Cultural Medicine Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
Front Public Health. 2024 May 9;12:1356605. doi: 10.3389/fpubh.2024.1356605. eCollection 2024.
With the increasing numbers of refugees from Ukraine affected by the ongoing war, there is a high risk of trauma-related stress due to low local health and mental health literacy care. Perceived good health is a human right. Earlier studies show that intervention for refugees can reduce and prevent post-migration stress and anxiety. The present explorative study aimed to investigate the feasibility and effectiveness of a short, trauma-focused group intervention (in Swedish "hälsoskola") for Ukrainian-speaking refugees (EU's mass refugee directive). This intervention was part of an ESF project aiming to get the subjects closer to the labor market in Västernorrland County, Sweden.
A mixed-methods design, a participatory methodology, and an evaluation were used. Data were obtained with a short questionnaire in Ukrainian. It included a visual analogue health-rating scale, an observation, and an oral evaluation in groups. For practical and ethical reasons, there was no control group. Each group met five times for 2 h, a total of 10 h excluding pre- and post-assessment. There were eight sets of five group sessions per set, a total of 40 sessions. Brief initial and concluding breathing exercises sought to reduce stress among the participants.
Baseline data were obtained from 99 participants, mostly females. Data gathered directly after the group intervention from 57 participants who had filled in both the pre- and post-questionnaires showed that (1) perceived anxiety/stress was significantly reduced (chi-2 25,53, df = 4, < 001). (2) The participants showed significantly better perceived health as assessed on a visual analogue scale (average change from 63.16 to 71.18, < 0.001). This result was supported by the participants' questions, which were qualitatively evaluated using thematic content analysis. Five general themes stemmed from questions raised in dialogue with the participants plus observation with the respective local expert. The participants received answers to their questions, and their perceived negative attitudes to authorities changed to more positive ones.
By dialogue between the participants' needs of knowledge and direct answers by the local expert, respectively, was feasible and effective as they perceived trust and health and mental health literacy increased. Implications for primary prevention are discussed.
随着越来越多受俄乌战争影响的乌克兰难民的出现，由于当地卫生和心理健康素养水平较低，创伤相关的应激风险很高。感知良好的健康是一项人权。早期的研究表明，对难民的干预可以减少和预防移民后的压力和焦虑。本探索性研究旨在调查一种简短的、以创伤为重点的小组干预（瑞典语为“hälsoskola”）对讲乌克兰语的难民（欧盟大规模难民指令）的可行性和有效性。该干预措施是 ESF 项目的一部分，旨在使参与者更接近瑞典西诺尔兰郡的劳动力市场。
采用混合方法设计、参与式方法和评估。使用乌克兰语的简短问卷获得数据。它包括一个视觉模拟健康评分量表、观察和小组口头评估。出于实际和伦理原因，没有对照组。每个小组会面五次，每次 2 小时，总时长 10 小时，不包括前后评估。每组有五套，共 40 套。简短的初始和总结呼吸练习旨在减少参与者的压力。
从 99 名参与者中获得了基线数据，其中大多数是女性。从 57 名参与者中直接获得了小组干预后的数据，他们填写了前后问卷。数据显示：（1）感知到的焦虑/压力显著降低（卡方 25.53，df=4，<0.001）。（2）参与者在视觉模拟量表上评估的感知健康明显改善（平均变化从 63.16 到 71.18，<0.001）。这一结果得到了参与者问题的支持，这些问题通过与参与者的对话以及与当地专家的观察进行定性评估。从与参与者的对话中提出的五个一般主题加上与当地专家的观察，得出了五个主题。参与者得到了他们问题的答案，他们对当局的负面态度也变得更加积极。
通过参与者对知识的需求与当地专家的直接回答之间的对话，这种方法是可行和有效的，因为他们感知到信任度和健康及心理健康素养得到了提高。讨论了初级预防的影响。
