was weak evidence of the effectiveness of examined psychological treatments for depression in Turkish groups. No treatment has been examined in Moroccan groups. Salient obstacles to therapeutic success were socioeconomic problems, higher level of psychological symptoms at baseline, and negative attitudes towards psychotherapy. Possible facilitators were interventions attuned to social, cultural and individual needs. Results were most representative of first generation, low SES Turkish immigrant patients, and Moroccan-Dutch members of the general populations. CONCLUSION: Turkish and Moroccan immigrants with depression presented a comorbid symptom profile with more intertwined depressive and somatic complaints. There were indications that the available therapies are insufficient for Turkish groups, but the current evidence is scarce and heterogeneous, and RCTs suffer from methodological limitations.


Assuntos
Depressão/etnologia , Transtorno Depressivo/etnologia , Emigrantes e Imigrantes/psicologia , Grupos Étnicos/psicologia , Psicoterapia/estatística & dados numéricos , Adulto , Áustria , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Europa (Continente) , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , Países Baixos , Psicoterapia/métodos , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Suécia , Resultado do Tratamento , Turquia/etnologia
14.
BMC Health Serv Res ; 19(1): 7, 2019 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-30611262

RESUMO

BACKGROUND: The number of older adults with different ethnic and socioeconomic background is steadily increasing. There is a need for community-based health promotion interventions for older adults that are responsive to ethnic and socioeconomic diversity among target populations. The aim of this study is to explore encounters between older adults living in disadvantaged areas and health care professionals in the context of community-based health promotion. METHODS: Qualitative methods were used involving interviews and focus groups with older adults (n = 22) and municipal health care professionals (n = 8), and multiple observations were conducted. Data were analyzed thematically. RESULTS: Findings show a gap between health promotion services and older adults due to a perception of services as being neither accessible nor acceptable in the context of complex health and psychosocial needs. Health care professionals reported trust, proximity and presence as fundamental factors for improving acceptability and accessibility of health promotion services. CONCLUSIONS: There is a need to develop participatory approaches to engage older adults who live in disadvantaged areas in municipal health promotion services and to ensure that these services are relevant to these groups.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Promoção da Saúde/métodos , Envelhecimento Saudável/fisiologia , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Dinamarca/etnologia , Grupos Étnicos , Feminino , Grupos Focais , Pessoal de Saúde , Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Visita Domiciliar/estatística & dados numéricos , Humanos , Masculino , Paquistão/etnologia , Áreas de Pobreza , Turquia/etnologia , Populações Vulneráveis/estatística & dados numéricos
15.
BMC Pregnancy Childbirth ; 19(1): 1, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606156

RESUMO

BACKGROUND: Cesarean rates are higher in women admitted to labor ward during early stages rather than at later stages of labor. In a study in Germany, crude cesarean rates among Turkish and Lebanese immigrant women were low compared to non-immigrant women. We evaluated whether these immigrant women were admitted during later stages of labor, and if so, whether this explains their lower cesarean rates. METHODS: We enrolled 1413 nulliparous women with vertex pregnancies, singleton birth, and 37+ week of gestation, excluding elective cesarean deliveries, in three Berlin obstetric hospitals. We applied binary logistic regression to adjust for social and obstetric factors; and standardized coefficients to rank predictors derived from the regression model. RESULTS: At the time of admission to labor ward, a smaller proportion of Turkish migrant women was in the active phase of labor (cervical dilation: 4+ cm), compared to women of Lebanese origin and non-immigrant women. Rates of cesarean deliveries were lower in women of Turkish and Lebanese origin (15.8 and 13.9%) than in non-immigrant women (23.9%). In the logistic regression analysis, more advanced cervical dilatation was inversely associated with the outcome cesarean delivery (OR: 0.76, 95%CI: 0.70-0.82). In addition, higher maternal age (OR: 1.06, 95%CI: 1.04-1.09), application of oxytocic agents (OR: 0.55, 95%CI: 0.42-0.72), and obesity (OR: 2.25, 95%CI: 1.51-3.34) were associated with the outcome. Ranking of predictors indicate that cervical dilatation is the most relevant predictor derived from the regression model. CONCLUSIONS: Advanced cervical dilatation at the time of admission to labor ward does not explain lower emergency cesarean delivery rates in Turkish and Lebanese migrant women, despite the fact that this is the strongest among the predictors for emergency cesarean delivery identified in this study.


