Background
Depression is globally recognized as a major mental health problem in all age categories, particularly among those living in poor economic conditions and with low levels of education, including the hill tribe people in northern Thailand.
Methods
This cross-sectional study aimed to estimate the prevalence of depression and determine the factors associated with depression in the hill tribe population aged 40 and over in northern Thailand. Hill tribe people who lived in the selected villages and met the inclusion criteria were invited to participate in the study. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection. An interview was conducted in a private and confidential room in the selected villages between January and April 2019. Logistic regression was used to determine the factors associated with depression at a significance level of α = 0.05.
Results
A total of 601 participants were recruited into the study. More than half (64.23%) were women, 46.76% were Akha, 61.90% were aged 40–59 years, and 76.37% were married. Half of the participants were Christian (57.07%) and had no monthly income (51.25%), and 85% were illiterate. The overall prevalence of depression was 39.10%: 75.74% had mild depression, 17.88% had moderate depression, and 6.38% had severe depression. In the multivariate model, three variables were found to be associated with depression: being female, having a history of substance abuse, and experiencing stress six months prior. Compared to men, women were 2.09 times (95% CI 1.30–3.35) more likely to have depression. Those who had a history of substance abuse were more likely to have depression than those who did not have a history of substance abuse (AOR = 1.97; 95% CI 1.25–3.10). Those who had a history of stress in the prior 6 months were more likely to have depression than those who did not (AOR = 6.43; 95% CI 4.20–9.85).
Conclusion
Public health screening programs to identify depression in the hill tribe population are urgently needed, particularly for women, those who have abused psychoactive substances, and those who have experienced stress.
Background
Hill tribe children, an ethnic minority group in Thailand, experience wide-ranging social and health inequalities. Previous reports indicate that hill tribe children, especially age under 5 years, face social health disadvantages but little is known about the underlying causes. Exploring healthcare utilization among hill tribe children is therefore essential and it may well provide some insight.
Methods
A qualitative study was conducted using purposive sampling techniques to recruit participants based on our criteria. In-depth interviews and focus-group discussions were employed to explore the experiences of parents (n = 20), community leaders (n = 20), and healthcare providers (n = 20) when caring for children aged under 5 years. Interview transcripts were coded, and thematic analysis was then performed.
Results
The participants shared their experiences with accessing healthcare services in underserved areas. Barriers to access was the central theme identified. Sub-themes included: (1) distance matters, (2) education and socioeconomic deprivation, (3) lack of cultural sensitivity, (4) communication problems, (5) tradition, beliefs, and differences in cultural practice, (6) lack of child health professionals, and (7) bureaucratic hurdles.
Conclusions
Healthcare services and environments must be transformed to provide healthcare services, education, and information appropriate to the cultures and beliefs prevalent in the hill tribe population.
Objective
We synthesized the effects of mindfulness‐based interventions (MBIs) on psychological outcomes in college and university students during the COVID‐19 pandemic.
Method
Ten electronic databases were searched from inception to December 2021. We reviewed studies with college and university students receiving MBIs with psychological outcomes. We only reviewed studies written in English. A random‐effects model was used to compute the effect size.
Results
Overall, MBIs showed a significantly moderate improvement in anxiety (g = 0.612, 95% CI: 0.288−0.936, I2 = 77%); depression (g = 0.372, 95% CI: 0.032−0.713, I2 = 72%); and mindfulness (g = 0.392, 95% CI:0.102−0.695, I2 = 64%) compared with control groups, while these interventions had a small effect in reducing stress, but not a significant one (g = 0.295, 95% CI: −0.088 to 0.676, I2 = 77%) compared with control groups.
Conclusion
MBIs significantly improved psychological outcomes among college and university students during the COVID‐19 pandemic. Clinicians and health providers should consider using MBIs as alternative complementary treatment for improving and preventing anxiety and depression in college and university students during COVID‐19.
Clinical Relevance
The use of MBIs for college and university students is an effective method to decrease anxiety, depressive symptoms, and increase mindfulness. MBIs would become a very useful means of alternative complementary treatment in mental health and clinical psychiatry
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