乌干达城市、半农村和农村定居点冲突难民的心理困扰与社会支持：负担及关联
Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations.
作者信息
Seruwagi Gloria, Nakidde Catherine, Lugada Eric, Ssematiko Maria, Ddamulira Dunstan P, Masaba Andrew, Luswata Brian, Ochen Eric A, Okot Betty, Muhangi Denis, Lawoko Stephen
机构信息
Makerere University School of Public Health, Kampala, Uganda.
Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda.
出版信息
Confl Health. 2022 May 12;16(1):25. doi: 10.1186/s13031-022-00451-3.
BACKGROUND
Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic.
METHODS
Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed in SPSS-version 22, and statistical significance was assumed at p < 0.05.
RESULTS
Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress [F(2, 1011) = 47.91; p < 0.001], higher availability of social interaction [F(2, 1011) = 82.24; p < 0.001], lower adequacy of social interaction [F(2, 1011) = 54.11; p < 0.001], higher availability of social attachment [F(2, 1011) = 47.95; p < 0.001], and lower adequacy of social attachment [F(2, 1011) = 50.54; p < 0.001] than peers in urban settlements. Adequacy of social interaction significantly explained variations in psychological distress levels overall and consistently across settlements, after controlling for plausible confounders. Additionally, adequacy of social attachment significantly explained variations in psychological distress levels among refugees in rural settlements, after controlling for plausible confounders.
CONCLUSION
There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. To address psychological distress, Mental Health and Psychosocial Support Services (MHPSS) should focus on strategies which strengthen the existing social networks among refugees. Variations in social support are a key predictor of distress which should guide tailored need-adapted interventions instead of duplicating similar and generic interventions across diverse refugee settlements.
背景
近期研究表明，由于新冠疫情以及为应对疫情对民众实施的限制措施，全球心理困扰呈上升趋势。我们研究了新冠疫情期间乌干达城市、半农村和农村定居点冲突难民的心理困扰与社会支持之间的关联。
方法
采用两阶段整群抽样法，从乌干达城市、半农村和农村难民定居点随机抽取1014名成年难民，收集有关心理困扰、社会支持、人口统计学、社会经济和行为变量的横断面调查数据。数据在SPSS 22版本中进行分析，p < 0.05时具有统计学意义。
结果
居住在农村/半农村定居点的难民表现出更高水平的心理困扰[F(2, 1011) = 47.91；p < 0.001]、更高的社交互动可得性[F(2, 1011) = 82.24；p < 0.001]、更低的社交互动充分性[F(2, 1011) = 54.11；p < 0.001]、更高的社会依恋可得性[F(2, 1011) = 47.95；p < 0.001]以及更低的社会依恋充分性[F(2, 1011) = 50.54；p < 0.001]，高于城市定居点的同龄人。在控制了可能的混杂因素后，社交互动充分性总体上并在各个定居点一致地显著解释了心理困扰水平的差异。此外，在控制了可能的混杂因素后，社会依恋充分性显著解释了农村定居点难民心理困扰水平的差异。
结论
乌干达冲突难民在心理困扰和社会支持方面存在定居点不平等（即农村与城市）。为解决心理困扰问题，心理健康和社会心理支持服务（MHPSS）应侧重于加强难民现有社交网络的策略。社会支持的差异是困扰的关键预测因素，应指导量身定制的需求适应性干预措施，而不是在不同的难民定居点重复类似的通用干预措施。
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