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越南山区农民的心理困扰:一项关于患病率及相关因素的横断面研究。

Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors.

作者信息

Hoang Men Thi, Do Khanh Nam, Pham Hai Quang, Nguyen Cuong Tat, Ha Giang Hai, Vu Giang Thu, Tran Bach Xuan, Latkin Carl, Ho Roger C M, Ho Cyrus Sh

机构信息

Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam.

Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam.

出版信息

BMJ Open. 2020 Aug 6;10(8):e038490. doi: 10.1136/bmjopen-2020-038490.

Abstract

BACKGROUND

Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health.

OBJECTIVES

This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam.

DESIGN AND SETTING

A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection.

PARTICIPANTS

A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors.

RESULTS

The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress.

CONCLUSION

This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.

摘要

背景

心理困扰一直被认为是全球农民面临的一个主要健康问题。在越南,约50%的农民生活在农村和山区。然而,关于心理困扰如何影响山区农民的健康,人们了解甚少。

目的

本研究旨在调查越南山区农民心理困扰的患病率及其相关危险因素。

设计与地点

2018年8月至9月在越南木州县进行了一项横断面研究。采用结构化问卷和面对面访谈收集数据。

参与者

招募了197名年龄至少18岁、说越南语、当时未患严重疾病且居住在木州的农民作为随机样本。

主要和次要结局指标

采用凯斯勒心理困扰量表(K6)来测量心理困扰。应用托比特回归和逻辑回归来表明相关因素。

结果

心理困扰的患病率为38.2%(95%置信区间31.3%至45.5%)。患有更多合并症(比值比=6.17;95%置信区间1.44至26.43)、饮酒(比值比=3.86;95%置信区间1.02至14.59)以及从卫生工作者处获取健康信息(比值比=3.77;95%置信区间1.22至11.66)与心理困扰的患病率呈正相关。相比之下,超重(比值比=0.29;95%置信区间0.09至0.93)、将书籍作为健康信息的主要来源(比值比=0.11;95%置信区间0.01至0.8)以及社区卫生工作者进行家访的次数较多(比值比=0.38;95%置信区间0.14至0.99)与心理困扰的患病率呈负相关。

结论

本研究突出了山区农民心理困扰的高患病率。提供常规的心理和身体健康筛查、发展社区卫生工作者以提供临床支持以及提高健康意识对于减少该人群的心理困扰至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34a0/7412583/3f5e486961b0/bmjopen-2020-038490f01.jpg

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