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Pyo Y, Kwon KH. Factors Affecting Diasporic Women's Quality of Life: A Systematic Review. J Multidiscip Healthc 2024; 17:3665-3676. [PMID: 39100905 PMCID: PMC11296358 DOI: 10.2147/jmdh.s467091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/14/2024] [Indexed: 08/06/2024] Open
Abstract
Objective This literature review assesses the factors that influence the quality of life of migrant women in the diasporic with the goal of improving their quality of life and creating more supportive social adjustment in the public health field. Methods The systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We searched the databases of Scopus, PubMed, SAGE journal, Springer, and Google Scholar for scientific articles on the quality of life of diasporic and migrant women. We screened and removed duplicates, analyzed the full text of the articles to identify potentially relevant studies, and extracted data from matched articles. Results The literature search yielded 34 articles. Only 10 articles that met all inclusion criteria were included in the systematic review after peer review. Conclusion The literature shows that the quality of life of diasporic women is influenced by four main factors: sociodemographic predictors, social adjustment predictors, health-related predictors, and psychological predictors. Identifying them is important to improve quality of life and find the right solutions to improve the quality of life of marginalized groups in society. To improve the quality of life for diasporic women, I suggest implementing government policies such as language education, vocational training, stronger protection laws, and better healthcare access. Additionally, establishing cultural exchange and networking programs is crucial for fostering cultural understanding.
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Affiliation(s)
- Yeonhee Pyo
- Department of Beauty Cosmetics, College of Biomedical and Health Science, Konkuk University, Chungju, 27478, Republic of Korea
| | - Ki Han Kwon
- College of General Education, Kookmin University, Seoul, 02707, Republic of Korea
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Lee YX, Auwerda ST, Jellema K, Vliet Vlieland TPM, Arwert HJ. Ethnic disparities in long-term outcomes and health care usage after stroke in the Netherlands. Disabil Health J 2024; 17:101582. [PMID: 38246799 DOI: 10.1016/j.dhjo.2024.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Poststroke health-related quality of life (HRQOL) is an important outcome that may be influenced by ethnicity. OBJECTIVE To compare long-term HRQOL, mental health and healthcare utilization between stroke survivors with a European (EUB) and non-European background (NEUB) in a hospital population. METHODS In this retrospective cohort study patients completed questionnaires 2-5 years after stroke. Assessments included the EuroQol-5D-3L (EQ-5D), Short Form (SF-36, with physical and mental component summary scales, PCS and MCS), Hospital Anxiety and Depression Scale (HADS; scores ≥8 indicate clinically relevant complaints) and a questionnaire on the usage of services from physicians and/or healthcare professionals (HCP) in the past 6 months. Linear and logistic regression analysis was used, adjusted for age, sex, level of education and functional outcome. RESULTS We included 207 patients (169 EUB, 38 NEUB); mean age 63.8 years (SD 14.4); 60.4 % male; mean follow up 36.3 months (SD 9.9). The EQ-5D and the PCS were higher in EUB versus NEUB patients (42.9 vs 35.4, p < 0.01; 0.76 vs 0.60, p < 0.01). The MCS showed a comparable, non-significant trend. The percentage of patients with HADS depression ≥8 was higher in NEUB patients versus EUB patients (54.3 % vs 29.8 %; p > 0.01). Significantly more NEUB patients had visited two or more physicians in the past six months compared to EUB patients (52.0 % vs 26.0 %; p = 0.01) whereas the use of services from HCP was similar. CONCLUSIONS NEUB stroke patients had worse outcomes regarding HRQOL and depressive symptoms compared to EUB patients. NEUB patients visited more physicians.
