University of Connecticut Health Center, MC3910, 263 Farmington Ave., Farmington, CT, 06030, USA,
J Immigr Minor Health. 2013 Dec;15(6):1065-72. doi: 10.1007/s10903-012-9715-2.
Mental health problems among Southeast Asian refugees have been documented. However, longer term health consequences of mass violence as re-settled refugees age are less well described. This study investigated relationships among trauma symptoms, self-reported health outcomes, and barriers to healthcare among Cambodian and Vietnamese persons in Connecticut. An internet phone directory was used to generate a list of names that was compared to 2000 census data to estimate the proportion of the population in each group. From these lists, 190 telephone listings were selected at random. Interviewers telephoned selected listings to screen for eligible participants and obtain an appointment for interview. Surveys were administered through face-to-face interviews during home visits conducted in Khmer or Vietnamese. The Harvard Trauma Questionnaire assessed trauma symptoms. Questions regarding the presence of physician diagnosed heart disease, hypertension, diabetes, and chronic pain were adapted as written from the Health Interview Survey. Healthcare access and occurrence were measured with questions regarding cost and access, patient-provider understanding, and interpretive services. Hierarchical modeling was used to account for respondent nesting within family. Analyses controlled for age, sex, and country of origin. Individuals who reported greater trauma symptoms were more likely to report heart disease by a factor of 1.82, hypertension by a factor of 1.41, and total count of diseases by a factor of 1.22, as well as lower levels of subjective health. Greater trauma symptoms were also associated with greater lack of understanding, cost and access problems, and the need for an interpreter. Although the majority of Southeast Asian immigrants came to the United States as refugees approximately 20-30 years ago, there continues to be high levels of trauma symptoms among this population which are associated with increased risk for disease and decreased access to healthcare services.
东南亚难民的心理健康问题已有相关记录。然而，大规模暴力事件对重新安置的难民的长期健康后果描述得较少。本研究调查了康涅狄格州柬埔寨和越南人创伤症状、自我报告的健康结果以及医疗保健障碍之间的关系。使用互联网电话目录生成一份名单，然后将该名单与 2000 年的人口普查数据进行比较，以估计每组人群的比例。从这些名单中，随机选择了 190 个电话号码。访谈员通过电话联系选定的电话号码，筛选合格的参与者，并安排面谈时间。调查是通过家访期间进行的面对面访谈进行的，使用的语言是高棉语或越南语。哈佛创伤问卷评估创伤症状。关于心脏病、高血压、糖尿病和慢性疼痛的医生诊断的问题是根据健康访谈调查中书面问题改编的。医疗保健的获取和发生情况是通过询问费用和获取、患者与提供者的理解程度以及口译服务来衡量的。层次模型用于解释受访者在家庭内的嵌套情况。分析控制了年龄、性别和原籍国。报告创伤症状较重的人更有可能报告心脏病的风险增加 1.82 倍，高血压的风险增加 1.41 倍，疾病总数的风险增加 1.22 倍，以及主观健康水平较低。创伤症状较重还与理解程度较低、费用和获取问题以及需要口译服务有关。尽管大多数东南亚移民大约 20-30 年前作为难民来到美国，但该人群中仍存在较高水平的创伤症状，这与疾病风险增加和医疗保健服务获取减少有关。
