Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries

Boor, Catharina van der; Amos, Rebekah; Nevitt, Sarah J; Dowrick, Christopher; White, Ross

doi:10.1186/s13031-020-00292-y

Cited by 43 publications

(42 citation statements)

References 51 publications

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“…This could be due to only a handful of studies being relevant and the use of different measures in a variety of contexts, but is also an indication of the need to replicate our results in larger studies. Although numerous studies have found that mental distress predict quality of life [ 27 , 28 ], few have investigated this as a mediator between trauma and quality of life as we proposed in our third hypothesis. One study of adult Ethiopians in refugee camps found that trauma from displacement had both a direct effect upon HRQoL and an indirect effect through mental distress [ 29 ].…”

Section: Discussionmentioning

confidence: 92%

“…Resettlement can therefore be stressful, but also involve personal growth and resilience [ 55 ], and as such it supports Antonovsky’s criticism of early stress theories for assuming that stressors were inherently negative and the importance of focussing on health resources [ 56 ]. Social support and positive coping styles are suggested as protective factors buffering mental distress in refugee children and youth [ 3 , 4 ] and are also associated with increased quality of life [ 18 , 27 ]. Our models did not investigate any protective factors, and further studies should include such measures.…”

Section: Discussionmentioning

confidence: 99%

“…It might therefore be relevant to consider quality of life as an alternative outcome to mental distress, in the "ecological model of refugee distress". However, the association between mental distress and quality of life has also been repeatedly verified among youth in general [28] and in refugees [27,29], and purely replacing quality of life as an outcome, would not account for the potential influence of mental distress on quality of life. Hence, this study aims to further explore the "ecological model of refugee distress" by including quality of life as an outcome, and mental distress as an additional mediator (see Fig.…”

Section: Introductionmentioning

confidence: 99%

“…A UN report of Syrian youth in Jordan found greatly reduced levels [ 26 ]. Context and measurements could be contributors to these differences, but pre- and post-migration variables are also consistently associated with quality of life [ 7 , 27 ]. It might therefore be relevant to consider quality of life as an alternative outcome to mental distress, in the “ecological model of refugee distress”.…”

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life in refugee youth and the mediating role of mental distress and post-migration stressors

2021

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Purpose The aim of this study is to explore how potentially traumatic events (PTEs) from war and flight influence health-related quality of life (HRQoL) in young refugees after recent resettlement. In a model based on earlier theory, we tested if post-migration stressors and mental distress mediated the effect of PTEs on HRQoL, individually and in serial. We also explored how different types of post-migration stressors influenced different dimensions of HRQoL. Methods This study used a cross-sectional design where 160 Syrian youth recently resettled in Norway completed questionnaires at school between May and December 2018. Correlations between types of post-migration stressors and dimensions of HRQoL were explored and a serial multiple mediator model was tested. Models were adjusted for age and gender, using two types of mental distress; post-traumatic stress disorder (PTSD) and general mental distress. Results Higher levels of PTEs reduced experienced HRQoL, but this direct effect was mediated by post-migration stressors alone and in serial with mental distress. Despite high levels of mental distress, this did not affect HRQoL independently, only in serial mediation with increased post-migration stressors. Economic concerns and discrimination were types of post-migration stressors affecting several dimensions of HRQoL. Conclusion Quality of life in refugee is affected by past events from war, stressors in current resettlement and elevated mental distress through complex interrelations. The study reiterates the importance of considering structural and everyday post-migration stressors in policy and intervention to improve the health and wellbeing of refugee youth.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life in refugee youth and the mediating role of mental distress and post-migration stressors

2021

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“…Focusing on wellbeing allows a shift from a narrow focus on the presence or absence of mental illness alone to a fuller, richer consideration of what factors can bring vitality to the person's lived experiences. Unfortunately, there has been a comparative lack of research focusing on subjective wellbeing and quality of life of FDP (Turrini et al, 2019;van der Boor et al, 2020a). We believe that, rather than being viewed exclusively as a health issue, the mental health and psychosocial wellbeing of FDP needs to be understood as a human rights issue that includes a focus on key principles such as participation in society, nondiscrimination, human dignity and empowerment.…”

Section: Mental Health Psychosocial Wellbeing and Human Developmentmentioning

confidence: 99%

Enhancing the capabilities of forcibly displaced people: a human development approach to conflict- and displacement-related stressors

