Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Saale, Germany.
Department of Public Health, Institute for Health, Brandenburg University for Technology Cottbus-Senftenberg, Senftenberg, Germany.
Eur Child Adolesc Psychiatry. 2022 Dec;31(12):1857-1870. doi: 10.1007/s00787-021-01762-1. Epub 2021 Mar 29.
Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations.
对无人陪伴未成年难民（UMR）的心理社会关怀（PSC）的研究主要采用了社会流行病学方法，并侧重于该领域专家的观点。相比之下，关于当前 PSC 的不同背景因素和潜在机制的知识，这些知识可以为政策建议提供信息，但却很少。本研究旨在揭示 PSC 对 UMR 的背景、机制和结果。为了进行现实主义综述（RR），根据现实主义综合 RAMESES 出版标准，对科学证据和灰色文献进行了综合。基于电子数据库（例如 PubMed）中的迭代关键字搜索和筛选，从 2005 年到 2019 年，有 34 项研究被纳入现实主义综合研究。提取了基于理论的背景-机制-结果配置（CMO），以解释潜在的过程和机制。主导的 CMO 以它们的相关性为特征，包括 UMR 过渡的交叉点（例如，青春期和移民）、他们对文化和性别敏感的 PSC 的需求以及 PSC 的供应不足。这些背景和结果由前、围产期和迁徙后压力源以及护理结构介导，并且受到总体话语和概念的影响。它们包括 UMR 的 PSC 中的不利和有利机制。现有文献通过不同学科和方法来理解 UMR 的 PSC，但并未提供对微观-宏观交叉点和包括的话语的全面概述。纳入非专业人员的观点和交叉方法可以为卫生服务研究提供信息。对 UMR 相关的韧性和脆弱性的分类结构、他者化的话语以及限制性的健康政策的反思，可以指导政策建议。