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Affiliation(s)
- Y X Lee
- Haaglanden Medical Center, Department of Neurology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
| | - S T Auwerda
- Basalt Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, the Netherlands.
| | - K Jellema
- Haaglanden Medical Center, Department of Neurology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
| | - T P M Vliet Vlieland
- Leiden Universitary Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
| | - H J Arwert
- Haaglanden Medical Center, Department of Rehabilitation, Lijnbaan 32, 2512 VA, The Hague, the Netherlands; Basalt Rehabilitation Center, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
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Delbari A, Akbarzadeh I, Saatchi M, Tabatabaei FS, Bidkhori M, Abolfathi Momtaz Y, Mohseni-Bandpey R, Hooshmand E. The Association of Social Support, Depression, and Loneliness with Health-Related Quality of Life in Over 50 Years Adults: Ardakan Cohort Study on Ageing (ACSA). Exp Aging Res 2023:1-14. [PMID: 37879966 DOI: 10.1080/0361073x.2023.2273164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/15/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND AND AIM Social factors play a crucial role in the quality of life of + 50 adults. This study aimed to investigate the association between social support, depression, and loneliness and the health-related quality of life in + 50 adults of Ardakan. METHODS This was a cross-sectional study from the first phase of Ardakan Cohort Study on Aging (ACSA) in 2019. Health-Related Quality of Life (HRQoL, SF-16), Duke Social Support Index (DSSI), and Center for Epidemiologic Studies Depression Scale (CES-D10) were used to assess the variables of interest. Multivariable linear regression was used to model the associated factors with the score of the SF-16 tool in two dimensions; physical (PCS) and mental (MCS). FINDINGS A total of 5197 over 50 years individuals included in this study; The mean age was 62.2 ± 7.3 years old, and 52% were male. The mean score for PCS and MCS subscales was 45.6 (95% CI 45.4 to 45.9) and 49.3 (95% CI 49.0 to 49.5), respectively. Adjusted for other variables, having less feeling level of loneliness, and not having depressive symptoms were related to better PCS and MCS scores. CONCLUSION The HRQoL for the mental aspect of HRQoL was better than the physical in elder populations. Also, much more focus should be paid to older adults who experience inadequate social support, higher levels of loneliness, and depressive symptoms.
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Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Isa Akbarzadeh
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, School of Rehabilitation, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh-Sadat Tabatabaei
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Mohseni-Bandpey
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Hooshmand
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Briere J, Wang SH, Khanam UA, Lawson J, Goodridge D. Quality of life and well-being during the COVID-19 pandemic: associations with loneliness and social isolation in a cross-sectional, online survey of 2,207 community-dwelling older Canadians. BMC Geriatr 2023; 23:615. [PMID: 37777717 PMCID: PMC10542692 DOI: 10.1186/s12877-023-04350-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND The far-reaching health and social sequelae of the COVID-19 pandemic among older adults have the potential to negatively impact both quality of life (QoL) and well-being, in part because of increased risks of loneliness and social isolation. The aim of this study was to examine predictors of QoL and well-being among Canadian older adults within the context of the pandemic, including loneliness and social isolation. METHODS This cross-sectional, online survey recruited older adult participants through community organizations and research participant panels. Measures included the: Older People's Quality of Life Scale-B, WHO-5, DeJong Gierveld Loneliness Scale, Lubben Social Network Scale and five COVID-19 specific items assessing impact on loneliness and social isolation. Multiple linear regression models were used to adjust for potential confounders. RESULTS A total of 2,207 older Canadians (55.7% female, with a mean age of 69.4 years) responded to the survey. Over one-third strongly disagreed that the pandemic had had a significant effect on either their mental (35.0%) or physical health (37.6%). Different patterns of predictors were apparent for QoL and well-being. After adjusting for all variables in the models, the ability of income to meet needs emerged as the strongest predictor of higher QoL, but was not associated with well-being, except for those who chose not to disclose their income adequacy. Age was not associated with either QoL or well-being. Females were more likely to experience lower well-being (β=-2.0, 95% C.I. =-4.0,-0.03), but not QoL. Reporting three or more chronic health conditions and that the COVID-19 pandemic had a negative impact on mental health was associated with lower QoL and well-being. Loneliness was a predictor of reduced QoL (β=-1.4, 95% C.I. =--1.6, -1.2) and poor well-being (β=-3.7, 95% C.I. =-4.3,-3.0). A weak association was noted between QoL and social isolation. CONCLUSIONS The COVID-19 pandemic is associated with differential effects among older adults. In particular, those with limited financial resources and those with multiple chronic conditions may be at more risk to suffer adverse QoL and well-being consequences. Loneliness may be a modifiable risk factor for decreased QoL and well-being amenable to targeted interventions.
