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At least 1,063 records · Page 59Linked to original sources
PubMed1997

Effects of war trauma on Cambodian refugee adolescents' functional health and mental health status.

OBJECTIVE: To measure the effect of war trauma on the functional health and mental health status of Cambodian adolescents living in a refugee camp on the Thai-Cambodian border. METHOD: A multistage probability sample identified 1,000 households in the camp known as Site Two. Interviews were conducted in each household with randomly selected adults 18 years of age and older. All adolescents aged 12 and 13 years old, along with one parent were interviewed. One hundred eighty-two adolescents (94 girls, 88 boys) and their parents participated. Culturally sensitive instruments were used including Cambodian versions of the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR). RESULTS: Parents and adolescents reported the latter having experienced high levels of cumulative trauma, especially lack of food, water, and shelter. Mean Total Problem scores were in ranges similar to those of adolescents receiving clinical care in the United States, Netherlands, and Israel. Nearly 54% (53.8%) had Total Problem scores in the clinical range by parent report on the CBCL and 26.4% by adolescent report on the YSR. The most commonly reported symptoms were somatic complaints social withdrawal attention problems, anxiety, and depression. The dose-effect relationship between cumulative trauma and symptoms was strong for parent reporting on the CBCL; the subscales on both the YSR and CBCL for Anxious/Depressed and Attention Problems revealed dose-effect associations. Dose-effect relationships between cumulative trauma and social functioning or health status were lacking. CONCLUSION: The high levels of emotional distress in this population of Cambodian adolescents and corresponding dose-effect relationships reveal the important negative psychosocial impact of violence on Cambodian adolescents. Lack of findings related to physical health status and the presence of positive social functioning of many youths should not deter health care providers and public health officials from diagnosing and treating underlying high levels of psychological distress.

Adaptation, Psychological↗
PubMed1998

Prevalence of posttraumatic stress disorder and major depressive disorder in Tibetan refugee children.

OBJECTIVE: In an exploratory survey the prevalence of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) was estimated in children who escaped from Tibet and found refuge in Tibetan settlements in India. METHOD: As part of an exploratory mission of the international medical relief organization Doctors Without Borders (Medecins Sans Frontieres), 61 randomly selected children from four group homes of the Tibetan Children Village in Dharamsala, India, were interviewed for symptoms of PTSD and MDD. RESULTS: 11.5% of the children met DSM-IV criteria for PTSD, and the same proportion met criteria for MDD. Children who had arrived from Tibet more recently (in the previous 18 months) showed a tendency for greater prevalence of PTSD than children who had been refugees longer. CONCLUSION: Tibetan children who succeed in their journey into exile suffer levels of stress-related disorders comparable with those of children in war situations or those exposed to natural disasters. However, in this population, several protective factors may help reduce the level of distress over time.

Adolescent↗
PubMed1999

The Quebec Adolescent Refugee Project: psychopathology and family variables in a sample from 35 nations.

OBJECTIVE: This study presents the results of a psychiatric epidemiological survey using a sample of adolescents from refugee families. METHOD: The sample included 203 adolescents, aged 13 to 19 years, coming from 35 countries. Psychopathology was assessed with the Diagnostic Interview Schedule for Children Version 2.25 and general functioning with the Children's Global Assessment Scale (CGAS). RESULTS: The total rate of psychopathology excluding simple phobia was 21% compared with 11% in a province-wide survey of young adolescents. Overanxious disorder had a high prevalence of 13%. The rates of major depression and conduct disorders were also high, at 5% and 6%. The rate of 3% of attempted suicide was similar to the rate found in Montreal high schools. Girls had a higher rate of psychopathology than boys, with a gender ratio similar to the one found in the provincial survey. Father's long-term unemployment in the first year of settlement was associated with psychopathology for the whole sample, and family structure was associated with psychopathology for boys only. CONCLUSIONS: The high rate of psychopathology in this group confirmed results from other surveys with similar samples. On the other hand, the CGAS scores indicated that many of the adolescents with a diagnosis had good social adaptation.

