Health-related quality of life and migration: a cross-sectional study on elderly Iranians in Sweden

Differences in health-related quality of life between native and foreign-born gynaecological cancer patients in Sweden: a five-year cross-sectional study

PURPOSE

To examine differences in health-related quality of life (HRQoL) between native and foreign-born gynaecological cancer patients in Sweden, taking into account clinical, demographic, and socioeconomic factors.

METHODS

The 30-item European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and a study-specific questionnaire covering demographic and socioeconomic factors were answered by 684 women aged ≥ 18 years old, diagnosed in 2014, 2016, or 2018 with gynaecological cancer in the Stockholm-Gotland health care region, Sweden. Clinical data were obtained from the Swedish Cancer Register. Data were analysed using the Kruskal-Wallis test and linear regression.

RESULTS

The women had a mean age of 65.4 years, with 555 (81.1%) born in Sweden, 54 (7.9%) in other Nordic countries (ONC), 43 (6.3%) in other European countries (OEC), and 32 (4.7%) in non-European countries (NEC). HRQoL differed significantly between the four groups for 14 of the 15 QLQ-C30 scales/items. On average, Swedish-born women scored 2.0, 15.2, and 16.7 points higher for QoL/functioning scales/items and 2.2, 14.1, and 18.7 points lower for symptom scales/items, compared with ONC-, OEC-, and NEC-born women, respectively. In adjusted analyses, none of the differences between Swedish-born and ONC-born women were significant, while for OEC- and NEC-born women the differences were significant for most QLQ-C30 scales/items.

CONCLUSION

HRQoL differs between native and foreign-born gynaecological cancer patients in Sweden, with lower HRQoL the further from Sweden the women are born. A more individualised cancer care, with tailored support to optimize HRQoL is needed for this vulnerable group of patients.

Social Inequalities and Health among Older Immigrant Women in the Nordic Countries: An Integrative Review

Introduction

The Nordic countries have a surprisingly strong relative socioeconomic health inequality. Immigrants seem to be disproportionately affected due to their social economic position in the host countries. Healthcare professionals, including nurses, have a professional obligation to adhere to fairness and social equity in healthcare. The aim of this review was to identify and synthesize research on health status and the impact of social inequalities in older immigrant women in the Nordic countries.

Methods

We conducted an integrative review guided by the Whittemore and Knafl integrative review method. We searched multiple research databases using the keywords immigrant, older, women, socioeconomic inequality, health inequality, and Nordic countries. The results were limited to research published between 1990 and 2021. The retrieved articles were screened and assessed by two independent reviewers.

Results

Based on the few studies on older immigrant women in the Nordic countries, the review findings indicate that they fare worse in many health indicators compared to immigrant men and the majority population. These differences are related to various health issues, such as anxiety, depression, diabetes, multimorbidity, sedentary lifestyle, and quality of life. Lower participation in cancer screening programs is also a distinctive feature among immigrant women, which could be related to the immigrant women's help-seeking behavior. Transnational family obligations and responsibilities locally leave little room for prioritizing self-care, but differing views of health conditions might also contribute to avoidance of healthcare services.

Conclusion

This integrative review shows that there is a paucity of studies on the impact of social inequalities on the health status of older immigrant women in the Nordic countries. There is a need for not only research focused on the experiences of health status and inequality but also larger studies mapping the connection between older immigrant women's economic and health status and access to healthcare services.