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Affiliation(s)
- Jennifer Briere
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, Canada
| | - Sophia Haotong Wang
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, Canada
| | - Ulfat Ara Khanam
- Health Sciences Program, College of Medicine, Canadian Centre for Health and Safety in Agriculture, Respiratory Research Centre, University of Saskatchewan, Saskatoon, Canada
| | - Josh Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Donna Goodridge
- College of Medicine, Respiratory Research Centre, University of Saskatchewan, Saskatoon, Canada.
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Health-Related Quality of Life among Rural-Urban Migrants Living in Dhaka Slums: A Cross-Sectional Survey in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910507. [PMID: 34639807 PMCID: PMC8508420 DOI: 10.3390/ijerph181910507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The study aimed to assess the health-related quality of life (HRQoL) and its associated factors among urban slum dwellers who migrated from different rural parts of Bangladesh. METHODS The present study analyzed data from a Migration and Mobility Determinants on Health survey and was conducted in 2017 among 935 migrant slum dwellers of Dhaka city (North & South) and Gazipur City Corporations, as a part of the icddr,b's Urban Health and Demographic Surveillance System (UHDSS). The face-to-face interviews were conducted with the adult population by using a semi-structured questionnaire that included variables related to socio-demographics, migration, occupation, and HRQoL (SF-12). Bivariate and multiple linear regression analyses were performed to determine the factors associated with HRQoL. RESULTS The mean (±SD) scores of physical component summary (PCS), and mental component summary (MCS) were 57.40 ± 22.73 and 60.77 ± 22.51, respectively. As per multiple regression analysis, lower PCS scores were associated with having older age, being female, and not having any job. Mean MCS scores were significantly lower among participants who reported having older age, not having any job, not working/ less working hours (≤8 h/day), as well as increased work-related stress in the current urban slum. CONCLUSIONS The findings suggest that available urban social protection programs should include a comprehensive social safety net for the improvement of the slum infrastructure as well as proper health care and risk mitigation plans at workplaces.
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El Fakiri F, Bouwman-Notenboom J, Agyemang C. Ethnic differences in functional limitations: a comparison of older migrants and native Dutch older population. Eur J Public Health 2021; 32:214-219. [PMID: 34557916 PMCID: PMC8975522 DOI: 10.1093/eurpub/ckab080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Although the older migrants population in Europe is expected to grow substantially in the coming years, there is little information about their health status and particularly functional limitations. This study examined the association of ethnicity and mobility, hearing and visual limitations in comparison to the general population in the Netherlands, and whether relevant characteristics explained the potential differences between older migrants and non-migrants. Methods Secondary data analysis of 12 652 subjects 55 years and older who participated in the health survey in the four largest Dutch cities. To establish limitations in vision, hearing and mobility, the Organization for Economic Co-operation and Development (OECD) questionnaire was used. Logistic regression analysis was used to examine the association between limitations and ethnic background, subsequently adjusting for demographic and socio-economic characteristics and relevant health- and lifestyle-related factors. Results Older migrants had higher prevalences of functional limitations. The age- and- gender adjusted ORs were 2 to 8-fold compared with older non-migrants. After adjusting for socioeconomic status and health-and lifestyle indicators, Moroccan, Turkish and Surinamese migrants still had increased ORs for visual limitations [ORs (95% CI), respectively: 2.48 (1.49–4.14), 3.08 (1.75–5.41) and 1.97 (1.33–2.91)] compared with the Dutch. For mobility limitations, only the Turkish migrants had an OR twice as high (2.19; 1.08–4.44) as the non-migrants. No significant differences were found between Antillean/Aruban migrants and non-migrants. Conclusions Important ethnic inequalities exist in various functional limitations, particularly in vision. These results underline the importance of tailored preventive interventions in older migrants to detect and prevent these limitations at an early stage.