Adaptation, Psychological↗
PubMed1997

Diarrheal epidemics among Rwandan refugees in 1994. Management and outcome in a field hospital.

We describe the clinical course and outcome of Rwandan refugees with cholera-like illness (n = 567) and clinical dysentery (n = 1,062) treated at the Israeli Army field hospital in the disaster region of Goma, Zaire, during the summer of 1994. Vigorous fluid administration was the primary therapy, complemented with antibiotics for patients with presumed Shigella infection. Recovery rates were 94% and 96% for patients with cholera and dysentery, respectively. Mortality was substantially affected by comorbid conditions such as pneumonia and meningitis, which occurred in one-quarter of these patients. Infective, metabolic, and surgical complications (including three cases of intussusception) may have contributed to the deaths. The outcome of patients during diarrheal epidemics of cholera or bacillary dysentery may be favorable, even in disaster settings, if patients are evacuated promptly to medical facilities and appropriate therapy is instituted. We close with general observations on procedures to be followed in future epidemics of diarrheal diseases.

Adolescent↗
PubMed1984

Acute paranoid disorder in a Southeast Asian refugee.

The clinical course of a 23-year-old male Vietnamese refugee who was seen for psychiatric evaluation and treatment after a self-inflicted abdominal stab wound is described. His attempted suicide was precipitated by a rejection of his romantic advances by an American woman and teasing by fellow co-workers that he was a Communist spy. Central to the development of paranoid delusions in this patient was the fact that he had been a member of the Communist forces in Cambodia and feared deportation. Emigration and acculturative stressors were seen as contributing significantly to this patient's paranoid disorder.

Acculturation↗
PubMed1986

The psychosocial adjustment of the Amerasian refugees. Findings from the Personality Inventory for Children.

The purpose of this study was to investigate the psychosocial adjustment of 24 Amerasian youths who had immigrated to the United States in 1983 and 1984. The Personality Inventory for Children (PIC) was translated into Vietnamese and administered to 18 mothers of Amerasian youths in a social service agency in a large southern city. Respondents reported significant mood disturbance and psychological distress in their children. Specifically, the depression, somatization, withdrawal, and psychosis subscales of the PIC were clinically elevated for the entire group. An evaluation of individual profiles revealed marked tendencies toward somatization and withdrawal. These findings are consistent with other studies on the psychosocial adjustment of Southeast Asian refugees.

Adaptation, Psychological↗
PubMed1989

Psychosocial adjustment of Hmong refugees during their first decade in the United States. A longitudinal study.

Over their first decade in the United States, 100 Hmong refugees were studied on three occasions. Data included demographic characteristics, acculturation skills, traditional affiliations and pastimes, material acquisitions, psychosocial problems, and self-rating scales. In addition to a description of the data changes, a multiple regression analysis was performed. Changes demonstrated considerable evidence of acculturation, psychiatric care seeking, and greatly reduced symptom levels for several symptom complexes. However, a large minority of subjects remain illiterate, unable to speak English, generally involved with other Hmong but not with the majority society, and/or have high symptom levels on self-rating scales. Regarding symptom changes, depression, somatization, phobia, and self-esteem symptoms improved the most with time and acculturation. On the contrary, anxiety, hostility, and paranoid symptoms changed little. Multiple regression analyses indicated that strong traditional ties (e.g., large household size, being an herbal healer), older age, marital problems, and medical complaints were most associated with high symptom levels.

Acculturation↗
PubMed1994

Chronic posttraumatic stress disorder in Vietnamese refugees. A prospective community study of prevalence, course, psychopathology, and stressors.

