Department of Adolescent Medicine and Eating Disorders, Princess Margaret Hospital for Children, Perth, Western Australia, Australia School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Telethon Kids Institute, Western Australia, Australia Refugee Health Service, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
Arch Dis Child. 2016 Jul;101(7):670-6. doi: 10.1136/archdischild-2014-307221. Epub 2015 Oct 15.
Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals.
青少年难民是一个弱势群体,他们有着独特的医疗保健需求,与年轻和老年群体不同。这一年龄段的青少年常见的健康问题包括传染病,其次是营养缺乏和其他慢性疾病。此外,青少年难民往往经历过多次创伤性压力源,患心理健康问题的风险更高。在青春期发育的同时应对这些问题会增加更多的挑战,并可能导致或加剧健康风险行为的出现。教育困难和文化适应问题进一步加剧了这些问题。有过拘留经历或父母不在身边的青少年尤其处于危险之中。尽管越来越多的青少年难民在高收入国家重新安置,但对他们特定医疗保健需求的了解有限。研究数据主要是从儿科和成人队列研究中推断出来的。全面管理这一群体所面临的医疗和心理问题具有挑战性,需要了解可能对有效医疗保健服务产生影响的社会经济因素。法律和伦理问题会进一步使管理复杂化,以文化上适当的方式解决这些问题至关重要。早期识别和管理在高收入国家重新安置的青少年难民所面临的医疗保健问题是改善长期健康结果和未来医疗保健负担的关键。这篇综述文章旨在提高儿科医生和其他卫生专业人员对这些问题的认识和了解。