Health-related quality of life and sense of coherence among Polish immigrants in Germany and indigenous Poles

Quality of Life and Sense of Coherence in Cancer Patients of German, Turkish and Polish Origin-A Cross-Sectional Study

BACKGROUND

Due to a variety of symptoms and side-effects of cancer treatment, quality of life can be considerably impaired in cancer patients. Especially, cancer patients with a migration background seem to be at risk. The objective of our study is to investigate the quality of life and sense of coherence in adult cancer patients of German, Turkish and Polish origin.

METHODS

We assessed sociodemographic, migration-specific and cancer-related parameters. Quality of life was measured via the EORTC QLQ-C30, sense of coherence was measured with the SOC-13.

RESULTS

We included 227 patients in the study (59.5% native Germans, 40.5% with migration background). Native Germans did not differ in quality of life compared to all migrants. However, more nausea and vomiting (NV) and higher appetite loss (AP) was found in Turkish migrants compared to Polish migrants and native Germans. For sense of coherence, we observed significantly higher scores for native Germans compared to all migrants. Turkish migrants had significantly lower scores compared to native Germans.

CONCLUSIONS

A Turkish migration background seems to play an important role in the perception of symptoms, especially of nausea and vomiting and appetite loss. Culture-specific aspects should be considered in cancer care.

Impact of new country, discrimination, and acculturation-related factors on depression and anxiety among ex-Soviet Jewish migrants: data from a population-based cross-national comparison study

Migration, displacement, and flight are major worldwide phenomena and typically pose challenges to mental health. Therefore, migrants' mental health, and the factors which may predict it, have become an important research subject. The present population-based cross-national comparison study explores symptoms of depression, anxiety, and somatization, as well as quality-of-life in samples of ex-Soviet Jewish migrants settling in three new countries: Germany, Austria and Israel, as well as in a sample of non-migrant ex-Soviet Jews in their country of origin, Russia. In the current study, we investigate the relationship of perceived xenophobiа and antisemitism, acculturation attitudes, ethnic and national identity, as well as affiliation with Jewish religion and culture to the psychological well-being of these migrants. Furthermore, we consider xenophobic and antisemitic attitudes as well as the acculturation orientation of the new countries' societies, assessed in the native control samples. Our data suggest that attitudes of the new country's society matter for the mental health of this migrant group. We conclude that the level of distress among ex-Soviet Jewish migrants seems to depend, among other factors, on the characteristics of the new country and/or specific interactions of the migrant population with the society they are settling in.

Acculturation, Adaptation, and Health among Croatian Migrants in Austria and Ireland: A Cross-Sectional Study

Since Croatia joined the European Union, majority of the studies on Croatian emigrants have predominantly addressed the reasons for migration and their future predictions. The primary purpose of this study was to investigate the relationship between the sense of coherence, health behavior, acculturation, adaptation, perceived health, and quality of life (QoL) in first-generation Croatian migrants living in Austria and Ireland. Our study is the first study that addresses the perceived health and QoL of Croatian migrants since the last emigration wave in 2013. An online survey was conducted in Austria (n = 112) and Ireland (n = 116) using standardized questionnaires. Multiple linear regression analyses were conducted for emigrated Croats to identify the predictors of perceived health and QoL. The analyses revealed that the sense of coherence and psychological adaptation were the strongest predictors of perceived health and QoL in Austria and Ireland. Furthermore, in the environmental domain of QoL, a higher education, higher net income, life in Austria rather than Ireland, better health behavior, higher sense of coherence, and better psychological and sociocultural adaptation explained 55.9% of the variance. Health policies and programs should use the salutogenic model to improve the health-related quality of life and psychological adaptation of Croatian migrants.

Religiosity, perceived anti-Semitism, xenophobia and mental health: Experiences of Jewish immigrants from the former Soviet Union in Austria and Germany

Research about the relation between migration and mental health as well as factors influencing the mental health of migrants has been growing because challenges of migration can constitute a significant mental health burden. However, its divergent findings seem to reflect group-specific differences, e.g., regarding country of origin and receiving country. Almost no empirical studies about individual migrant groups in different receiving countries have been undertaken so far. The present population-based study explores symptoms of depression, anxiety, and somatization as well as quality of life in an Austrian and a German sample of ex-Soviet Jewish migrants. We mainly investigate the relationship of religiosity and perceived xenophobic and anti-Semitic discrimination to the psychological condition of the migrants. Standardized self-report scales, specifically the Beck-Depression-Inventory-II (BDI), State-Trait-Anxiety-Inventory (STAI), Brief Symptom Inventory (BSI), and WHO Quality of Life Questionnaire (WHOQOL-BREF), were used to measure mental health. Ex-Soviet Jewish migrants in Austria showed significantly more symptoms of depression than those in Germany. Regression analyses support a protective effect of religiosity on mental health in the sample in Germany and an adverse effect of perceived discrimination in the sample in Austria. The present study reveals a less favorable situation for ex-Soviet Jewish migrants in Austria, in terms of income, residence status, and xenophobic attitudes in the local population, compared to the group in Germany. Furthermore, our data suggest that the receiving country matters for the mental health of this migrant group. However, further research is needed to support these conclusions.

