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抑郁、社会因素与农业工人医疗保健利用。

Depression, social factors, and farmworker health care utilization.

机构信息

Aguirre Division, JBS International, Burlingame, CA 94010, USA. ageorges@jbsinternational. com.

出版信息

J Rural Health. 2013 Aug;29 Suppl 1:s7-16. doi: 10.1111/jrh.12008. Epub 2013 Feb 22.

Abstract

PURPOSE

Farmworkers frequently live in rural areas and experience high rates of depressive symptoms. This study examines the association between elevated depressive symptoms and health care utilization among Latino farmworkers.

METHODS

Data were obtained from 2,905 Latino farmworkers interviewed for the National Agricultural Workers Survey. Elevated depressive symptoms were measured using the Center for Epidemiologic Studies Depression short-form. A dichotomous health care utilization variable was constructed from self-reported use of health care services in the United States. A categorical measure of provider type was constructed for those reporting use of health care.

RESULTS

Over 50% of farmworkers reported at least 1 health care visit in the United States during the past 2 years; most visits occurred in a private practice. The odds of reporting health care utilization in the United States were 45% higher among farmworkers with elevated depressive symptoms. Type of provider was not associated with depressive symptoms. Women were more likely to seek health care; education and family relationships were associated with health care utilization.

CONCLUSIONS

Latino farmworkers who live and work in rural areas seek care from private practices or migrant/Community Health Clinics. Farmworkers with elevated depressive symptoms are more likely to access health care. Rural health care providers need to be prepared to recognize, screen, and treat mental health problems among Latino farmworkers. Outreach focused on protecting farmworker mental health may be useful in reducing health care utilization while improving farmworker quality of life.

摘要

目的

农场工人经常居住在农村地区,且抑郁症状发生率较高。本研究旨在探讨拉丁裔农场工人中抑郁症状升高与医疗保健利用之间的关联。

方法

数据来自接受全国农业工人调查的 2905 名拉丁裔农场工人的访谈。采用流行病学研究中心抑郁短式量表来衡量抑郁症状升高。根据在美国使用医疗保健服务的自我报告,构建了一个医疗保健利用的二分变量。对于报告使用医疗保健的人,构建了一个提供者类型的分类度量。

结果

超过 50%的农场工人报告在过去 2 年中至少在美国进行了 1 次医疗保健访问;大多数就诊发生在私人诊所。抑郁症状升高的农场工人报告在美国使用医疗保健的可能性高 45%。提供者类型与抑郁症状无关。女性更有可能寻求医疗保健;教育和家庭关系与医疗保健的利用有关。

结论

居住和工作在农村地区的拉丁裔农场工人从私人诊所或移民/社区卫生诊所寻求医疗服务。抑郁症状升高的农场工人更有可能获得医疗保健。农村医疗保健提供者需要准备好识别、筛查和治疗拉丁裔农场工人的心理健康问题。专注于保护农场工人心理健康的外展工作可能有助于减少医疗保健的利用,同时提高农场工人的生活质量。

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