DIGNITY, Danish Institute against Torture, 2100 Copenhagen, Denmark.
Department of Child Psychiatry, Mongi Slim Hospital, La Marsa 8030, Tunisia.
Int J Environ Res Public Health. 2024 Oct 16;21(10):1363. doi: 10.3390/ijerph21101363.
We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females.
我们旨在了解风险（创伤史、健康问题、财务问题、家庭问题）和保护因素（朋友支持、家庭支持）如何直接影响以及通过对抑郁的影响，进而影响突尼斯成年人在 COVID-19 大流行期间的日常功能（例如，自我护理、活动能力、社会参与），并特别关注性别差异。我们使用突尼斯 24 个省的所有移动电话号码的随机数字拨号，招募了一个具有代表性的 2014 名参与者样本（男性 1024 名，女性 990 名）。女性报告的抑郁程度更高，功能受损更严重，感染 COVID-19 的可能性更高。路径分析表明，当允许男性和女性的路径不同时，模型拟合良好，这为性别差异提供了证据。在女性中，创伤暴露与抑郁之间以及抑郁与年龄与功能之间的关联更强。来自朋友的社会支持仅对男性是一种保护因素。对于男性，除了朋友的支持外，所有研究变量都通过与抑郁的关联间接与功能相关。对于女性，家庭责任和健康问题都有直接和间接的影响，而其他研究变量仅通过抑郁与功能相关。研究结果深入了解了可以针对男性和女性进行干预的因素，以减少抑郁和改善日常功能。
