Impact of traumatic events incurred by asylum-seekers on mental health and utilization of medical services.

Autor: Siman-Tov M; Emergency management & disaster medicine department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Bodas M; Emergency management & disaster medicine department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; National Center for Trauma & Emergency Medicine Research, the Gertner Institute for Health Policy and Epidemiology, Tel Hashomer, Ramat Gan, Israel., Wang A; Medical School for International Health, Ben-Gurion University of the Negev, Beer Sheva, Israel., Alkan M; Medical School for International Health, Ben-Gurion University of the Negev, Beer Sheva, Israel., Adini B; Emergency management & disaster medicine department, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. adini@tauex.tau.ac.il.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2019 Sep 06; Vol. 27 (1), pp. 85. Date of Electronic Publication: 2019 Sep 06.
DOI: 10.1186/s13049-019-0665-8
Abstrakt: Background: Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events.
Objective: To identify the scope and types of medical services required by asylum-seekers and the relationship between delayed medical care to development of post-traumatic stress disorder (PTSD) and overutilization of medical services.
Methods: Asylum-seekers that entered Israel between 2009 and 2012 who utilized the Open Clinic of Physicians for Human Rights were interviewed to record their experiences in the Sinai, and document the traumatic events they were exposed to, their medical diagnoses, and clinic visits. Linkages between diagnoses to exposure to traumatic events and period of time until presentation to the clinic were investigated.
Results: Male vs female asylum-seekers visited the clinic more times (24% vs 15% respectively, utilized > 5 visits). Higher ransom and longer periods in Sinai correlated with higher number of clinic visits and PTSD. Asylum-seekers with PTSD versus other medical complaints approached the clinic more times (> 5 visits). Asylum-seekers that approached the clinic closer to their arrival time (up to 18 months from arrival) versus a later period (> 18 months) presented a significantly lower prevalence of PTSD (3.4 and 40.5% respectively; p < 0.001) and lower utilization of clinic's services (p < 0.001).
Conclusions: PTSD among asylum-seekers appears to be associated more with length of exposure to stressful events than number/types of traumatic events and with delay in receiving medical care. Improving access to medical care may reduce asylum-seekers' development of PTSD and lead to lower utilization of services.
Databáze: MEDLINE
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