Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
BMC Psychiatry. 2023 Jan 4;23(1):11. doi: 10.1186/s12888-022-04502-0.
The COVID-19 pandemic has created significant challenges in 2020 in the world and Iran. To help vulnerable groups such as refugees during the response and recovery phases of the COVID-19 pandemic, identifying the quality of life (QOL) and its associated factors is helpful. Considering that research in this field is limited, this study evaluated the effect of social determinants of health on the quality of life among Afghan refugees in Iran during the COVID-19 pandemic.
We conducted a cross-sectional study on 300 Afghan refugees and migrants in Alborz province, Iran, from February to May 2022 using Convenience sampling. Data were completed using the socioeconomic status scale (SES), World Health Organization's quality of life -BREF (WHOQOL), Depression, Anxiety and Stress Scale-21 Items (DASS-21), and COVID-19 Post-Traumatic Stress Disorder Checklist (COVID-PTSD). In addition, path analysis was applied to evaluate the relationships among the research variables with quality of life.
64.3% of the study participants were male, with a mean of 29.29 ± 9.64 years. The path analysis showed that SES had the most positive relationship (B = .266), and the number of COVID-19 cases had the most negative relationship (B = -.169) with the quality of life from both paths. The self-rated health had the most positive relationship (B = .25), and the DASS score had the most negative relationship (B = -.2) with the quality of life through only one path. Access to medical services was the only variable that indirectly had a positive causal relationship with QOL (B = .044).
We provided an empirical model that illustrates the relationships between quality of life and social determinants of health among Afghan refugees and migrants during the Covid19 pandemic. The negative emotional states of Depression, Anxiety, and Stress (DAS) as a mediator play an essential role in the quality of life and other variables.
2020 年，COVID-19 大流行给全球和伊朗带来了巨大挑战。为了在 COVID-19 大流行的应对和恢复阶段帮助难民等弱势群体，确定生活质量（QOL）及其相关因素是有帮助的。考虑到这一领域的研究有限，本研究评估了健康社会决定因素对伊朗 COVID-19 大流行期间阿富汗难民生活质量的影响。
我们于 2022 年 2 月至 5 月在伊朗阿尔博兹省采用便利抽样对 300 名阿富汗难民和移民进行了横断面研究。使用社会经济地位量表（SES）、世界卫生组织生活质量-BREF（WHOQOL）、抑郁、焦虑和压力量表-21 项（DASS-21）和 COVID-19 创伤后应激障碍检查表（COVID-PTSD）完成数据。此外，路径分析用于评估研究变量与生活质量之间的关系。
研究参与者中 64.3%为男性，平均年龄为 29.29±9.64 岁。路径分析显示，SES 与生活质量呈最正相关（B=0.266），COVID-19 病例数与生活质量呈最负相关（B=-0.169）。自评健康与生活质量呈最正相关（B=0.25），DASS 评分与生活质量呈最负相关（B=-0.2），仅通过一条路径。获得医疗服务是唯一与 QOL 呈正相关的间接因果变量（B=0.044）。
我们提供了一个经验模型，说明了 COVID-19 大流行期间阿富汗难民和移民生活质量与健康社会决定因素之间的关系。抑郁、焦虑和压力（DAS）等负面情绪状态作为中介在生活质量和其他变量中起着重要作用。