Effects of Living Conditions, Subjective Integration, and Social Networks on Health-Related Quality of Life among the Migrant Elderly Following Children in Jinan, China

With accelerated urbanization in China, an increasing number of the migrant elderly following children (MEFC) have appeared. This study aims to explore the effects of living conditions, subjective integration, and social networks on the health-related quality of life (HRQOL) of MEFC in Jinan, China. HRQOL was assessed by the 12-item Short-Form Health Survey, which included the mental component summary (MCS) and the physical component summary (PCS). Univariate analyses and binary logistic regression were used to investigate the association between the above indicators and HRQOL. A total of 656 MEFC were selected by multi-stage cluster random sampling, 25.2% and 25.0% of whom were defined as poor MCS and poor PCS, respectively. Those who understood the local dialect, could trust others, and connected with friends were more likely to have good MCS; those with a nanny, faulty elevator, and no support from their spouse were the reverse. MEFC who were trans-city, had no elevator or a faulty elevator, and went to the hospital alone were more likely to have poor PCS; those who approved of living conditions in their hometowns were the reverse. Results indicated that better living conditions, stronger subjective integration, and wider social networks led to higher HRQOL of MEFC. Implications of the government, communities, and families of MEFC were given to improve their HRQOL.

Working Below Skill Level as Risk Factor for Distress Among Latin American Migrants Living in Germany: A Cross-Sectional Study

About 84,710 Latin American migrants currently live in Germany. Knowledge about their work situation in relation to their skill level and its association with mental health is limited. Therefore, the aims of this study were to assess the prevalence of working below skill level and its association with the prevalence of distress in Latin Americans living in Germany. This cross-sectional study included a convenience sample of 282 Latin American migrants living in Germany. Participants were recruited by a short online (Facebook, personal contacts) or interview-based questionnaire from November 2015 to April 2016. Questions included skill level, job category (categorized by ISCO 2008 code), socio-demographics, violence at the workplace and distress. The latter was assessed by Goldberg's General Health Questionnaire using a cut-off of 4/5. Descriptive statistics were followed by logistic regression analyses adjusting for potential confounders. About half of the study population reported symptoms of distress (45%). 63% of the population worked below skill level. 12-months prevalence of violence at the workplace was 14%. After adjustment, working below skill level was statistically significantly related to distress (odds ratio 2.80; 95% confidence interval 1.58-4.95). Working below skill level is common in Latin American migrants in Germany and may result in poor psychosocial well-being.

Mental health among immigrants in Germany - the impact of self-attribution and attribution by others as an immigrant

Background

In Germany, the term ‘migration background’ has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’.

Methods

In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors.

Results

A total of 10.7% of respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety.

Conclusions

It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.

Extent of the association between self-rated health and place of birth: a cross-sectional study among people at high risk of developing pre-diabetes and diabetes in Sweden

OBJECTIVE

The first aim was to determine the extent of the relationship between place of birth and self-rated health (SRH) in primary healthcare patients born outside Sweden and those born in Sweden. The second aim was to investigate whether socioeconomic and lifestyle factors explained any differences.

SETTING

Two academic primary healthcare centres in Stockholm County, Sweden.

PARTICIPANTS

825 patients at high risk of developing pre-diabetes and diabetes, aged 18-74 years, attending academic healthcare centres in areas with large numbers of immigrants, 56.8% born abroad and 43.2% born in Sweden. Patients with a diagnosis of diabetes were excluded. Inclusion criteria were based on previous research showing that people born in Middle Eastern and Asian countries who live in Sweden have a high prevalence of and risk for diabetes.

OUTCOME

SRH was dichotomised as optimal (very good/good) and suboptimal (fair/bad/very bad) and compared in those born outside Sweden and in Sweden.

RESULTS

There was a statistically significant difference in the SRH of the two groups (p=0.008). Logistic regression analysis showed a crude OR for reduced SRH of 1.46 (95% CI 1.10 to 1.92) in patients born outside Sweden. After controlling for education, employment and marital status, the OR increased to 1.50 (95% CI 1.11 to 2.02). After controlling for physical activity and smoking, it decreased to 1.36 (95% CI 1.00 to 1.85).

CONCLUSION

Socioeconomic and lifestyle factors influenced SRH. It could therefore be useful for clinicians to consider these factors when providing care for patients born outside Sweden and resettled in areas with large numbers of immigrants.