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Affiliation(s)
- Fatima El Fakiri
- Department of Epidemiology, Health Promotion and Care Innovation, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | | | - Charles Agyemang
- Department of Public & Occupation Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Tian T, Kong F, Li S. Effects of Living Conditions, Subjective Integration, and Social Networks on Health-Related Quality of Life among the Migrant Elderly Following Children in Jinan, China. Healthcare (Basel) 2021; 9:healthcare9040414. [PMID: 33918512 PMCID: PMC8066240 DOI: 10.3390/healthcare9040414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Tingting Tian
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Correspondence: (F.K.); (S.L.)
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Correspondence: (F.K.); (S.L.)
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Krist L, Dornquast C, Reinhold T, Becher H, Jöckel KH, Schmidt B, Schramm S, Icke K, Danquah I, Willich SN, Keil T, Brand T. Association of Acculturation Status with Longitudinal Changes in Health-Related Quality of Life-Results from a Cohort Study of Adults with Turkish Origin in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062827. [PMID: 33802126 PMCID: PMC7999343 DOI: 10.3390/ijerph18062827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 11/18/2022]
Abstract
Health-related quality of life (HRQL) among migrant populations can be associated with acculturation (i.e., the process of adopting, acquiring and adjusting to a new cultural environment). Since there is a lack of longitudinal studies, we aimed to describe HRQL changes among adults of Turkish descent living in Berlin and Essen, Germany, and their association with acculturation. Participants of a population-based study were recruited in 2012–2013 and reinvited six years later to complete a questionnaire. Acculturation was assessed at baseline using the Frankfurt acculturation scale (integration, assimilation, separation and marginalization). HRQL was assessed at baseline (SF-8) and at follow-up (SF-12) resulting in a physical (PCS) and mental (MCS) sum score. Associations with acculturation and HRQL were analyzed with linear regression models using a time-by-acculturation status interaction term. In the study 330 persons were included (65% women, mean age ± standard deviation 43.3 ± 11.8 years). Over the 6 years, MCS decreased, while PCS remained stable. While cross-sectional analyses showed associations of acculturation status with both MCS and PCS, temporal changes including the time interaction term did not reveal associations of baseline acculturation status with HRQL. When investigating HRQL in acculturation, more longitudinal studies are needed to take changes in both HRQL and acculturation status into account.
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Affiliation(s)
- Lilian Krist
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Correspondence:
| | - Christina Dornquast
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- German Center for Neurodegenerative Diseases (DZNE), 17489 Greifswald, Germany
| | - Thomas Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry und Epidemiology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (K.-H.J.); (B.S.); (S.S.)
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry und Epidemiology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (K.-H.J.); (B.S.); (S.S.)
| | - Sara Schramm
- Institute for Medical Informatics, Biometry und Epidemiology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (K.-H.J.); (B.S.); (S.S.)
| | - Katja Icke
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Ina Danquah
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Institute of Global Health (HIGH), Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.D.); (T.R.); (K.I.); (I.D.); (S.N.W.); (T.K.)
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany;
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“We are all under the same roof”: Coping and meaning-making among older Bhutanese with a refugee life experience. Soc Sci Med 2020; 264:113311. [PMID: 32890976 PMCID: PMC9412077 DOI: 10.1016/j.socscimed.2020.113311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/22/2020] [Accepted: 08/14/2020] [Indexed: 11/21/2022]
Abstract
Objective: Refugees have elevated risk of psychological distress and mental health disorders compared to the general population. The majority of research has been conducted with youth and younger adults, and little is known about the mental health of older refugees. We apply the theoretical framework of meaning making to understand how older Bhutanese with a refugee life experience cope with migratory traumas and grief. Method: We conduct semi-structured individual interviews with 41 ethnic-Nepali Bhutanese aged 50 and over with a refugee life experience resettled in the United States and analyze data using thematic content analysis. Results: Forced expulsion from Bhutan was viewed as a violation of core ethnic-Nepali beliefs and sense of purpose related to collective identity. Throughout their 30-year refugee life trajectory, participants utilized coping strategies, including interpersonal support, reappraisal of experiences of trauma and loss, and helping oneself by helping others, that were informed by, and strengthened, this collective identity. These strategies served to both reaffirm worldviews and make new, positive meaning out of a refugee life experience. Individuals who were unable to leverage these strategies struggled to find meaning. Conclusions: We discuss study implications for psychosocial services for older refugees and contribution to theory on meaning making among diverse, vulnerable populations who experience multiple traumas and loss.