The Cyprus Women’s Health Research (COHERE) initiative: normative data from the SF-36v2 questionnaire for reproductive aged women from the Eastern Mediterranean

Purpose

Describe the health-related quality of life for a representative cohort of women aged 18–55 in Northern Cyprus.

Methods

We utilised the SF-36-Health-Survey-version-2 (SF-36v2) questionnaire as part of the COHERE Initiative study to calculate the eight physical and mental subscale scores, as well as the two overall summary measures for physical and mental health, where we present results using Cyprus-specific scoring as well as scores based on the test developers’ algorithms. We examined associations between sociodemographic characteristics for both scores.

Results

A total of 7089 women fully completed the SF-36v2 questionnaire (mean age = 36.9), which was reliable and valid in this population. We observed better physical health in ages 18–25 compared to 46–55 (53.32 vs. 46.72 (p < 0.001)) and better mental health in women aged 46–55 compared to 18–25 (52.07 vs. 47.95 (p < 0.001)). Women in employment had better physical and mental health compared to those who were unemployed (physical: 50.25 vs 49.95, p < 0.001 and mental: 50.25 vs 49.24, p = 0.083) and scores increased as educational attainment increased (physical: 47.55 for primary to 51.58 for postgraduate, mental: 48.88 to 50.59, p < 0.001). Turkish Cypriot women had higher scores than Turkish women (physical: 50.42 vs 49.30, mental: 50.43 vs 49.10, p < 0.001).

Conclusion

These are the first population normative values published from a large representative sample of women between 18 and 55 years from the Eastern Mediterranean region. We found better physical health in younger women and better mental health in older women. Turkish Cypriot women and non-migrant women had better mental health, and HRQOL was highest in those in paid employment and those with a higher educational achievement.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-022-03100-7.

Towards Understanding Post-Socialist Migrants’ Access to Physical Activity in the Nordic Region: A Critical Realist Integrative Review

Experiences of, and access and barriers to, physical activity (PA) differ between individuals. This becomes perpetuated in a migration context. Although there is super-diversity between migrant groups, health research rarely accounts for this cultural diversity. More concerningly, the matter of context is rarely scrutinized or juxtaposed with the specifics of certain ethnic groups. This integrative review assessed the evidence on post-socialist migrants’ PA levels, constraints, and enablers for PA in the Nordic region. The results show that post-socialist female migrants have an especially high risk of being physically inactive. The qualitative work elucidates socio-cultural factors that impose specific constraints on females when attempting to engage in PA. Furthermore, in scrutinizing the context, Nordic nature (Friluftsliv) is a viable way for migrants to access PA with additional health benefits (e.g., mental). However, the Nordic environment also poses specific PA challenges, such as harsh winters. This can be understood by considering post-socialist migrants’ prior use of, and attitude to, nature. The review highlights the importance of understanding specifics about both migrant groups and contexts through a critical-realist lens in the pursuit of providing PA opportunities. Future PA programs need to understand the contextual, sociohistorical, and cultural settings in which they and migrants are embedded.

Health Care Services Utilization of Persons with Direct, Indirect and without Migration Background in Germany: A Longitudinal Study Based on the German Socio-Economic Panel (SOEP)

There is ambiguous evidence with regard to the inequalities in health care services utilization (HCSU) among migrants and non-migrants in Germany. The aim of this study was to analyze the utilization of doctors and hospitalization of persons with direct and indirect migration background as well as those without in Germany. This study was based on data of the German Socio-Economic Panel using the adult sample of the years 2013 to 2019. HCSU was measured by self-reported utilization of doctors and hospitalization. Associations between HCSU and migration background were examined using multilevel mixed-effects logistic regression and zero-truncated multilevel mixed-effects generalized linear models. The odds ratios of utilization of doctors and hospitalization for persons with direct migration background compared with persons without migration background were 0.73 (p < 0.001) and 0.79 (p = 0.002), respectively. A direct migration background was associated with a 6% lower number of doctoral visits within three months compared with no migration background (p = 0.023). Persons with direct migration background still have a lower HCSU than persons without migration background in Germany. Access to health care needs to be ensured and health policy-makers are called upon to keep focus on the issue of inequalities in HCSU between migrants and non-migrants in Germany.