Health-related quality of life among Syrian refugees resettled in Sweden

PURPOSE

The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population.

METHODS

This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis.

RESULTS

Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score.

CONCLUSIONS

Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.

How Migrant Status Affects Health beyond Socioeconomic Status: Evidence from Austria

The debate on health inequalities usually focuses on the interplay between socioeconomic status (SES) and health, where it is widely accepted that the former influences the latter. However, little is known on whether the influence of SES on health is sufficient to explain the observed lower health statuses among various migrant groups in European countries. This paper presents a model that integrates the influences of SES and migrant status on health and tests its implications empirically for Austria. Several ordered logit regressions are performed, whose results show that particular migrant groups are disadvantaged with respect to health. In addition, the overall influence of migrant status on health is considerably stronger for women than for men, while health status of men is influenced by interactions between migrant status and occupational status.

Sociodemographic Factors Affecting the Quality of Life of Elderly Persons Attending the General Outpatient Clinics of a Tertiary Hospital, South-South Nigeria

Background

In the last few decades, the evaluation of the quality of life (QoL) among older adults has become increasingly important in health as well as in social sciences. There has been growing emphasis on the need to understand what influences older people's QoL as it is argued to be of greater value than the traditional outcome measures, such as health status.

Aim and Objective

The aim of this study was to determine the sociodemographic factors affecting the QoL of elderly patients attending the General Outpatient Clinics of the University of Uyo Teaching Hospital (UUTH), Uyo.

Methodology

The study was a cross-sectional descriptive study. Three hundred and ten elderly persons attending the General Outpatient Clinics of the UUTH for medical conditions between July and September 2014 were consecutively recruited for the study. Details of sociodemographic information were taken, and QoL of respondents was assessed using the older persons' QoL questionnaire. Data were analyzed using the Statistical Package for Social Sciences-17.0, and the level of statistical significance was set at P < 0.05.

Results

Of the three hundred and ten respondents recruited for the study, One hundred and seventy-seven (57.1%) were female and one hundred and thirty-three (42.9%) were male. The female-to-male ratio was 1.3:1. The age range of the respondents was between 60 and 90 years and the mean age (±standard deviation) was 67.4 (±6.6) years. Two hundred and thirty-two respondents (74.8%) had at least primary level of education and one hundred and sixty-one (51.9%) were married. The median monthly income was ₦ 25,500.00 with interquartile range of ₦ 10,000.00 to ₦ 50,000.00. From the study, 85.5% of the elderly reported an overall good QoL. High-income grade (P = 0.019), high social class (P = 0.036), and high level of education (P < 0.001) were the factors associated with good QoL in this study on univariate analysis.

Conclusion

A high percentage of respondents reported an overall good QoL. High-income grade, high social class, and high level of education were the factors associated with good QoL.

Investigating acculturation orientations of patients with an immigration background and doctors in Canada: implications for medical advice adherence

BACKGROUND

Increased immigration requires successful interaction of different cultures in various life domains, such as health. This study investigates acculturation orientation (AO) of immigrant patients and doctors native to the country, as a potential factor related to perceived medical advice adherence.

DATA AND METHODS

N = 171 immigrant patients (M = 54.38 years, SD = 17.94, range = 23-96, 74.3 % female) and their N = 12 doctors (M = 38.88 years, SD = 13.42, range = 27-66, 83 % female) from a hospital in Montreal, Canada, participated in a paper-based survey to assess AOs, patients' perceived expectations of their doctor (regarding adopting the new culture or keeping their previous culture), doctors' actual expectations, perceived quality of care and perceived adherence.

RESULTS

AO of patients significantly related to perceived adherence, via a path model involving perceptions of doctors' expectations and perceived quality of care. Integration was positively related to perceived adherence, while Marginalization was negatively related to it. Doctors' AOs were not significant.

CONCLUSION

Patient perceptions seem to be a significant factor to be considered when striving to improve immigrant medical advice adherence.

