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重新安置初期寻求庇护者医疗保健利用的预测因素。

Predictors of Asylum Seekers' Health Care Utilization in the Early Phase of Resettlement.

作者信息

Kindermann David, Zeyher Valentina, Nagy Ede, Friederich Hans-Christoph, Bozorgmehr Kayvan, Nikendei Christoph

机构信息

Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.

Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.

出版信息

Front Psychiatry. 2020 May 28;11:475. doi: 10.3389/fpsyt.2020.00475. eCollection 2020.

Abstract

BACKGROUND

Asylum seekers display high prevalence rates of posttraumatic stress disorder, depression, anxiety, and panic disorder due to pre-, peri-, and post-migration stressors. In contrast to the high mental health burden, health care utilization among asylum seekers in the early phase of resettlement is low. However, the early stages after migration are a particularly vulnerable phase in which psychosocial support measures are needed to prevent mental disorders from becoming chronic.

OBJECTIVE

To identify predictors of asylum seekers' health care utilization in the early stages of resettlement.

METHODS

Using hierarchical logistic regression analysis, the variance explanation of the (1) general utilization of health care services as well as the individual utilization of (2) outpatient psychiatrists, (3) counselling centers, and (4) general practitioners was analyzed in = 65 asylum seekers. A structured interview on health care utilization took place between three to five months after assessment of possible predictors. We defined the following three groups of predictors a) the sociodemographic variables gender, age, number of children, religion, language proficiency, b) the psychological variables sense of coherence and emotion regulation as well as c) the asylum seekers' psychiatric diagnoses.

RESULTS

Individual sociodemographic factors, such as gender, age, and number of children as well as the emotion regulation strategy of expressive suppression and sense of coherence were shown to be predictive for the utilization of health care services among asylum seekers.

CONCLUSIONS

Low-threshold, culture-sensitive treatment offers for asylum seekers should be established in the early phase after migration. General practitioners should be a central hub for further referrals to disorder-specific treatments.

摘要

背景

由于迁移前、迁移期间和迁移后的压力源,寻求庇护者中创伤后应激障碍、抑郁症、焦虑症和恐慌症的患病率很高。与高心理健康负担形成对比的是,寻求庇护者在重新安置早期的医疗保健利用率很低。然而,迁移后的早期阶段是一个特别脆弱的时期,需要采取心理社会支持措施来防止精神障碍发展为慢性病。

目的

确定寻求庇护者在重新安置早期医疗保健利用情况的预测因素。

方法

采用分层逻辑回归分析,对65名寻求庇护者的(1)医疗保健服务的总体利用情况以及(2)门诊精神科医生、(3)咨询中心和(4)全科医生的个体利用情况的方差解释进行了分析。在评估可能的预测因素后的三到五个月内,进行了一次关于医疗保健利用情况的结构化访谈。我们定义了以下三组预测因素:a)社会人口统计学变量,性别、年龄、子女数量、宗教、语言能力;b)心理变量,连贯感和情绪调节;以及c)寻求庇护者的精神科诊断。

结果

个体社会人口统计学因素,如性别、年龄和子女数量,以及表达抑制的情绪调节策略和连贯感,被证明是寻求庇护者医疗保健利用情况的预测因素。

结论

应在迁移后的早期阶段为寻求庇护者建立低门槛、对文化敏感的治疗服务。全科医生应成为进一步转诊至针对特定疾病治疗的核心枢纽。

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