A community cohort of 145 Vietnamese boat refugees in Norway was prospectively studied for presence of chronic posttraumatic stress disorder (PTSD) after resettlement. Ten percent had PTSD on arrival and/or after 3 years. This group had been exposed to significantly more traumatic stress before their escape (e.g., reeducation camps, combat, and other war incidents) and had more psychopathology (SCL-90-R Global Assessment Scale) after resettlement. A logistic regression analysis indicated that different types of traumatic stress had an independent relationship with chronic PTSD. Nine SCL-90-R items discriminated between the PTSD group and the rest both on arrival and follow-up. These were not anxiety items, but related to interpersonal sensitivity, somatization, and aggression. The inclusion of additional diagnostic features in the criteria for chronic PTSD is indicated.

Adolescent↗
PubMed1998

Relationship of child loss to psychiatric and functional impairment in resettled Cambodian refugees.

One hundred sixty eight respondents, recruited from a community of resettled Cambodian refugees in Massachusetts, were interviewed for a study of trauma, physical and emotional health, and functioning. Of the 161 respondents who have ever had any children, 70 parents (43%) reported the death of between one and six of their children. Child loss was positively associated with health-related concerns, a variety of somatic symptoms, and culture-bound conditions of emotional distress. No relationship was found with conventional psychiatric symptoms of depression and posttraumatic stress disorder. Parents whose children died were performing most routine daily activities and participating in social activities to a similar and even greater extent than were parents who did not lose children. Nevertheless, child loss was strongly associated with a perception of health-related limitation in both physical functioning and social activities. Further research on the prevalence of child loss and its impact on long-term adjustment in survivors of mass trauma is indicated.

Adult↗
PubMed2001

Self-reported life event patterns and their relation to health among recently resettled Iraqi and Kurdish refugees in Sweden.

This paper presents the findings of a longitudinal study of life events in refugees belonging to different language groups from Iraq. Eighty-six individuals were included in the study. Data regarding life events and self-reported health measurements were collected after baseline assessment with 3-monthly intervals on three occasions. Posttraumatic stress disorder was diagnosed by means of a structured interview at baseline. The results indicate that the subjects were influenced to a great extent by political events and the situation of significant others in the home country. Further, the number of negative life events in the host country showed a significant association with self-rated deteriorated health. In subjects with posttraumatic stress disorder, the effects of certain life events were more pronounced.

Adolescent↗
PubMed1984

Specific health problems of Southeast Asian refugees in middle Tennessee.

Three diseases representative of specific health conditions affecting the Southeast Asian refugees living in middle Tennessee are leprosy (chronic bacterial infections), liver fluke infection (parasitic diseases), and hemoglobin E-beta-thalassemia (hematologic disorders). In this paper we discuss incidence, causative agent, mode of transmission, metabolic abnormalities, and management of these conditions.

Asia, Southeastern↗
PubMed1991

Exploring gender and culture with Khmer refugee women: reflections on participatory feminist research.

This article discusses the process and findings from a study based on the paradigm of feminist participatory research. The research is first discussed in relation to contemporary feminist scholarship. The project combined elements of community health nursing practice and feminist research in a support group with Khmer refugee women. The research explored psychosocial adjustment and the construction of gender among Khmer women. Methods of data collection included life history and trauma history interviews, discussion of dream narratives and Cambodian myths, and participant observation. Findings included four recurring themes identified in the women's stories. The research process is discussed in terms of its implications for nursing praxis.

Cambodia↗
PubMedDate not supplied

Outreach strategies for Southeast Asian communities: experience, practice, and suggestions for approaching Southeast Asian immigrant and refugee communities to provide thalassemia education and trait testing.