Health promotion programme design and efficacy in relation to ageing persons with culturally and linguistically diverse backgrounds: a systematic literature review and meta-analysis

BACKGROUND

Health promotion has the potential to empower people to develop or maintain healthy lifestyles. However, previous research has visualised serious health and healthcare inequities associated with ageing, cultural affiliations and linguistic preferences. Therefore, this study was part of a larger health promotion project, set out to bridge barriers to health for ageing persons who have migrated to Sweden. More specifically, the present study aimed to elucidate the content and effects of multidimensional health promotion programmes in the context of ageing persons with culturally and linguistically diverse backgrounds.

METHODS

Databases were systematically searched to identify relevant randomised controlled trial publications. All potentially relevant publications were assessed for relevance and design and after this screening, a final sample of eight publications could be included in the review. Those publications evaluated six different programmes and a mixed-methods approach to data analysis was applied, using a combination of narrative synthesis, meta-analyses and evidence grading.

RESULTS

The findings suggest a multidimensional health promotion programme design for ageing persons with culturally and linguistically diverse backgrounds, involving culturally and linguistically modified activities and health information that should be provided by professionals with a person-centred approach. In addition, the meta-analyses revealed statistically significant effects in favour of health promotion on: general health, depression, mental health, physical health, and vitality. However, the evidence for the identified effects is low, and further research findings are likely to change the estimations.

CONCLUSIONS

The present study provides an aggregation of health promotion intervention research with older persons with culturally and linguistically diverse backgrounds; a group of people who are commonly excluded from research, and marginalised when it comes to health and healthcare. By visualising the core components of health promotion programmes with proven efficacy, the findings provide guidance for further explorations of how health promotion should be designed to minimise inequities in health.

The Association between Discrimination and Psychological and Social Well-being

Background

Discrimination is known to negatively affect the psychological well-being of migrants. Less is known on the association between discrimination and social well-being.

Aim

We examined the association between experienced discrimination and psychological (mental health, quality of life) and social well-being (loneliness, feelings of safety, trust towards society) in Russian, Somali and Kurdish migrants in Finland.

Methods

We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1795 persons of Russian, Somali or Kurdish origin aged 18–64 years. Experiences of discrimination, loneliness, safety and trust towards society were measured using interview questions. Mental health symptoms were measured using the HSCL-25 and quality of life using EUROHIS-QOL. Logistic regression analyses were conducted to investigate the associations between discrimination and psychological and social well-being, separately for the three ethnic groups.

Results

Discrimination increased the odds for mental health symptoms and decreased the odds for quality of life among Russian and Kurdish migrants, but not Somalis. Discrimination was associated with feeling unsafe and decreased trust towards society among all migrants. Among Kurds, discrimination increased the odds also for loneliness.

Conclusions

Discrimination is an essential threat to the psychological and social well-being of Russian, Somali or Kurdish migrants.

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

Immigrants are faced with several impediments in the host country that may affect their quality of life (QoL), but little is known about the impact of these stressors as well as about the protective role of sense of coherence (SoC) in the context of Polish immigration to Germany. Health Related QoL (Short Form Health Survey SF-36) and SoC (Sense of Coherence Scale SOC-29) were assessed in a total sample consisting of 511 participants aged between 18 and 84 years (260 Polish immigrants in Germany and 251 indigenous Poles). Polish immigrants reported a significantly lower mental and physical health-related QoL than the German norm population, but they were comparable to native Poles. This result remained the same when the model was adjusted for age but physical health status was better for immigrants compared with indigenous Poles. Both groups scored significantly lower for SoC than Germans, but did not differ from each other. The main differences concerning the examined variables were with respect to the German norm population and are putatively shaped by culture.

Health-related quality of life of latin-american immigrants and spanish-born attended in spanish primary health care: socio-demographic and psychosocial factors

Background

This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed.

