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乌克兰境内国内流离失所者的躯体痛苦模式:一项横断面调查分析。

Patterns of somatic distress among internally displaced persons in Ukraine: analysis of a cross-sectional survey.

机构信息

Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.

Ilia State University, Tbilisi, Georgia.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2019 Oct;54(10):1265-1274. doi: 10.1007/s00127-019-01652-7. Epub 2019 Feb 25.

Abstract

PURPOSE

There are often high rates of mental disorders in low- and middle-income countries during humanitarian crises, but the prevalence of somatic distress (SD) is underreported in the existing health service research. We aim to examine the patterns of SD among internally displaced persons (IDPs) in Ukraine, who were forcibly displaced due to the ongoing conflict in the country's eastern region.

METHODS

The study design was a cross-sectional survey of 2203 adult IDPs throughout Ukraine. The survey collected data on sociodemographic characteristics, traumatic life events (Life Events Checklist), utilisation of mental health care services, and self-reported outcomes of SD (Patient Health Questionnaire 15), anxiety (Generalised Anxiety Disorder 7), depression (Patient Health Questionnaire 9), and post-traumatic stress (PTSD Checklist). Descriptive and multivariate regression analyses were used.

RESULTS

Over half of respondents (n = 1142, 55%) were identified as being at risk of SD (PHQ-15 score ≥ 6), and the prevalence of moderate (n = 377, 18%) and high severity SD risk (n = 275, 13%) was substantial. There were significant associations (p < 0.05) between SD and age, female gender, economic status, self-reported depression and post-traumatic stress, and multiple trauma exposures. Being at risk of SD was also significantly associated with increased functional disability. Use of mental health care services was low across this population and only high SD risk seemed to be a reliable predictor of care-seeking behaviour.

CONCLUSIONS

There is a significant risk of SD among IDPs in Ukraine. Our results illustrate the need for targeted health service research and regional programs to ensure that mental health needs are appropriately met.

摘要

目的

在人道主义危机期间,中低收入国家的精神障碍发病率往往很高,但现有卫生服务研究中对躯体痛苦(SD)的患病率报道不足。我们旨在研究因该国东部地区持续冲突而被迫流离失所的乌克兰境内国内流离失所者(IDPs)的 SD 模式。

方法

研究设计是对整个乌克兰的 2203 名成年 IDP 进行的横断面调查。该调查收集了社会人口统计学特征、创伤性生活事件(生活事件清单)、精神卫生保健服务的利用情况以及自我报告的 SD(患者健康问卷 15)、焦虑(广泛性焦虑症 7)、抑郁(患者健康问卷 9)和创伤后应激(PTSD 清单)结果的数据。采用描述性和多变量回归分析。

结果

超过一半的受访者(n=1142,55%)被确定为存在 SD 风险(PHQ-15 评分≥6),中度(n=377,18%)和高度 SD 风险(n=275,13%)的患病率相当高。SD 与年龄、女性性别、经济状况、自我报告的抑郁和创伤后应激以及多种创伤暴露之间存在显著关联(p<0.05)。存在 SD 风险也与功能障碍显著相关。该人群对精神卫生保健服务的利用程度较低,只有高 SD 风险似乎是寻求护理行为的可靠预测指标。

结论

乌克兰 IDPs 存在重大的 SD 风险。我们的研究结果表明,需要有针对性的卫生服务研究和区域计划,以确保适当满足精神卫生需求。

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