Skattningsskala för postmigratorisk stress hos flyktingar
Doktorand Andreas Malm har tillsammans med Fredrik Saboonchi, Petter Tinghög och Jurgita Narusyte (verksam vid Sektionen för Försäkringsmedicin, CNS, Karolinska Institutet) publicerat en artikel i tidskriften Conflict and Health. Artikeln har titeln The refugee post-migration stress scale (RPMS) – development and validation among refugees from Syria recently resettled in Sweden, och finns att läsa Open access på: https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-019-0246-5
Despite the growing recognition of the impact of post-resettlement factors on the mental health of refugees, a clear definition of the concept of post-migration stress, as well as an updated, valid instrument for assessing the construct, are still lacking. The aim of the current study was to develop and validate the Refugee Post-Migration Stress Scale (RPMS), a concise, multi-dimensional instrument for assessing post-migration stress among refugees.
Based on a review of previous research and observations from a refugee trauma clinic, a preliminary 24-item instrument was developed, covering seven hypothesized domains of post-migration stress: perceived discrimination, lack of host country specific competences, material and economic strain, loss of home country, family and home country concerns, social strain,and family conflicts.
In the context of a population-based survey of mental health among refugees from Syria recently resettled in Sweden ( n = 1215), the factorial structure of the RPMS was investigated. Confirmatory Factor Analysis revealed slightly insufficient fit for the initial theorized multi-domain model. Exploratory Factor Analysis in four iterations resulted in the omission of three items and an adequate fit of a 7-factor model, corresponding to the seven hypothesized domains of post-migration stress. To assess concurrent validity, correlational analyses with measures of anxiety, depression, post-traumatic stress disorder (PTSD), and mental wellbeing were carried out. All domains of post-migration stress showed significant correlations with anxiety, depression, and PTSD scores, and significant negative correlations with mental wellbeing scores.
The newly developed RPMS appears to be a valid instrument for assessing refugee post-migration stress. Our findings that post-migration stress primarily relating to social and economic factors seems to be associated with mental ill health among refugees is in line with previous research.