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Rousseau C, Frounfelker RL. Mental health needs and services for migrants: an overview for primary care providers. J Travel Med 2019; 26:5251755. [PMID: 30561687 DOI: 10.1093/jtm/tay150] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND The objective of this article is to present an overview of the burden, spectrum of diseases and risk factors for mental illness among subgroups of migrants, namely, immigrants, refugees and individuals with precarious legal status. This expert review summarises some of the implications for primary care services in migrant receiving countries in the global North. METHODS A broad literature review was conducted on the epidemiology of mental health disorders in migrants and the available evidence on mental health services for this population focusing on key issues for primary care practitioners in high-income countries. RESULTS Although most migrants are resilient, migration is associated with an over-representation of mental disorder in specific subpopulations. There is a general consensus that stress-related disorders are more prevalent among refugee populations of all ages compared to the general population. Relative to refugees, migrants with precarious legal status may be at even higher risk of depression and anxiety disorders. Persistence and severity of psychiatric disorders among migrant populations can be attributed to a combination of factors including severity of trauma exposures during the migration process. Exposure to stressors after resettlement, such as poverty and limited social support, also impacts mental illness. Services for migrants are affected by restricted accessibility and should address cultural and linguistic barriers to and issues in the larger social environment that impact psychosocial functioning. CONCLUSION There is substantial burden of mental illness among some migrant populations. Primary care providers seeking to assist individuals need to be cognizant of language barriers to and challenges of working with interpreters as well as sensitive to cultural and social contexts within the diagnosis and service delivery process. In addition, best practices in screening migrants and providing intervention services for mental disorders need to be sensitive to where individuals and families are in the resettlement trajectory.
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Affiliation(s)
- Cécile Rousseau
- McGill University-Division de psychiatrie sociale et culturelle, CLSC Parc Extension 7085 Hutchison, Local 204.2, Montreal, Quebec, Canada
| | - Rochelle L Frounfelker
- McGill University-Division de psychiatrie sociale et culturelle, CLSC Parc Extension 7085 Hutchison, Local 204.2, Montreal, Quebec, Canada
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11
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Zhu Y, Liu J, Qu B, Yi Z. Quality of life, loneliness and health-related characteristics among older people in Liaoning province, China: a cross-sectional study. BMJ Open 2018; 8:e021822. [PMID: 30429143 PMCID: PMC6252650 DOI: 10.1136/bmjopen-2018-021822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 08/09/2018] [Accepted: 10/02/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The aim of the study was to examine the relations among quality of life (QOL), loneliness and health-related characteristics in a sample of Chinese older people. DESIGN Cross-sectional study. SETTING Communities in Dandong city, Liaoning province, China. PARTICIPANTS Sample of 732 older people aged 60 and older who were living in Dandong, Liaoning province, China. METHODS A questionnaire was administered to the participants face-to-face. The questionnaire contained four sections: demographic characteristics, health-related characteristics, the EQ-5D Scale and the UCLA Loneliness Scale. The t-test, F-test and multivariable linear regression analyses were performed to individually test associations between the demographic data, health-related characteristics, loneliness and QOL. RESULTS Chronic diseases, loneliness, age and smoking status were negatively associated with QOL (p<0.05). Satisfaction with health services, income and physical activity were positively associated with QOL (p<0.05). CONCLUSIONS Loneliness, chronic diseases and health service satisfaction were important factors related to low QOL among older people in China. The findings indicate that reducing loneliness, managing chronic diseases and improving the health service may help to improve the QOL for older people.