Health-Related Quality of Life of Persons with Direct, Indirect and No Migration Background in Germany: A Cross-Sectional Study Based on the German Socio-Economic Panel (SOEP)

Global migration towards and within Europe remains high, shaping the structure of populations. Approximately 24% of the total German population had a migration background in 2017. The aim of the study was to analyze the association between migration background and health-related quality of life (HrQoL) in Germany. The analyses were based on 2014 and 2016 data of the German Socio-Economic Panel. Differences in sociodemographic characteristics between migrant and non-migrant samples were equal by employment of the entropy balancing weights. HrQoL was measured using the physical (PCS) and mental (MCS) component summary scores of the SF-12v2. Associations between PCS and MCS scores and migration background were examined using Student’s t-test. The mean PCS and MCS scores of persons with migration background (n = 8533) were 51.5 and 50.9, respectively. Persons with direct migration background had a lower PCS score (−0.55, p < 0.001) and a higher MCS score (+1.08, p < 0.001) than persons without migration background. Persons with direct migration background differed with respect to both physical and mental HrQoL from persons without migration background in the German population. Differences in HrQoL for persons with indirect migration background had p = 0.305 and p = 0.072, respectively. Causalities behind the association between direct migration background and HrQoL are to be determined.

Women in Refugee Camps: Which Coping Resources Help Them to Adapt?

: The present study aimed to explore the coping resources and mental health of women who have fled Syria to a neighboring European country. To that end, we examined the roles of sociodemographic factors, situational factors, and personal and community sense of coherence (SOC and ComSOC, respectively) in mental-health outcomes. One hundred and eleven refugee women aged 19-70 filled out self-reported questionnaires during August 2018 in a refugee camp in Greece. The questionnaires asked the participants for demographic information (i.e., age, level of education level, and time spent in the camp) and also addressed the situational factors of having received aid from various organizations, appraisal of danger during the war in Syria, and exposure to war experiences, as well as the coping resources of SOC and ComSOC. The results show that time spent in the camp, appraisal of danger, SOC, and ComSOC all play significant roles in predicting the variance of various mental-health outcomes. Together, those factors predict 56% of anxiety, 53% of depression, and 58% of somatization. SOC was also found to mediate the relationships between time spent in the camp and outcome variables, as well as the relationships between the appraisal of danger and the outcome variables. This indicates that SOC is crucial for good adaptation. These results will be discussed in light of the salutogenic theory.

Health-Related Lifestyle Behavior and Religiosity among First-Generation Immigrants of Polish Origin in Germany

Background: Health-related lifestyle behaviors such as smoking, alcohol consumption, physical inactivity and obesity are major cardiovascular risk factors. Previous studies have mostly demonstrated a favorable association between religiosity and these cardiovascular risk factors; however, no studies have investigated this relationship in Polish immigrants. The aim of this cross-sectional study was to examine the association between health-related lifestyle behaviors and religiosity in Polish immigrants in Germany. Methods: The smoking patterns, frequency of alcohol consumption, physical activity, and presence of overweight/obesity were assessed in 257 first-generation immigrants of Polish origin living in Germany. Religiosity was measured with the Centrality of Religiosity Scale (CRS, Huber, 2003) consisting of 15 items that categorized the respondents into intrinsically, extrinsically, and not/marginally religious. Results: After adjusting for various sociodemographic, migration, and health-related characteristics, intrinsic religiosity was significantly associated with a lower risk of being a smoker (odds ratios (OR) = 0.34, confidence intervals (CI) = 0.15–0.76) and was also associated with a lower risk of alcohol consumption (OR = 0.33, CI = 0.15–0.71), but a higher risk of being overweight/obese (OR = 2.53, CI = 1.15–5.56) in comparison with extrinsic/marginal religiosity. No significant relationship was found between religiosity and physical activity. Conclusions: In Polish immigrants, intrinsic religiosity acts as a protective factor against some cardiovascular risk factors (smoking and alcohol consumption).

Health of Central and Eastern European migrants in Germany: healthy migrant effects and good health maintained?

Purpose

The purpose of this paper is to analyse the health level and health dynamics of migrants from Central and Eastern Europe (CEE), broadly defined, in Germany. Population health in CEE compares badly to Germany. Lifestyle changes and access to better health care in Germany can lead to health improvement of migrants.

Design/methodology/approach

Longitudinal data from the German Socio-Economic Panel are used. First, the time trends of immigrant and native health are analysed graphically. Second, regression analysis is conducted, controlling for demographic and socio-economic factors when estimating the country of origin effects on health. Finally, regression models are estimated to investigate if social and economic integration significantly improves the subjective well-being of the immigrant groups.

Findings

Evidence is found for significantly better subjective health of migrants compared to the natives, even if demographic and socio-economic factors are controlled for. Only part of the health advantage is explained by selective migration. The health of the more advantaged migrants tend to decline slower than of the natives.

Social implications

If migrants are economically and socially integrated in the host country then their presence is unlikely to increase the health burdens of the host country.

Originality/value

The existing knowledge on the health developments of migrants from CEE in other European countries is limited. Based on richer statistical information, the results of this paper partly contradict earlier findings in the literature, in particular no evidence is seen for worse or quickly declining health of immigrants.