This article outlines general strategies for outreaching to Southeast Asian immigrant and refugee communities with thalassemia education. Because of positive net migration and increased birthrates during the last 15 years, Asian Pacific Islanders are among the fastest growing populations in California. Dr. Fred Lorey of California Newborn Screening shows that 1 of 12 Southeast Asians is a carrier of hemoglobin E, demonstrating a particular need to outreach to these communities. The challenge of educating Southeast Asian populations include language barriers, differences in cultural and/or religious beliefs, geographic location, and unfamiliarity with and/ or mistrust of Western health care systems. In addition, outreach workers must consider the great diversity of ethnicity, language, literacy, and education levels, and degree of acculturation to the US within the Asian/Southeast Asian groups. It is crucial before embarking on any outreach campaign to understand the history and make-up of the target audience, including ethnic minorities and dialects, to translate written materials into appropriate languages or audio formats, and to have a group of trained interpreters for events. Additionally, a continuing education model for the outreach/medical staff is important to maintain robust understanding of these diverse communities. Specific strategies include using visual aids, medical professionals as authority figures, and bicultural high school and college students during presentations. Finally, establishing trust and maintaining a continued presence in communities are the most important aspects of a successful outreach campaign.

Asia, Southeastern↗
PubMed2003

Subacute sclerosing panencephalitis with remission in a Bosnian refugee child.

Subacute sclerosing panencephalitis (SSPE) virtually disappeared from the US after mass measles immunization programs dating from the 1960s. However, SSPE has reappeared in internationally adopted children and in refugee children emigrating from developing or war torn countries lacking effective measles immunization programs. SSPE usually occurs 6 to 8 years after a bout of measles in early childhood; death typically follows within 1 to 3 years. What is often not reported in textbooks is that spontaneous remission occurs in a small subset of children with documented SSPE.

Bosnia and Herzegovina↗
PubMed2006

Mazzotti reaction after presumptive treatment for schistosomiasis and strongyloidiasis in a Liberian refugee.

We report a case of the Mazzotti reaction in a 13-year-old Liberian refugee after presumptive treatment of schistosomiasis and strongyloidiasis with ivermectin, praziquantel and albendazole. The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms.

Adolescent↗
PubMed2006

Evaluation of malaria screening in newly arrived refugees to the United States by microscopy and rapid antigen capture enzyme assay.

Before an empiric malaria treatment program, >60% of Liberian refugees had malaria on arrival to Minnesota. We compared microscopy with rapid antigen testing for detecting asymptomatic parasitemia. Nine of 103 (8.7%) had malaria by polymerase chain reaction (blood smear and rapid testing had a sensitivity of 22%). The empiric treatment program has decreased the rate of imported asymptomatic malaria. Blood film and rapid antigen testing are poor screening tests.

Adolescent↗
PubMed2003

Sampling in difficult to access refugee and immigrant communities.

We evaluated sampling strategies and trust-building activities in a large multiphase epidemiologic study of torture prevalence in populations that were difficult to locate and enroll. Refugee groups under study were Somalis from Somalia and Oromos from Ethiopia who were living in Minneapolis and St. Paul, Minnesota, in 1999-2002. Without a complete sampling frame from which to randomly recruit participants, we employed purposive sampling methods. Through comparative and statistical analyses, we found no apparent differences between our sample and the underlying population and discovered no effects of recruiting methods on study outcomes, suggesting that the sample could be analyzed with confidence. Ethnographic trust and rapport-building activities among investigators, field staff, and immigrant communities made it possible to obtain the sample and gather sensitive data. Maintaining a culture of trust was crucial in recovering from damaging environmental events that threatened data collection.

Analysis of Variance↗
PubMed2004

A ten-year treatment outcome study of traumatized Cambodian refugees.

The purpose of this study was to assess treatment outcome among 23 severely traumatized Cambodian refugee patients with posttraumatic stress disorder who had been in continuous treatment for 10 or more years. Primary outcome parameters were symptom severity, social and vocational disability, and subjective quality of life. All patients were interviewed using standard assessment tools by a research psychiatrist not connected with the treatment, and charts were reviewed for past and current traumas and for treatment history. There was a wide range of current posttraumatic stress disorder symptom scores, but current depression scores were very low. Thirteen patients were judged to have good outcomes, and 10 had relatively poor outcomes. Reported degree of previous trauma and demographic factors did not distinguish between the two outcome groups. Sixty percent of patients greatly improved. However, even with comprehensive continuous treatment over a period of 10 or more years, a substantial minority was still impaired.

Acculturation↗