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Affiliation(s)
- Yaxin Zhu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Jie Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Bo Qu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Zhe Yi
- Department of Prothodontics, School of Stomatology, China Medical University, Shenyang, People’s Republic of China
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12
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Slotman A, Cramm JM, Nieboer AP. Validation of the Aging Perceptions Questionnaire Short on a sample of community-dwelling Turkish elderly migrants. Health Qual Life Outcomes 2017; 15:42. [PMID: 28222807 PMCID: PMC5320659 DOI: 10.1186/s12955-017-0619-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 02/17/2017] [Indexed: 11/23/2022] Open
Abstract
Background Aging perceptions have been found to be major contributors to health in old age. To quantitatively explore aging perceptions among elderly Turkish migrants, valid and reliable Turkish-language instruments are needed. The objective of the current study was to examine the construct validity and reliability of the Turkish-language version of the seven-dimension Aging Perceptions Questionnaire Short version (APQ-S) in a sample of community-dwelling elderly Turkish migrants in the Netherlands. Methods A questionnaire including the Turkish-language APQ-S was administered to 438 community-dwelling Turkish migrants aged 65–99 years who resided in Rotterdam, the Netherlands. The APQ-S includes 21 items in seven dimensions (timeline chronic and cyclical, consequence positive and negative, control positive and negative, and emotional representations). The questionnaire also contained items measuring well-being, physical and mental health-related quality of life, and number of chronic conditions. Results The latent factor model of the Turkish APQ-S was found to have an acceptable fit (root mean square error of approximation = .06; standardized root mean square residual = .07; comparative fit index = .90). Each indicator loaded significantly on its corresponding latent factor, and standardized factor loadings > .40 supported the convergent validity of the Turkish APQ-S dimensions. The APQ-S was also found to have acceptable construct validity in terms of its inter-factor structure and its expected associations with various health measures and age, gender, educational level, and marital status. Contrary to expectations, income level was not associated with any APQ-S dimension. With the exception of timeline cyclical (α = .56), each APQ-S dimension had acceptable reliability, with Cronbach’s alpha values ranging from .75 (timeline chronic) to .88 (control positive). Most APQ-S dimension scores differed significantly between elderly Turkish migrants and a general population of elderly Rotterdam residents, with Turkish elders having more negative and less positive aging perceptions. Conclusion The Turkish-language version of the APQ-S is a psychometrically valid and reliable instrument for the assessment of aging perceptions among elderly Turkish migrants. Further research is needed to gain insight into aging perceptions and their health and sociodemographic correlates in this population. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0619-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne Slotman
- Department of Socio-Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands
| | - Jane M Cramm
- Department of Socio-Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands
| | - Anna P Nieboer
- Department of Socio-Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands.
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13
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Guan M. Measuring the effects of socioeconomic factors on mental health among migrants in urban China: a multiple indicators multiple causes model. Int J Ment Health Syst 2017; 11:10. [PMID: 28070220 PMCID: PMC5217273 DOI: 10.1186/s13033-016-0118-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 12/29/2016] [Indexed: 11/10/2022] Open
Abstract
Objectives Since 1978, rural–urban migrants mainly contribute Chinese urbanization. The purpose of this paper is to examine the effects of socioeconomic factors on mental health of them. Their mental health was measured by 12-item general health questionnaire (GHQ-12). Methods The study sample comprised 5925 migrants obtained from the 2009 rural-to-urban migrants survey (RUMiC). The relationships among the instruments were assessed by the correlation analysis. The one-factor (overall items), two-factor (positive vs. negative items), and model conducted by principal component analysis were tested in the confirmatory factor analysis (CFA). On the basis of three CFA models, the three multiple indicators multiple causes (MIMIC) models with age, gender, marriage, ethnicity, and employment were constructed to investigate the concurrent associations between socioeconomic factors and GHQ-12. Results Of the sample, only 1.94% were of ethnic origin and mean age was 31.63 (SD = ±10.43) years. The one-factor, two-factor, and three-factor structure (i.e. semi-positive/negative/independent usefulness) had good model fits in the CFA analysis and gave order (i.e. 2 factor>3 factor>1 factor), which suggests that the three models can be used to assess psychological symptoms of migrants in urban China. All MIMIC models had acceptable fit and gave order (i.e. one-dimensional model>two-dimensional model>three-dimensional model). Conclusions There were weak associations of socioeconomic factors with mental health among migrants in urban China. Policy discussion suggested that improvement of socioeconomic status of rural–urban migrants and mental health systems in urban China should be highlighted and strengthened. Electronic supplementary material The online version of this article (doi:10.1186/s13033-016-0118-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ming Guan
