Gagliardi Juliette, Brettschneider Christian, König Hans-Helmut
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Department of Economics, University of Bologna, Via Zamboni 33, Bologna, 40126, Italy.
Confl Health. 2021 Jun 2;15(1):44. doi: 10.1186/s13031-021-00378-1.
To systematically review studies on HRQOL, measured by the WHOQOL-Bref instrument, of refugees in general and clinical populations who are settled in the community of the hosting country, and outline the differences in scores among the two population groups and across the four domains of WHOQOL-Bref (physical, psychological, social relationships and environment domain) as well as factors impacting those outcomes.
Several databases were systematically searched by using a broad search strategy. Additionally, a hand search for grey literature was performed. Studies had to comply with the following inclusion criteria: (a) population of refugees; (b) living in the community of the country of destination; (c) assessing HRQOL through the WHOQOL-Bref instrument.
15 studies were identified and divided into two subgroups: (a) general population of refugees (b) clinical population of refugees, who were specifically selected for their mental status or because they had experienced relevant past traumas. Although we can outline common patterns among the two groups, in terms of domains scoring the highest and the lowest, heterogeneous values of HRQOL are observed across the studies included.
Individuals who were included in the clinical refugee group have a lower quality of life in respect to the general population of refugees. However, among the two groups different patterns can be outlined considering each domain of HRQOL: higher scores for the Physical and lower for the Environment domain when considering the general population of refugees and higher scores for the Environment and lower for the Psychological domain when referring to the clinical one. These lower scores are probably due to having a higher rate of mental distress and being more exposed to somatization, stigmatization and barriers to access the healthcare system of the hosting country.
系统回顾使用世界卫生组织生活质量简表（WHOQOL-Bref）对定居在东道国社区的普通难民群体和临床难民群体的健康相关生活质量（HRQOL）进行测量的研究，概述这两个人口群体之间以及WHOQOL-Bref四个领域（身体、心理、社会关系和环境领域）得分的差异，以及影响这些结果的因素。
采用广泛的搜索策略对多个数据库进行系统检索。此外，还对手头灰色文献进行了检索。纳入研究必须符合以下标准：（a）难民群体；（b）居住在目的地国社区；（c）通过WHOQOL-Bref工具评估HRQOL。
共识别出15项研究，并分为两个亚组：（a）普通难民群体；（b）临床难民群体，该群体因精神状态或过去经历过相关创伤而被特意挑选。尽管我们可以概述两组之间的共同模式，即得分最高和最低的领域，但在所纳入的研究中，HRQOL的值存在异质性。
临床难民组个体的生活质量低于普通难民群体。然而，在这两组中，考虑到HRQOL的每个领域，可以概述出不同的模式：在普通难民群体中，身体领域得分较高，环境领域得分较低；而在临床难民群体中，环境领域得分较高，心理领域得分较低。这些较低的得分可能是由于精神痛苦发生率较高，以及更容易出现躯体化、被污名化和难以获得东道国医疗系统服务的情况。
