Simsek Zeynep, Keklik Ayşana Zehra, Demir Canan, Munir Kerim M
Harran University, Faculty of Medicine, Public Health Department Yenisehir Campus 63100 Sanliurfa-Turkey.
Developmental Medicine Center | Boston Children's Hospital 300 Longwood Ave, Boston, MA 02115.
Int J Environ Agric Res. 2017 Jan;3(1):21-29.
Mental health problems represent a major component of the global burden of disease. The primary objective of this study was to assess the prevalence and predictors of psychological wellbeing among farmworkers and to evaluate their mental health services need for in rural primary health care settings.
The study sample comprised 1855 farmworkers (918 women, and 937 men) who were selected using probability cluster sampling method at 95% confidence interval (87.6 % response rate). The 12-item General Health Questionnaire (GHQ-12) and socio-demographic information form were used to data collection.
The overall prevalence of mental health problems was 31.5%; the prevalence among women was 1.4 times that of men (35%, females; 28.2%, males). Logistic regression analyses revealed that poor general health, as well as presence of chronic diseases and exposure to traumatic life events predicted mental ill health among both sex. Poor economic situation, being seasonal migrant farmworker, and pesticide exposure history affected male mental health problems; while type of settlement, history of having disabled child at birth, and not having a family physician were significant predictors of female mental ill health ( < 0.05).
These findings highlight the need for systematic development of community-based mental health services in conjunction with rural primary health care center and an integrated approach to health care of farmworkers. These include screening, early identification and treatment of mental health problems, development of non-communicable disease (NCD) control program, maternal health services and urgent measures to improve farmworkers' work safety and pesticide applications.
心理健康问题是全球疾病负担的主要组成部分。本研究的主要目的是评估农场工人心理健康状况的患病率和预测因素,并评估他们在农村初级卫生保健机构对心理健康服务的需求。
研究样本包括1855名农场工人(918名女性和937名男性),采用概率整群抽样方法选取,置信区间为95%(应答率为87.6%)。使用12项一般健康问卷(GHQ-12)和社会人口学信息表进行数据收集。
心理健康问题的总体患病率为31.5%;女性患病率是男性的1.4倍(女性为35%,男性为28.2%)。逻辑回归分析显示,总体健康状况不佳、患有慢性病以及经历创伤性生活事件是两性心理健康问题的预测因素。经济状况差、季节性流动农场工人身份以及农药接触史影响男性心理健康问题;而居住类型、出生时有残疾子女的病史以及没有家庭医生是女性心理健康问题的重要预测因素(P<0.05)。
这些发现凸显了与农村初级卫生保健中心协同系统开展社区心理健康服务以及采用综合方法为农场工人提供医疗保健的必要性。这些措施包括筛查、早期识别和治疗心理健康问题、制定非传染性疾病控制项目、孕产妇保健服务以及采取紧急措施改善农场工人的工作安全和农药使用情况。