- Family Issues Center at Xuchang University, School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan China
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14
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van Assen MALM, Pallast E, Fakiri FE, Gobbens RJJ. Measuring frailty in Dutch community-dwelling older people: Reference values of the Tilburg Frailty Indicator (TFI). Arch Gerontol Geriatr 2016; 67:120-9. [PMID: 27498172 DOI: 10.1016/j.archger.2016.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/19/2016] [Accepted: 07/20/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The objectives of this study were to provide reference values of the Tilburg Frailty Indicator (TFI) for community-dwelling older people by age, sex, marital status, ethnicity, education, income, and residence, and examine the effects of these seven socio-demographic variables on frailty. METHODS 47,768 individuals aged 65 years and older living in the Netherlands completed a health questionnaire (58.5% response rate), including the TFI. The TFI is a self-report questionnaire for measuring frailty, developed from an integral approach of frailty, including physical, psychological, and social domains. RESULTS Reference values were provided for men and women separately, as a function of age. We found associations of all socio-demographic variables with frailty, also after controlling for the effects of age. These associations held for both sexes and for big cities as wells as more rural areas. For instance, the effect of age was large for total and physical frailty, women were more frail than men, and some very large average frailty differences between the ethnic groups were found, with autochthon people having the lowest frailty score. CONCLUSIONS In conclusion, this study offers reference values of the TFI by socio-demographic characteristics and explains frailty using these characteristics. This information will support researchers, policymakers and health care professionals in interpreting scores of the TFI, which may guide their efforts to reduce frailty and its adverse outcomes.
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Affiliation(s)
- Marcel A L M van Assen
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands; Department of Sociology, Utrecht University, Utrecht, The Netherlands
| | - Esther Pallast
- Department of Health Promotion, Regional Public Health Service, Hart voor Brabant, 's-Hertogenbosch, The Netherlands
| | - Fatima El Fakiri
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands; Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.
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15
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Gobbens RJJ, van Assen MALM. Psychometric properties of the Dutch WHOQOL-OLD. Health Qual Life Outcomes 2016; 14:103. [PMID: 27416861 PMCID: PMC4946232 DOI: 10.1186/s12955-016-0508-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the internal consistency reliability and construct validity of the Dutch version of the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD). METHODS The psychometric properties of the Dutch WHOQOL-OLD were examined in a cross-sectional study using a sample of 1,340 people aged 60 years or older. Participants completed a Web-based questionnaire, the 'Senioren Barometer'. Reliability was evaluated using Cronbach's alpha and corrected item-total correlations. Construct validity of the Dutch WHOQOL-OLD was evaluated with confirmatory factor analyses, and correlations within and between scales, using scales WHOQOL-BREF, Short Form Health Survey (SF-12), Tilburg Frailty Indicator (TFI), and the Emotional and Social Loneliness Scale (ESLS). RESULTS The reliabilities of the six WHOQOL-OLD facets or subscales were sufficient to good (.66-.91). The convergent validity of the WHOQOL-OLD was good, whereas our findings on the divergent validity of the WHOQOL-OLD were somewhat mixed. Findings corroborating the divergent validity were that the 6-factor model fitted better than the second-order factor model, and WHOQOL-OLD facets sensory abilities, past, present and future activities, death and dying, intimacy correlated more strongly with similar than dissimilar scales. Not fully supporting divergent validity were the extremely high correlations between the factors corresponding to autonomy, past, present and future activities, and social participation. CONCLUSION We offer Dutch healthcare and social workers an instrument with good psychometric properties for measuring quality of life in older people. Further research on interrelations between WHOQOL-OLD facets is recommended.
