Near-death experiences, attacks by family members, and absence of health care in their home countries affect the quality of life of refugee women in Germany: A multi-region, cross-sectional, gender-sensitive study

BMC Medicine
Volume 16, Issue 1, 2018

Near-death experiences, attacks by family members, and absence of health care in their home countries affect the quality of life of refugee women in Germany: A multi-region, cross-sectional, gender-sensitive study (Article) (Open Access)

Jesuthasan J. , Sönmez E. , Abels I. , Kurmeyer C. , Gutermann J. , Kimbel R. , Krüger A. , Niklewski G. , Richter K. , Stangier U. , Wollny A. , Zier U. , Oertelt-Prigione S.* , Shouler-Ocak M. , Ahmadi S. , Akope L. , Altiner A. , Al-Dhabi A.A.A. , Al-Obadi R. , Al-Sadeh R. , Al-Zamel Y. , Alabdalah R. , Alshika R. , Arefaine Y. , Boukacem A. , Dasthi M. , Fandi L. , Fandi M. , Farrokh H.N. , Gol M.F. , Fecadu T. , Giuliano S. , Gretschmann H. , Habtemariam F. , Haghighi N. , Halabi B. , Hamadeh S. , Hassan F. , Herrmann X. , Hmimda S. , Isele D. , Kananian S. , Kharghanian H. , Letzel S. , Elham M. , Mahdi A.A. , Mahir S. , Maier K. , Massood R. , Neutzner S. , Niko J. , Pajuhandeh A. , Peter L. , Ghalab R.A.Q. , Quadri A. , Rasuli S. , Sabet F. , Sabet Z. , Sharif-Ali K. , Shyshko K. , Starck A. , Taubitz H. , Tewelde U. , Tober-Lau P. , Tober-Lau S. , Witte Z. , and on behalf of the Female Refugee Study (FRS) Investigators

^a Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, Berlin, 10115, Germany
^b Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, Berlin, 10115, Germany, Marmara University, School of Medicine, Department of Psychiatry, Istanbul, Turkey
^c Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, Berlin, 10115, Germany
^d Charité-Universitätsmedizin, Office of the Equal Opportunities Officer, Berlin, Germany
^e Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
^f Insitute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
^g Insitute of General Practice, University Medical Center Rostock, Rostock, Germany
^h University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
ⁱ University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany, Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany, Faculty for Medical Sciences, UGD University Stip, Stip, North Macedonia
^j Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
^k Insitute of General Practice, University Medical Center Rostock, Rostock, Germany
^l Insitute of Occupational, Social and Environmental Medicine, University Medical Center of the University of Mainz, Mainz, Germany
^m Department of Primary and Community Care, Radboud University Medical Center, P.O. Box 9101, Nijmegen (117), 6500 HB, Netherlands, Institute of Legal Medicine, Charité-Universitätsmedizin, Turmstr. 21, Haus N, Berlin, 10559, Germany
ⁿ Psychiatric University Clinic of Charité at St. Hedwig Hospital, Große Hamburger Straße 5 - 11, Berlin, 10115, Germany
^o Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^p Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^q Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^r Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^s Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^t Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^u Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^v Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^w Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^x Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^y Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^z Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^a Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^b Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^c Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^d Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^e Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^f Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^g Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^h Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
ⁱ Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^j Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^k Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^l Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^m Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
ⁿ Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^o Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^p Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^q Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^r Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^s Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^t Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^u Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^v Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^w Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^x Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^y Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^z Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^a Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^b Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^c Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^d Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^e Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^f Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^g Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^h Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
ⁱ Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^j Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^k Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^l Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^m Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
ⁿ Faculty for Social Sciences, Technical University Nuremberg GSO, Nuremberg, Germany
^o [Affiliation not available]

Abstract

Background: The year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in the home country and during the flight affected the quality of life of refugee women arriving in Germany in 2015-2016. Methods: Six hundred sixty-three women from six countries (Afghanistan, Syria, Iran, Iraq, Somalia, and Eritrea) living in shared reception facilities in five distinct German regions were interviewed by native speakers using a structured questionnaire. Sociodemographic data and information about reasons for fleeing, traumatic experiences, symptoms, quality of life, and expectations towards their future were elicited. All information was stored in a central database in Berlin. Descriptive analyses, correlations, and multivariate analyses were performed. Results: The most frequent reasons cited for fleeing were war, terror, and threat to one's life or the life of a family member. Eighty-seven percent of women resorted to smugglers to make the journey to Europe, and this significantly correlated to residence in a war zone (odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.4-4.6, p = 0.003) and homelessness prior to fleeing (OR = 2.1, 95% CI = 1-4.3, p = 0.04). Overall the described quality of life by the women was moderate (overall mean = 3.23, range of 1-5) and slightly worse than that of European populations (overall mean = 3.68, p < 0.0001). The main reasons correlating with lower quality of life were older age, having had a near-death experience, having been attacked by a family member, and absence of health care in case of illness. Conclusions: Refugee women experience multiple traumatic experiences before and/or during their journey, some of which are gender-specific. These experiences affect the quality of life in their current country of residence and might impact their integration. We encourage the early investigation of these traumatic experiences to rapidly identify women at higher risk and to improve health care for somatic and mental illness. © 2018 The Author(s).

Author Keywords

Traumatic experiences Migration Women Refugees Quality of life

Index Keywords

Afghanistan educational status Germany Eritrea refugee war exposure Syrian Arab Republic Terrorism human Refugees middle aged Ethnic Groups statistics and numerical data Stress, Psychological mental stress Iraq ethnic group Aged death Iran ethnology satisfaction Mental Disorders Cross-Sectional Studies mental disease quality of life Surveys and Questionnaires Young Adult cross-sectional study family psychology Humans Adolescent Domestic Violence life expectancy male female questionnaire Article adult migration age sex factor Somalia Sex Factors Syria expectation psychotrauma exposure to violence family violence life threat senescence Healthcare Disparities health care availability health care disparity homelessness

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85041452544&doi=10.1186%2fs12916-017-1003-5&partnerID=40&md5=a3770f4f061014d926b4f2a4e4ba0241

DOI: 10.1186/s12916-017-1003-5

ISSN: 17417015

Cited by: 8

Original Language: English