Assuntos
Cesárea/estatística & dados numéricos , Primeira Fase do Trabalho de Parto/fisiologia , Trabalho de Parto/fisiologia , Admissão do Paciente/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Berlim/epidemiologia , Feminino , Humanos , Líbano/etnologia , Modelos Logísticos , Idade Materna , Pessoa de Meia-Idade , Paridade , Gravidez , Fatores de Risco , Fatores de Tempo , Turquia/etnologia , Adulto Jovem
16.
Z Gerontol Geriatr ; 52(4): 336-341, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-29728825

RESUMO

BACKGROUND: Traditional municipal services are not successful at reaching Turkish seniors. Compared to native Germans Turkish seniors have a lower social participation. OBJECTIVE: Do native language groups hosted by a German organization promote the social participation of Turkish seniors? How does social participation take place in the ZWAR networks (between work and retirement; a project to strengthen social participation of seniors) and which factors promote or reduce social participation? MATERIAL AND METHODS: Qualitative structuring content analysis of two group discussions, which were based on guided interviews. RESULTS: The social participation of Turkish-speaking seniors was strengthened on three levels: (1) through regular meetings of the Turkish ethnic group social relationships were promoted and German language skills and other skills were improved. Through mutual sharing and understanding of the stressors specific to migration, emotional support was provided. The sharing of mutual cultural and linguistic backgrounds created a sense of community and meetings were perceived as an antidote to migrants' exhausting lives in German society. (2) At the organizational level, participation was promoted through extensive group events. Regardless of their cultural background all participants identified as equal ZWAR members. The ZWAR project functioned as an umbrella organization for participation in the intercultural context. (3) Participation in community events created contacts with community stakeholders and fostered volunteer work. Hence, participants were able to use their skills, and therefore broaden their horizons. CONCLUSION: Turkish ZWAR networks promoted the social participation of members because integration with their ethnic group reduced access barriers, broadened members' scopes of action, and created new opportunities for participation.


Assuntos
Participação da Comunidade/métodos , Relações Interpessoais , Participação Social , Apoio Social , Migrantes/psicologia , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Compreensão , Alemanha , Humanos , Entrevistas como Assunto , Linguagem , Pesquisa Qualitativa , Aposentadoria , Rede Social , Turquia/etnologia
17.
Gesundheitswesen ; 81(8-09): 621-628, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-29890515

RESUMO

BACKGROUND: Recruitment of participants from all population groups is a known challenge in social epidemiological research. A multitude of potentially useful strategies for the recruitment of ethnic minorities and certain migrant groups have been proposed. However, existing publications have not answered the question whether such strategies are applicable to a birth cohort study in Germany. The aim of the present study was to present recruitment strategies for migrants in a birth cohort using the example of the BaBi study. METHODS: As a preparatory step, focus group discussions were conducted with pregnant and postpartum women and structured interviews with midwives and gynecologists in order to assess suitability of study information materials, questionnaires and language preferences. The pilot study, conducted from October 2013 to October 2016, tested different recruitment strategies. The entire recruitment period was accompanied by continuous evaluation in order to assess and adapt the process to ensure successful recruitment of migrants. RESULTS: Of the 980 participants, 390 had a migration background (40%). Both active and passive recruitment strategies were explored in which Turkish language translations and multicultural personnel were used. Passive recruitment via gynecological practices and midwives required pregnant women to have high levels of motivation. Active recruitment in postnatal wards (where women were approached by study nurses after birth) increased the proportion of participants with a migration background from 22 to 49%. Early monitoring of our recruitment strategy thus enabled us to improve participation rates. CONCLUSION: For recruitment of women with a migration background, it is crucial to use both careful preparation in the form of qualitative measures (focus groups, structured interviews) and a pilot study. Extra resources should be planned from the beginning for diverse recruitment strategies and a higher personnel demand (e. g., for translations and back translations). Efforts for the inclusions of migrants in social epidemiological studies in Germany should be a routine process.