Methods

A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected.

Results

Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable “exposure to political violence” was significantly associated with the mental health component (p = 0.014).

Conclusions

The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on social inclusion in the host society and focus on improving social support networks in order to foster and maintain the health and HRQoL of this group.

Ethnicity does not account for differences in the health-related quality of life of Turkish, Moroccan, and Moluccan elderly in the Netherlands

BACKGROUND

Data on how different groups of elderly immigrants perceive health-related quality of life (HRQOL) is scarce and research on the influence of ethnicity on HRQOL across ethnic groups is missing. Measuring HRQOL may help to detect cross-cultural differences and to decide whether ethnic-specific health and prevention programmes are required to improve HRQOL. We investigated differences in HRQOL among three elderly immigrant populations with a special focus on the contribution of ethnicity, in addition to other well-known determinants, to HRQOL.

METHODS

Data were collected between October 2011 and July 2012 as part of the project entitled "Stem van de oudere migrant", a quasi-experimental study in the Netherlands focussing on health of immigrant elderly. A survey was conducted among 201 elderly (aged 55 years and older) Moroccans (98), Turks (69), and Moluccans (34). HRQOL was assessed using the SF-12, measuring physical and mental health composite scores (PCS resp. MCS). Chi-square tests and ANOVAs were performed for group comparison. Hierarchical multiple linear regressions were conducted to examine whether ethnicity uniquely contributed to the observed variance in HRQOL when multimorbidity, loneliness, socio-demographics, and acculturation were taken into account.

RESULTS

Moroccans had the lowest scores on PCS (34.3 ± 31.4) and MCS (42.1 ± 27.0), followed by Turks (45.7 ± 27.0 for PCS and 54.7 ± 22.2 for MCS), and Moluccans (71.7 ± 21.2 for PCS and 74.4 ± 22.1 for MCS). Ethnicity was not independently associated with PCS and MCS scores, in contrast to loneliness (PCS β -0.461, p < 0.001 and MCS β -0.435, p < 0.001) and multimorbidity (PCS β -0.380, p < 0.001 and MCS β -0.398, p < 0.001). Gender was independently associated with PCS (β 0.148, p = 0.026) and attachment to Dutch culture with MCS (β 0.144, p = 0.029).

CONCLUSIONS

The lower level of HRQOL reported by elderly immigrant populations was affected by multimorbidity and loneliness but not ethnicity. Similar to native elders, interventions aiming at improving HRQOL for immigrant elderly should focus on loneliness and (mental and physical) disease. Finally, health literacy deserves attention to maintain health.

TRIAL REGISTRATION

ISRCTN89447795.

Quality of life of Turkish type 2 diabetics in Germany and Turkey--a comparison between Hamburg and Istanbul

OBJECTIVES

The analyses address the following research questions: (1) Do Turkish diabetics in Germany and Turkey differ in terms of quality of life? (2) If yes, can these differences (in part) be explained by social factors (age, gender, education, household size), functional limitations and availability of support? (3) Are social factors, functional limitations and availability of support differently associated with quality of life among Turkish diabetics in Germany and Turkey?

DESIGN

For this comparative cross-sectional study, 111 patients with type 2 diabetes were personally interviewed in Istanbul (Turkey) and 294 Turkish patients in Hamburg (Germany). For quality of life measurement we have used the Turkish version of the WHOQOL-Bref-26. Sociodemographics included age, sex, education and household-size. Health related functional limitations were assessed on the basis of an index of (instrumental) activities of daily living including the availability of help. Statistical analyses were conducted on group comparisons with Chi-square- and T-tests as well as linear regressions.

RESULTS

There are no significant differences between Turkish diabetics in Germany and Turkey in the physical and the psychological dimensions of the WHOQOL-Bref. However, in the WHOQOL-domains 'social QoL' and 'environmental QoL' Turkish diabetics living in Hamburg have a significantly better quality of life than their counterparts in Istanbul. These differences cannot be explained by individual sociodemographic factors, functional limitations and availability of support. Furthermore, we found much stronger positive associations between education and quality of life in Istanbul than in Hamburg.

