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苏丹的“迷失男孩”:在美国重新安置的无人陪伴难民未成年人的医疗服务利用情况和健康功能结局

The "lost boys" of Sudan: use of health services and functional health outcomes of unaccompanied refugee minors resettled in the U.S.

作者信息

Geltman Paul L, Grant-Knight Wanda, Ellis Heidi, Landgraf Jeanne M

机构信息

Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA,

出版信息

J Immigr Minor Health. 2008 Oct;10(5):389-96. doi: 10.1007/s10903-007-9110-6.

Abstract

To assess whether mental health counseling and other health services were associated with functional health outcomes of unaccompanied Sudanese refugee minors in the U.S., this study was a descriptive survey of 304 Sudanese refugee minors in foster care through the U.S. Unaccompanied Refugee Minors Program (URMP). Functional health outcomes included scores of Child Health Questionnaire (CHQ) scales and questions regarding care for symptoms or problems associated with behavioral disorders, i.e. somatization. Posttraumatic stress disorder (PTSD) was assessed using the Harvard Trauma Questionnaire (HTQ). Health services questions derived from the National Health Interview Survey. Minors reported high rates of counseling (45%); however no differences were noted in counseling use by those with PTSD compared with others. Counseling was not associated with health outcomes. The majority (76%) reported seeking medical care for symptoms or problems often associated with behavioral and emotional problems; however such care-seeking was more common among those with PTSD (OR = 2.5, 95% CI = 1.004-6.26). Through the efforts of the URMP, the Sudanese unaccompanied minors received high levels of psychosocial support despite the absence of their biological parents. Those with worse functional health were no more likely than others to have received mental health counseling while being more likely to seek care from any health professional. This was also the case for those with PTSD compared to those without it. In linear regression analyses, reported receipt of mental health counseling did not impact either positively or negatively on the score of any CHQ scale.

摘要

为评估心理健康咨询及其他健康服务是否与在美国无人陪伴的苏丹难民未成年人的功能健康结局相关,本研究通过美国无人陪伴难民未成年人项目(URMP)对304名寄养中的苏丹难民未成年人进行了描述性调查。功能健康结局包括儿童健康问卷(CHQ)量表得分以及有关护理行为障碍相关症状或问题(即躯体化)的问题。使用哈佛创伤问卷(HTQ)评估创伤后应激障碍(PTSD)。健康服务问题源自国家健康访谈调查。未成年人报告的咨询率很高(45%);然而,与其他人相比,PTSD患者在咨询使用方面未发现差异。咨询与健康结局无关。大多数人(76%)报告为行为和情绪问题常伴有的症状或问题寻求医疗护理;然而,这种寻求护理的情况在PTSD患者中更为常见(比值比=2.5,95%置信区间=1.004 - 6.26)。通过URMP的努力,苏丹无人陪伴的未成年人尽管没有亲生父母,但仍获得了高水平的心理社会支持。功能健康较差的人与其他人相比,接受心理健康咨询的可能性并不更高,但更有可能向任何健康专业人员寻求护理。患有PTSD的人与未患PTSD的人相比也是如此。在线性回归分析中,报告接受心理健康咨询对任何CHQ量表得分均未产生积极或消极影响。

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