Department of Family Health Care Nursing, School of Nursing, 2 Koret Way, Box 0606, University of California, San Francisco, San Francisco, CA, USA, 94143-0606.
Xianga Nursing School, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China.
Public Health. 2020 Apr;181:151-157. doi: 10.1016/j.puhe.2019.12.006. Epub 2020 Feb 28.
Depression has been associated with numerous adverse health conditions. This study sought to determine the frequency of significant depressive symptoms and whether or not acculturative stress, discrimination, and reproductive health conditions were risk factors for significant depressive symptoms in migrant working women in China.
The design of this study is cross-sectional.
Data were derived from a survey of female migrant workers at three employment sites in Changsha, China. The associations between acculturative stress, discrimination, reproductive health, and risk for significant depressive symptoms were obtained using F-tests for mean differences, correlations, ordinary least squares regression, and logistic regression analysis.
Between March and June 2017, 232 eligible female participants completed the survey among whom the median age was 34.36 years (standard error 0.43) and 25.58% reported significant depressive symptoms. Significant depressive symptoms were associated with higher education (F-test, P = .006), all four acculturative stress factors (r = 0.15 to r = 0.29), both institutional and interpersonal discrimination (r = 0.29, r = 0.35), age (r = - 0.13), and self-rated health (r = - 0.19). In multivariate regression analysis of depression scale scores, interpersonal discrimination was the strongest predictor (beta = 0.238, P = .002) among the nine factors identified in bivariate analysis. None of the other predictors (age, self-rated health, education, acculturative stress, and institutional discrimination) showed significant associations with the depression scale. Similar results were obtained for a multivariate logistic regression analysis of a clinically important threshold for depression (<10 versus ≥ 10 on the depression scale). Only interpersonal discrimination significantly distinguished between clinical depression categories (odds ratio = 2.607 per unit change in the index, P = .001).
Migrant women workers in China appear to be at risk for significant depressive symptoms, and interpersonal discrimination appears to be an important risk factor in this setting. Acculturative stress and institutional discrimination may also be relevant risk factors, as suggested in our bivariate analysis, but in our sample, the correlations between the stress and discrimination factors are high enough to compromise identification of unique associations between acculturation stress and depression. Government, community and workplace education, and psychosocial services for migrant women are recommended.
抑郁与许多不良健康状况有关。本研究旨在确定有显著抑郁症状的频率，以及文化适应压力、歧视和生殖健康状况是否是中国移民女性工作者出现显著抑郁症状的危险因素。
本研究的设计是横断面的。
数据来自于 2017 年 3 月至 6 月在中国长沙三个工作地点对女性移民工人的调查。采用均值差异 F 检验、相关分析、普通最小二乘法回归和逻辑回归分析，获得文化适应压力、歧视、生殖健康与出现显著抑郁症状风险之间的关联。
在 2017 年 3 月至 6 月期间，232 名符合条件的女性参与者完成了调查，其中中位数年龄为 34.36 岁（标准误差 0.43），25.58%报告有显著抑郁症状。显著抑郁症状与较高的教育程度（F 检验，P=0.006）、四个文化适应压力因素（r=0.15 至 r=0.29）、机构性和人际歧视（r=0.29，r=0.35）、年龄（r=-0.13）和自我评估健康状况（r=-0.19）有关。在抑郁量表评分的多变量回归分析中，人际歧视是 9 个双变量分析中确定的因素中最强的预测因素（β=0.238，P=0.002）。其他预测因素（年龄、自我评估健康状况、教育程度、文化适应压力和机构性歧视）与抑郁量表均无显著关联。对抑郁量表上一个有临床意义的临界值（<10 与≥10）进行多变量逻辑回归分析也得到了类似的结果。只有人际歧视在临床抑郁类别中显著区分（指数每单位变化的优势比=2.607，P=0.001）。
中国的移民女性工人似乎有出现显著抑郁症状的风险，人际歧视似乎是这种情况下的一个重要危险因素。文化适应压力和机构性歧视也可能是相关的危险因素，正如我们的双变量分析所表明的那样，但在我们的样本中，压力和歧视因素之间的相关性很高，以至于无法确定文化适应压力和抑郁之间的独特关联。建议为移民女性提供政府、社区和工作场所教育以及心理社会服务。
