Social Determinants of Resilience Among Syrian Refugees in Jordan

The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health

Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.

Factors Contributing to Resilience Among First Generation Migrants, Refugees and Asylum Seekers: A Systematic Review

Objectives: We aimed at 1) collating and evaluating the current evidence on factors contributing to resilience of adult transnational migrants, 2) identifying methodological factors which contribute to the findings, 3) identifying and analyzing promotive and preventive factors contributing to the findings. Methods: A systematic search for relevant studies published until 2021 was conducted in PubMed, PsycINFO, PTSDPubs, and Web of Science. Both, quantitative and qualitative peer-reviewed observational studies reporting on resilience and wellbeing, sense of coherence, or post-traumatic growth outcomes among transnational migrants (aged 18+). Risk of Bias was assessed using the Critical Appraisal Skills Program for qualitative studies and the Appraisal Tool for cross-sectional studies. Due to the heterogeneity of studies we did a narrative review. Results: Database search yielded 3,756 unique records, of those n = 80 records, representing n = 76 studies met the inclusion criteria. The studies provided knowledge on resilience for n = 9,845 transnational migrants across 23 countries. All studies except two were cross sectional. N = 45 reported on resilience, n = 4 on Sense of Coherence and n = 15 on Post-Traumatic Growth. The study methods were not related to the findings. Future orientation, hope and religion/spirituality, caring for others and having opportunities were shown to be more pertinent to resilience outcomes than institutional care structures. Conclusion: Our findings highlight that mental health professionals and policymakers should try to support positive perspectives for the future and encourage policies tailored towards giving refugees opportunities to work, learn and care and to help others.

Understanding Mental Health Status of Syrian Refugee and Jordanian Women: Novel Insights from a Comparative Study

(1) Background: War and displacement are well-known predictors of negative mental health outcomes among affected populations. This is especially relevant for refugees of war, particularly women, who often repress their mental health needs due to family responsibilities, social stigma, and/or cultural pressures. In this study, we compared the mental health status of urban Syrian refugee women (n = 139) with local Jordanian women (n = 160). (2) Methods: Psychometrically validated Afghan Symptom Checklist (ASC), Perceived Stress Scale (PSS), and Self-Report Questionnaire (SRQ) examined psychological distress, perceived stress, and mental health, respectively. (3) Results: According to independent t-tests, Syrian refugee women scored higher than Jordanian women on the ASC [mean score (SD): 60.79 (16.67) vs. 53.71 (17.80), p < 0.001], PSS [mean score (SD): 31.59 (8.45) vs. 26.94 (7.37), p < 0.001], and SRQ [mean score (SD): 11.82 (4.30) vs. 10.21 (4.72), p = 0.002]. Interestingly, both Syrian refugee and Jordanian women scored higher than the clinical cutoff in the SRQ. Regression analyses indicated that more educated women were less likely to score high on the SRQ (β = -0.143, p = 0.019), particularly in the anxiety and somatic symptoms subscale (β = -0.133, p = 0.021), and were less likely to exhibit symptoms of ruminative sadness (β = -0.138, p = 0.027). Employed women were more likely to exhibit high coping ability than unemployed women (β = 0.144, p = 0.012). (4) Conclusions: Syrian refugee women scored higher than Jordanian women in all used mental health scales. Access to mental health services and enhancing educational opportunities would help mitigate perceived stress and may enhance stress-coping abilities.

Adversity, emotion, and resilience among Syrian refugees in the Netherlands

Background

Syrian refugees comprise the vast majority of refugees in the Netherlands. Although some research has been carried out on factors promoting refugee resilience, there have been few empirical studies on the resilience of Syrian refugees.

Method

We used a qualitative method to understand adversity, emotion, and the factors contributing to resilience in Syrian refugees. We interviewed eighteen adult Syrian refugees residing in the Netherlands and used thematic analysis to identify the themes.

Results

We identified themes and organized them into three main parts describing the challenges (pre and post-resettlement), key emotions pertaining to those experiences, and resilience factors. We found six primary protective factors internally and externally promoting participants' resilience: future orientation, coping strategies, social support, opportunities, religiosity, and cultural identity. In addition, positive emotions constituted a key feature of refugees’ resilience.

Conclusion

The results highlight the challenges and emotions in each stage of the Syrian refugees’ journey and the multitude of factors affecting their resilience. Our findings on religiosity and maintaining cultural identity suggest that resilience can be enhanced on a cultural level. So it is worth noting these aspects when designing prevention or intervention programs for Syrian refugees.

Mental health outcomes in Syrian refugees: A systematic review

BACKGROUND

Syria is the main country of origin for refugees in the world. The prevalence of mental disorders in this population is high, but there is a lack of more comprehensive data on mental health issues in this population.

AIM

This study aims to review the literature for mental health outcomes in Syrian refugees.

METHODS

We performed a systematic quantitative literature review of original observational studies indexed on the MEDLINE via PubMed, Embase, Web of Science, PsycINFO, LILACS, and SciELO databases with quantitative data reporting mental health outcomes in Syrian refugees. A descriptive analysis was conducted, and the quality of the included studies was assessed using an adaptation from The National Institutes of Health (NIH) quality assessment tool for observational studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed.

RESULTS

A total of 64 studies were included. The majority were published between 2019 and 2020, and focused on the prevalence of post-traumatic stress disorder (PTSD), depression, and anxiety, with a wide range of variations. Other outcomes were difficulties in the post-migration period and promotive factors for mental health, such as resilience, positive coping strategies, and psychosocial well-being.

CONCLUSIONS

High prevalence rates of mental disorders were observed, as well as risk factors for their occurrence. Studies showed a very high variability of prevalence rates and heterogeneity in methodologies. There is a need for research focusing on other determinants and specific necessities for mental health, especially in the post-resettlement period.