Siriwardhana Chesmal, Wickramage Kolitha, Siribaddana Sisira, Vidanapathirana Puwalani, Jayasekara Buddhini, Weerawarna Sulochana, Pannala Gayani, Adikari Anushka, Jayaweera Kaushalya, Pieris Sharika, Sumathipala Athula
Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK.
Institute for Research & Development, Colombo, Sri Lanka.
BMC Public Health. 2015 Mar 28;15:299. doi: 10.1186/s12889-015-1632-6.
Nearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka.
A cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered.
A total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group.
To our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is highlighted by the considerably high prevalence of CMD among adults in left-behind families. A policy framework that enables health protection whilst promoting migration for development remains a key challenge for labour-sending nations.
近十分之一的斯里兰卡人作为国际移民工人在国外就业。对于那些留在国内的家庭成员的心理健康状况，人们知之甚少。本研究旨在探讨经济移民对斯里兰卡留守家庭心理健康（常见精神障碍）的影响。
采用多阶段抽样的横断面调查在斯里兰卡的六个地区（占出境移民工人人口的62%）进行。招募了经济移民家庭中的配偶和非配偶照料者（那些为孩子提供大量照料的人）。使用患者健康问卷对成年人的心理健康进行测量。收集了人口统计学、社会经济、移民相关和卫生利用信息。
共招募了410个移民工人家庭（应答率：95.1%）。为55个家庭招募了配偶和非配偶照料者，共纳入277名配偶和188名照料者。非配偶照料者组的总体健康状况较差、当前诊断疾病和医疗就诊频率较高。常见精神障碍（CMD；抑郁症、躯体形式障碍、焦虑症）的总体患病率为20.7%（95%CI 16.9 - 24.3），配偶中的患病率为14.4%（95%CI 10.3 - 18.6），非配偶照料者中的患病率为29.8%（95%CI 23.2 - 36.4）。非配偶照料者组中抑郁症（25.5%；95%CI 19.2 - 31.8）和躯体形式障碍（11.7%；95%CI 7.0 - 16.3）的患病率较高。在对年龄和性别进行调整后，家庭中未回国的移民工人、小学教育程度以及低入境汇款频率与配偶的CMD相关，而在非配偶照料者组中，未接受教育、总体健康状况差和医疗就诊次数增加与之显著相关。
据我们所知，这是首批通过标准化诊断工具在斯里兰卡和南亚地区探索国际移民工人成年留守家庭成员特定心理健康结果的研究之一。留守家庭中成年人CMD的患病率相当高，凸显了经济移民的负面影响。对于劳务输出国来说，建立一个既能促进移民发展又能保障健康的政策框架仍然是一项关键挑战。