White

Boor

2021

Epidemiol Psychiatr Sci

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Aims The mental health of individuals who have been forcibly displaced can be impacted both by war-related traumatic events and displacement-related stressors, which arise as a consequence of their migratory journey and subsequent experiences. In addition to focusing on mental disorders, there is a need to explore broader psychosocial outcomes that are important for forcibly displaced people. Our aim is to present a coherent explanatory framework to understand how both past traumatic events and ongoing stressors operating throughout forcibly displaced people's social environment can impact mental health and psychosocial wellbeing. Methods We describe the capability approach (CA), a human development framework that foregrounds individuals’ freedom to engage in forms of being and doing that are valuable to them. We consider the opportunities that the CA provides for understanding how a myriad of factors can impact forcibly displaced people, and how different forms of support can be configured to meet the needs of particular people and communities. Results The CA recognises that various factors can share a common putative causal mechanism in their impact on forcibly displaced people, i.e. these factors limit a person's ability to develop capabilities and their freedom to engage in valued forms of being and doing. The rights based ethos of the CA enables multisectoral and coordinated activity, which can be directed towards addressing factors across the social environment. Importantly, the CA helps to explain why particular forms of support may be more beneficial for individuals or communities at certain times compared to others. Conclusion The application of the CA can help to guard against the risk that the aspirations of assessment instruments and interventions aimed at supporting forcibly displaced people are narrowly focused on addressing distress and disorders, to instead adopt a more expansive focus on forcibly displaced people's potential and the possibilities that they wish to realise.

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Chronic Illness and Quality of Life 5 Years After Displacement Among Rohingya Refugees in Bangladesh

Hossain,

Baten,

Saadi

et al. 2024

JAMA Netw Open

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ImportanceRohingya refugees, forcibly displaced from Myanmar, face challenges adapting to Bangladesh. Examining their quality of life (QOL) is vital to identifying nuanced factors associated with their well-being, informing targeted interventions for an improved QOL.ObjectivesTo identify the QOL among Rohingya refugees 5 years after migration to Bangladesh, with a particular emphasis on understanding the complex interplay between sociodemographic factors and chronic illnesses.Design, Setting, and ParticipantsA cross-sectional study involving resettled Rohingya adults was conducted between May 18 and July 7, 2021, approximately 5 years after their resettlement in Bangladesh. Of the participants, 500 individuals were healthy, whereas 558 individuals were undergoing treatment for at least 1 chronic disease. Data were analyzed from January to February 2024.Main Outcomes and MeasuresThe study assessed QOL using the short version of the World Health Organization’s QOL Questionnaire, covering 4 domains: physical, psychological, social, and environmental. Scores were transformed to a maximum of 100. Tobit linear regression, adjusted for potential confounders, was employed for analysis.ResultsThe study included a total of 1058 respondents, who were predominantly female (630 participants [59.5%]) and had a mean (SD) age of 42.5 (16.1) years. Despite being healthy, individuals without chronic illnesses had median QOL scores ranging from 44 to 56 out of 100, indicating a relatively poor QOL. A total of 260 participants (46.6%) with chronic diseases reported very poor or poor QOL, in contrast to 58 healthy individuals (11.6%) in the fifth year after displacement. Specifically, patients with cancer and those who had multimorbidity exhibited the lowest QOL scores across all domains, with significant reductions in the physical health (10.57 decrease; 95% CI, −12.97 to −8.17) and psychological domain scores (7.20 decrease; 95% CI, −9.71 to −5.93) according to Tobit regression analysis.Conclusions and RelevanceThis study found that chronic illnesses were associated with all domains of QOL among Rohingya refugees, particularly those with musculoskeletal disorders, cancer, and multimorbid conditions. This heightened vulnerability may contribute to poor QOL in this population. By uncovering these disparities, the study lays the groundwork for targeted interventions and policies aligned with the United Nations’ goal of leaving no one behind in sustainable development efforts.

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Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries

Cited by 43 publications

References 51 publications

Health-related quality of life in refugee youth and the mediating role of mental distress and post-migration stressors

Health-related quality of life in refugee youth and the mediating role of mental distress and post-migration stressors

Enhancing the capabilities of forcibly displaced people: a human development approach to conflict- and displacement-related stressors

Chronic Illness and Quality of Life 5 Years After Displacement Among Rohingya Refugees in Bangladesh

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