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美国柬埔寨难民的身心健康共病与医疗服务可及性

Comorbid mental and physical health and health access in Cambodian refugees in the US.

作者信息

Berthold S Megan, Kong Sengly, Mollica Richard F, Kuoch Theanvy, Scully Mary, Franke Todd

机构信息

School of Social Work, University of Connecticut, 1798 Asylum Ave., West Hartford, CT, 06117, USA,

出版信息

J Community Health. 2014 Dec;39(6):1045-52. doi: 10.1007/s10900-014-9861-7.

Abstract

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

摘要

关于柬埔寨难民身体健康问题的患病率及其心理健康与身体健康之间的关系,所开展的研究甚少。我们确定了柬埔寨成年难民心理健康与身体健康问题之间的关系以及他们获得医疗服务的障碍。我们采用横断面调查设计,对康涅狄格州和马萨诸塞州西部的136名柬埔寨成年难民居民进行了滚雪球抽样调查。61%的受访者报告被诊断患有三种或更多身体疾病,73%的受访者患有抑郁症、创伤后应激障碍(PTSD)或两者皆有。语言和交通问题是获得医疗服务的主要障碍。可能同时患有PTSD和抑郁症的参与者的身体健康问题比没有这两种疾病的参与者多1.850倍(p>.001;置信区间1.334 - 2.566)。年龄对这种关系有调节作用。被诊断患有抑郁症和PTSD的参与者在整个年龄段报告的健康状况数量一致,而那些没有心理健康问题或仅患其中一种疾病的参与者在年轻时报告的健康状况较少,在年长时报告的较多。这两组与报告同时患有这两种疾病的组有显著差异。在美国重新安置的柬埔寨难民中,慢性共病的心理健康和身体健康疾病之间存在显著关系。无论年龄大小,同时患有抑郁症和PTSD会使柬埔寨难民面临身体健康问题的风险。治疗柬埔寨种族灭绝幸存者的人员必须识别并治疗他们普遍存在的共病健康状况。必须解决语言和交通障碍问题,以改善这一人群获得心理健康和身体健康护理的机会。

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