移民经历与污名化和应对策略之间的关联中的心理困扰的中介作用：对埃塞俄比亚归国移民的横断面研究。
The mediating role of psychological distress in the association between migration experiences and stigma and coping strategies: a cross-sectional study on Ethiopian migrant returnees.
机构信息
School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia.
出版信息
BMC Psychiatry. 2024 Nov 19;24(1):827. doi: 10.1186/s12888-024-06229-6.
BACKGROUND
Ethiopian migrants to the Middle East and South Africa are exposed to dangerous traveling and working conditions and their experiences are mostly tragic. They are unwelcomed not only by the situation in the destination but also by the community at home which is an important indicator of stigma and discrimination. However, there is lack of evidence on how psychological distress is associated with migration experiences, stigma and coping strategies. Therefore, it was aimed to determine the mediating effect of psychological distress in the association between migration experiences and stigma and discrimination and coping strategies.
METHODS
A total of 739 Ethiopian migrant returnees from the Middle East and South Africa were included in the study. A cross-sectional study was conducted in five migration hotspot areas in Ethiopia, namely Addis Ababa, Dessie, Shashemene, Hossana, and Gondar. Data related to socio-demographic, economic, migration experiences, psychological distress, coping strategies, and stigma and discrimination were collected. Psychological distress was measured using the 21- item version of the Depression, Anxiety and Stress Scale and coping strategies were measured with the Brief-COPE. Structural equation modeling was employed to estimate the relationship among variables.
RESULTS
About 395 (57.33%) of the participants reported symptoms of depression, 428 (59.86%) anxiety symptoms, and 313 (45.21%) stress symptoms. The mediated association between physical violence and coping strategy through psychological distress was 0.29 (adjusted β = 0.29, 95%CI: 0.15, 0.44). Denial of salary had positive direct (adjusted β = 1.00, 95%CI: 0.50, 1.50) and mediated (adjusted β = 1.20, 95%CI: 0.71, 1.68) associations with stigma and discrimination through psychological distress. Restricted freedom had positive mediated (adjusted β = 0.39, 95%CI: 0.13, 0.65) and total (adjusted β = 0.94, 95%CI: 0.59, 1.29) associations with stigma and discrimination through psychological distress.
CONCLUSION
Depression, anxiety, and stress symptoms are common among migrant returnees. Religious practice is the most commonly used coping mechanism. Psychological distress has positive mediating association with the relationships between denial of salary by employers and stigma and discrimination, physical violence and coping strategy, and restricted freedom and stigma and discrimination. Psychological interventions to deal with the psychological distress and stigma and discrimination of migrant returnees and to encourage the practice of positive coping strategies are warranted.
背景
前往中东和南非的埃塞俄比亚移民面临着危险的旅行和工作条件，他们的经历大多是悲惨的。他们不仅在目的地不受欢迎，而且在国内社区也不受欢迎，这是耻辱和歧视的一个重要指标。然而，关于心理困扰与移民经历、耻辱和歧视以及应对策略之间的关联，证据不足。因此，本研究旨在确定心理困扰在移民经历与耻辱和歧视及应对策略之间的关联中的中介作用。
方法
本研究共纳入了 739 名从中东和南非返回的埃塞俄比亚移民。在埃塞俄比亚的五个移民热点地区（亚的斯亚贝巴、德西、沙舍梅内、霍萨纳和贡德尔）进行了一项横断面研究。收集了与社会人口统计学、经济、移民经历、心理困扰、应对策略以及耻辱和歧视相关的数据。使用 21 项抑郁、焦虑和压力量表评估心理困扰，使用Brief-COPE 评估应对策略。采用结构方程模型估计变量之间的关系。
结果
约 395 名（57.33%）参与者报告有抑郁症状，428 名（59.86%）有焦虑症状，313 名（45.21%）有压力症状。通过心理困扰，身体暴力与应对策略之间的中介关联为 0.29（调整后的β=0.29，95%CI：0.15，0.44）。雇主拒付工资与耻辱和歧视之间存在直接的正相关（调整后的β=1.00，95%CI：0.50，1.50）和中介相关（调整后的β=1.20，95%CI：0.71，1.68），而心理困扰在其中起中介作用。限制自由与耻辱和歧视之间存在直接的正相关（调整后的β=0.39，95%CI：0.13，0.65）和完全的正相关（调整后的β=0.94，95%CI：0.59，1.29），而心理困扰在其中起中介作用。
结论
抑郁、焦虑和压力症状在移民归国者中较为常见。宗教活动是最常用的应对机制。心理困扰与雇主拒付工资和耻辱与歧视、身体暴力和应对策略以及限制自由和耻辱与歧视之间存在正相关的中介关系。有必要对移民归国者的心理困扰和耻辱与歧视进行心理干预，并鼓励他们采取积极的应对策略。
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