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Affiliation(s)
- Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, 1081 HV, Amsterdam, The Netherlands. .,Zonnehuisgroep Amstelland, Amstelveen, The Netherlands.
| | - Marcel A L M van Assen
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Department of Sociology, Utrecht University, Utrecht, The Netherlands
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16
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Bodewes AJ, Kunst AE. Involving hard-to-reach ethnic minorities in low-budget health research: lessons from a health survey among Moluccans in the Netherlands. BMC Res Notes 2016; 9:319. [PMID: 27328767 PMCID: PMC4915185 DOI: 10.1186/s13104-016-2124-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background There is little evidence on which strategies are effective in recruiting minority groups in low-budget health surveys. We evaluated different recruitment strategies for their impact on response rates in a hard-to-reach minority population in the Netherlands. Methods We conducted a health survey in 19 Moluccan districts (MDs). Each MD had its own set of recruitment strategies, such as information meetings, involving social or local media, involving community organizations, and door-to-door collection. The association between recruitment strategies and MD-specific response rates was assessed with logistic regression analysis. Results The overall response rate was 24 %, and varied from 9 to 58 %. Higher rates were obtained when the strategy included door-to-door collection (OR 1.57) and ‘active’ key informants (OR 1.68). No positive associations with response rates were observed of the other strategies. Conclusions The overall low response rate in this study may be due to high levels of distrust, segmentation within the community and high respect for privacy among Moluccans. Our study shows that in such communities, response may be increased by a highly personal recruitment approach and a strong commitment and participation of community key-figures.
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Affiliation(s)
- Adee J Bodewes
- Department of Public Health, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
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Lood Q, Häggblom-Kronlöf G, Dahlin-Ivanoff S. Health promotion programme design and efficacy in relation to ageing persons with culturally and linguistically diverse backgrounds: a systematic literature review and meta-analysis. BMC Health Serv Res 2015; 15:560. [PMID: 26674647 PMCID: PMC4682220 DOI: 10.1186/s12913-015-1222-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 12/08/2015] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
- Qarin Lood
- Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30, Gothenburg, Sweden.
- University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
- University of Gothenburg Centre for Ageing and Health (Agecap), Gothenburg, Sweden.
| | - Greta Häggblom-Kronlöf
- Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30, Gothenburg, Sweden.
- University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
- University of Gothenburg Centre for Ageing and Health (Agecap), Gothenburg, Sweden.
| | - Synneve Dahlin-Ivanoff
- Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30, Gothenburg, Sweden.
- University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
- University of Gothenburg Centre for Ageing and Health (Agecap), Gothenburg, Sweden.
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Steunenberg B, Verhagen I, Ros WJ, de Wit NJ. [Towards culturally sensitive care for elderly immigrants! Design and development of a community based intervention programme in the Netherlands]. Tijdschr Gerontol Geriatr 2014; 45:82-91. [PMID: 24691859 DOI: 10.1007/s12439-014-0068-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In Western countries, health and social welfare facilities are not easily accessible for elderly immigrants and their needs are sub optimally addressed. A transition is needed towards culturally sensitive services to make cure and care accessible for elderly immigrants. We developed an intervention programme in which ethnic community health workers (CHWs) act as liaisons between immigrant elderly and local health care and social welfare services. METHODS In a quasi experimental design, the effectiveness of introduction of CHWs, will be evaluated in three (semi) urban residential areas in the Netherlands within three different migrant groups and compared with a control group. The primary outcome is use of health care and social welfare facilities by the elderly. Secondary outcomes are quality of life and functional impairments. Implementation of the intervention programme will be examined with focus groups and data registration of CHW activities. In this paper design and methodological issues are discussed. DISCUSSION This study can contribute to the improvement of care for elderly immigrants by developing culturally sensitive care whereby the elderly immigrants themselves actively participate. To enable a successful transition, proper identification and recruitment of CHWs is required. Once proven effective, the CHW function can be further integrated into the existing local health care and welfare system.
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Affiliation(s)
- B Steunenberg
- Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht, The Netherlands,
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