Assuntos
Emigrantes e Imigrantes , Seleção de Pacientes , Gestantes , Estudos de Coortes , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Alemanha , Humanos , Grupos Minoritários , Projetos Piloto , Gravidez , Turquia/etnologia
18.
Psychol Rep ; 122(2): 731-747, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29558867

RESUMO

Antonovsky's concept "sense of coherence" (SOC) and the related measurement instrument "The Orientation to Life Questionnaire" (OLQ) has been widely applied in studies on health and well-being. The purpose of the present study is to investigate the cultural differences in factor structures and psychometric properties as well as mean scores of the 13-item form of Antonovsky's OLQ among Australian (n = 201), Finnish (n = 203), and Turkish (n = 152) students. Three models of factor structure were studied by using confirmatory factor analysis: single-factor model, first-order correlated-three-factor model, and the second-order three-factor model. Results obtained in all three countries suggest that the first- and second-order three-factor models fitted the data better that the single-factor model. Hence, the OLQ scoring based on comprehensibility, manageability, and meaningfulness scales was supported. Scale reliabilities and inter-correlations were in line with those reported in earlier studies. Two-way analyses of variance (gender × nationality) with age as a covariate showed no cultural differences in SOC scale scores. Women got higher scores on the meaningfulness scale than men, and age was positively related to all SOC scale scores indicating that SOC increases in early adulthood. The results support the three-factor model of OLQ which thus should be used in Australia, Finland, and Turkey instead of a single-factor model. Need for cross-cultural studies taking into account cultural correlates of SOC and its relation to health and well-being indicators as well as studies on gender differences in the OLQ are emphasized.


Assuntos
Atitude , Comparação Transcultural , Psicometria/normas , Senso de Coerência , Comportamento Social , Percepção Social , Adulto , Austrália/etnologia , Feminino , Finlândia/etnologia , Humanos , Masculino , Turquia/etnologia , Adulto Jovem
19.
Psychother Psychosom Med Psychol ; 69(5): 176-181, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-29653459

RESUMO

AIM: The present study compares the attitude towards psychotherapy of persons living in Germany with or without Turkish background. In this context, gender-related, disorder-specific and sociodemographic differences in openness towards psychotherapy are taken into account. METHODS: Individuals of Turkish origin (n=129) and individuals without migration background (n=129) were interviewed with the Questionnaire on Attitudes towards Psychotherapeutic Treatment, the Social Support Questionnaire, a short version of the Symptom-Checklist with the subscales anxiety, depression and somatization, and a sociodemographic questionnaire. RESULTS: The attitude towards psychotherapy is less positive in Turkish migrants than in people without migration background. Females, depressive individuals, persons with high social support, with children and a high level of education are more open towards psychotherapy. DISCUSSION: The attitude towards psychotherapy is influenced by gender, socio-demographic and disorder-specific factors and in particular by cultural factors. CONCLUSION: These results elucidate the need for better information about psychotherapy and the development of intercultural consulting services for migrants in Germany.


Assuntos
Atitude , Cultura , Emigrantes e Imigrantes/psicologia , Psicoterapia , Adulto , Comparação Transcultural , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Inquéritos e Questionários , Migrantes , Turquia/etnologia
20.
J Immigr Minor Health ; 21(4): 811-819, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30027505

RESUMO

Migrants are often poorly represented in epidemiological studies which limits the generalizability of the results of population-based studies. This study aimed to assess whether a community-based sampling (CBS) of persons of Turkish origin leads to differences in the participants' characteristics compared to a register-based sampling (RBS). The two sampling strategies were used to recruit participants in three cities in Germany (CBS: n = 641; RBS: n = 578). We compared sociodemographic, migration- and health-related characteristics. Census data were used as an external reference. Lower German language skills and a lower acculturation status were more prevalent in the CBS than in the RBS. While age and sex adjusted obesity prevalence differed [CBS: 37.8 (33.6-42.4); RBS 30.0 (26.3-34.0); census data 19.1 (18.2-20.1)], most other health indicators were similar across the samples. In conclusion, the CBS approach led to a greater representation of persons of Turkish origin with lower language skills and lower acculturation status. Nevertheless, both recruitment strategies provided similar estimates of health status indicators.


Assuntos
Aculturação , Métodos Epidemiológicos , Indicadores Básicos de Saúde , Migrantes , Feminino , Alemanha/epidemiologia , Humanos , Linguagem , Masculino , Obesidade/epidemiologia , Prevalência , Viés de Seleção , Turquia/etnologia
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