CONCLUSION

Beyond strong similarities between the two samples in sociodemographics, physical and mental health the social and environmental quality of life was significantly assessed better by the Turkish diabetics living in Hamburg. This is most likely an effect of public investment in social security, infrastructure and health care which is also influencing the decision as to where to spend life in retirement.

Assessment measures of Health-Related Quality of Life (HRQoL) of migrants: a systematic review

Purpose

– Definition-problems concerning the terms “migrant” and “Health-Related Quality of Life” (HRQoL) have a negative impact on the operationalization and measurement of the multidimensional and subjective construct of HRQoL. The aims of this systematic literature review are to address the following questions: How can the instruments used within the research field “migration and HRQoL” be described or categorized? Which dimensions (psychological, physical and social) and associated sub-dimensions have been used concerning measuring HRQoL when measures are applied to migrants?

Design/methodology/approach

– A systematic review was conducted. Three databases (Medline, Embase and Cinahl) were systematically searched for the investigation on HRQoL of migrants. Articles written in English, German and Polish, published since 2003 and meeting other inclusion criteria, were included in the final analysis.

Findings

– In the first stage a total of 4,062 studies were identified. However, very few studies were found to focus on HRQoL among migrants. Finally, 28 studies were included in the analysis. The results confirm that the terms “migrant” and “Quality of Life” and “Health-Related Quality of Life” are neither congruently used nor defined, respectively, within these studies, which consequently impacts deleteriously on the application and measurement of the concept in these groups. The majority of the studies reported to measure HRQoL with a well-known and validated HRQoL instrument. The physical dimensions (symptoms/pain/vitality, energy/vitality/sleep and the objective/subjective health status) are predominantly represented in the reviewed literature. The psychological dimension mostly includes sub-dimensions such as psychological stress and depressive symptoms; the social dimension was predominantly considered as the sub-dimension social relationships/networking.

Originality/value

– This paper highlights profound issues in the accurate assessment of HRQoL in migrants. This may have a significant impact on delivery of appropriate evidenced-based care for migrants in need of healthcare intervention.

Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan

PURPOSE

To examine associations between demographic variables, acculturation, and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.

DESIGN

A cross-sectional survey of 203 participants in southern Taiwan. Instruments included a demographic inventory, the Suinn-Lew Asian Self-Identity Acculturation Scale, and the Short Form Health Survey-Version 2.

FINDINGS

Most participants had low acculturation levels. Length of residency, number of children, marital status, level of education, religion of spouse, and employment status of spouse significantly correlated with level of acculturation, as did mental health, bodily pain, vitality, and social functioning.

DISCUSSION AND CONCLUSION

Programs are needed to encourage social assimilation for Vietnamese immigrant women in Taiwan. Culturally sensitive medical evaluations will ensure early treatment of mental and physical health problems caused by the stress of acculturation.

IMPLICATIONS FOR PRACTICE

An increased understanding of variables affecting Southeast Asian immigrant women's acculturation process will improve health status.

Health related quality of life among Iraqi immigrants settled in Malaysia

BACKGROUND

Migrants everywhere face several demands for health and maintaining good health and quality of life could be challenging. Iraqis are the second largest refugee group that has sought refuge in the recent years, yet little is known about their health related quality of life (HRQOL). The study aims at assessing the HRQOL among Iraqis living in Malaysia.

METHODS

A self-administered Arabic version of Sf-36 questionnaire was distributed among 300 Iraqi migrants in Malaysia. The questionnaire taps eight concepts of physical and mental health to assess the HRQOL. Univariate analysis was performed for group analysis (t test, ANOVA) and Multiple Linear Regression was used to control for confounding effects.

