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南澳大利亚农村地区从事农业和非农业工作的成年人寻求心理健康支持的障碍比较。

A comparison of barriers to mental health support-seeking among farming and non-farming adults in rural South Australia.

作者信息

Hull Melissa J, Fennell Kate M, Vallury Kari, Jones Martin, Dollman James

机构信息

Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.

Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.

出版信息

Aust J Rural Health. 2017 Dec;25(6):347-353. doi: 10.1111/ajr.12352. Epub 2017 Jun 15.

Abstract

OBJECTIVE

To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use.

DESIGN

A cross-sectional survey, modified from the Barriers to Help-Seeking Scale (BHSS), was conducted using a computer-assisted telephone interview.

SETTING

Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia.

PARTICIPANTS

Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses.

MAIN OUTCOME MEASURE

Farmers and non-farmers were compared on domain scores and individual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals.

RESULTS

In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers (P = 0.009) with a trend (P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference (P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers.

CONCLUSION

Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population.

摘要

目的

评估农村务农与非务农成年人在心理健康服务利用的感知障碍方面的差异。

设计

采用计算机辅助电话访谈进行一项横断面调查,该调查改编自求助障碍量表(BHSS)。

背景

受访者(年龄52.6±11.6岁)从南澳大利亚的三个农村地区招募。

参与者

分析纳入了约78名非农民和45名农民。78名退休人员和2名失业参与者被排除在分析之外。

主要结局指标

比较农民和非农民在改编后的BHSS的领域得分和个体项目反应,这些反应代表对心理健康求助支持的“农业”态度:坚忍克己、自力更生、问题最小化、污名化以及对卫生专业人员的不信任。

结果

在领域得分分析中,“控制需求和自力更生”对农民而言是比非农民更强的障碍(P = 0.009),在“问题最小化和顺从”领域农民中存在更强障碍的趋势(P = 0.07)。在项目层面反应分析中,农民和非农民在对“我发现难以理解我的医生/卫生专业人员”的反应上存在差异(P = 0.03),24.4%的农民认为这是一个障碍,而非农民的这一比例为15.3%。

结论

在心理健康方面,长期以来关于农民坚忍克己和自力更生的刻板印象在一定程度上得到了支持。澳大利亚农村地区的心理健康服务和专业人员可能需要调整他们的做法,以成功接触这一人群。

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