RESULTS

Two hundred and fifty three participants ranging in age from 18 to 67 years (Mean = 33.6) returned the completed questionnaire. The majority was males (60.1%) and more than half of the respondents (59.5%) were married. Less than half (45.4%) and about a quarter (25.9%) reported bachelor degree and secondary school education respectively and the remaining 28.7% had either a master or a PhD degree.Univariate analysis showed that the HRQOL scores among male immigrants were found to be higher than those of females in physical function (80.0 vs. 73.5), general health (72.5 vs. 60.7) and bodily pain (87.9 vs. 72.5) subscales. The youngest age group had significantly higher physical function (79.32) and lower mental health scores (57.62).The mean score of physical component summary was higher than the mental component summary mean score (70.22 vs. 63.34).Stepwise multiple linear regression, revealed that gender was significantly associated with physical component summary (β = - 6.06, p = 0.007) and marital status was associated with mental component summary (β = 7.08, p = 0.003).

CONCLUSIONS

From the data it appears that Iraqi immigrants living in Malaysia have HRQOL scores that might be considered to indicate a relatively moderate HRQOL. The HRQOL is significantly affected by gender and marital status. Further studies are needed to explore determinants of HRQOL consequent to immigration. The findings could be worthy of further exploration.

Factors of importance for self-reported mental health and depressive symptoms among ages 60-75 in urban Iran and Sweden

BACKGROUND

Depression is a common experience affecting 121 million people around the world. In high income countries, depression is one of the most common psychiatric conditions among the elderly. Studies show that immigrants are particularly at risk for mental ill health.

AIM

This study investigates the self-reported mental health among two Iranian groups; one born and residing in Iran and one consisting of Iranian immigrants in Sweden, as well as native Swedes living in Sweden. The study also aims to explore and compare self-reported depressive symptoms among three groups.

METHODS

This study is based on a cross-sectional design measuring self-reported health with a study specific questionnaire. The programme SPSS V.17.0 was used for all statistical analyses.

FINDINGS

1088 participants were approached (668 Iranians in Iran; 105 immigrated Iranians in Sweden; and 305 Swedes in Sweden). Factors effecting self-reported mental health was self-reported health, smoking, satisfaction with social life and also a sense of connection to ones cultural roots and traditions. Also demographic variables such as group belonging (Swedes vs. Iranians), sex and satisfaction with Income were shown to be important when performing the regression analysis. In the chi-square analysis the Iranian samples reported depressive symptoms to a larger extent than the Swedish group in all aspects of self-reported depressive symptoms. Self-reported depressive symptoms were reported to a greater extend in women compared to men. Our findings indicate that the Iranian populations living in both Tehran and Stockholm report depressive symptoms to an extent that merits concern. The findings indicate that Iranians living in Tehran and Iranians who have immigrated to Sweden require more attention regarding mental health care. Health care providers in both countries should be aware of the current state of mental health among Iranians in both Sweden and Iran.

Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review

OBJECTIVES

Knowledge about self-perceived health can help us understand the health status and needs among migrants and ethnic minorities in the European Union (EU) which is essential to improve equity and integration. The objective was to examine and compare self-perceived health among migrant and ethnic minority groups in the EU countries.

METHODS

Publications were ascertained by a systematic search of PUBMED and EMBASE. Eligibility of studies was based on the abstracts and the full texts. Additional articles were identified via the references. The final number of studies included was 17.

RESULTS

Publications were identified in 5 out of the 27 EU countries. In regard to self-perceived health, most migrants and ethnic minority groups appeared to be disadvantaged as compared to the majority population even after controlling for age, gender, and socioeconomic factors. Only limited cross-country comparisons could be carried out, still they revealed a parallel pattern of self-perceived health among similar migrant/ethnic minority groups.

CONCLUSIONS

Policies to improve social and health status, contextual factors, and access to healthcare among migrants and ethnic minorities are essential to reduce ethnic inequalities in health.