From: The impact of migration on the health status of Iranians: an integrative literature review
Author (year, Country) | Aim of study | Samples | Instruments | Main results | Type of study |
---|---|---|---|---|---|
Alizade-khoie 2011 Australia | To explore the impact of acculturation on health status | N = 302 Iranians Age > 65 y | Developed questionnaire from the NSW Older People’s Health Survey 1999 | • Iranian elderly immigrants suffer from high level psychological issues and physical activity limitation | Quantitative |
• English proficiency decreases the rate of depression and anxiety | |||||
Khavarpour 1997 [25] Australia | To determine the levels and predictors of psychological distress within the Iranians living in Sydney | N = 161 Iranians | General Health Questionnaire (GHQ-20) | • Students more likely to report psychological distress compared to full-time workers | Quantitative |
• migration contributes to psychological distress | |||||
• social support can reduce the experience of distress of unemployment and poor English proficiency | |||||
Steel et al. 2011 [27] Australia | To examine for differences in the trajectory of psychological symptoms and key indices of social adaptation amongst refugees over two years | N = 104 Iranian and Afghan immigrant | • The Harvard trauma questionnaire | • Language insufficiency results in increasing mental distress, social isolation, difficulty in acculturation process, and on-going resettlement difficulties | Quantitative |
• The Hopkins symptom checklist-25 | |||||
• The general health questionnaire | |||||
• The Penn State Worry questionnaire | |||||
• Post-migration living difficulties and detention experiences checklist | |||||
Neale 2007 [33] Australia | To examine the knowledge, use and satisfaction of local health care services | N = 98 Iranians, Afghan and Iraqi N = 23 Iranians | • Semi structured questionnaire | • poor English proficiency = dissatisfaction from health care services | Qualitative |
• focus group | |||||
• multiple-choice questionnaire | |||||
•open-ended questionnaire | |||||
Jafari 2010 [14] Canada | To examine the impact of immigration on mental health | N = 44 Iranians | • Focus group | • Low English proficiency resulted in social isolation, anxiety, mental problems, joblessness and unstable and aggressive behaviours | Qualitative |
• In-depth review | |||||
Dastjerdi 2012 [3] Canada | To identify the obstacles and issues that Iranian immigrants face to access to health care services through the lens of Iranian health care providers | N = 50 Iranian immigrant who work as health providers | • in-depth semi-structured individual interviews | • Language barrier and lack of knowledge of Canadian health care systems. | Qualitative |
• three focus groups | • Lack of trust in Canadian health care services due to financial limitations and fear of disclosure | ||||
• Narrative inquiry | |||||
Dastjerdi 2012 [15] Canada | To explore the Process of access to Health care services | N = 17 Iranians | • Individual face to face interview with a broad question then focused on health-relate experiences | • Getting isolated as a result of poor English skill | Qualitative |
• Telling story | • Tackling obstacles and being integrated | ||||
Dossa 2002 [31] Canada | To explore the pedagogical potential of stories of post revolution Iranian women living in Canada | N = 40 Iranian women | • Semi-structured interview | • Iranians experience discrimination | Qualitative |
• two focus groups | • Iranians experience depression | ||||
• Story telling | • language barriers can result in unemployment or underemployment | ||||
Tyndale et al. 2007 Canada | To explore the needs and experiences of Iranian immigrants about sexual health | N = 20 Iranians | • Semi structured interview | • difficulty in adjusting with new culture where sexuality is a usual fact | Qualitative |
• difficulties in receiving sexual health care because of misunderstanding (culture diversity) and shame and modesty | |||||
Guruge 2012 [38] Canada | To examine the relationship of violence and physical and mental health | N = 30 Iranian women | • Brief symptom Inventory | • about one third of Iranian immigrant women suffer from mental illness because of intimate partner violence | Quantitative |
• Harvard trauma Questionnaire | |||||
Ebrahimian 2012 Canada | To examine the effects of immigration on mental health of the Iranian immigrants residing in Toronto by comparing them to their counterparts in Iran | N = 200 Iranians | • Demographic questionnaire | • The rate of depression is higher amongst elderlies then younger immigrants | Quantitative |
• Depression Scale | • highly educated immigrants are less depressed than low-educated ones | ||||
Singhammer 2011 [26] Denmark | To explore the relationship of violence and mental health among Iranian immigrants | N = 991 Iranian women | • A questionnaire including health indicators, health risk factors, healthy behaviours & health care services | • Iranian women had the greatest rate of divorce among other ethnic minorities in Denmark | Quantitative |
• The rate of violence was reported higher amongst Iranian women than other minorities | |||||
Lipsicas et al. 2012 [4] European countries | To compare the frequencies of attempted suicide among immigrants and their hosts, between different immigrant groups, and between immigrants and their | N = 4160 immigrants from various countries included Iran | • Data were obtained from the WHO/EURO Multi-centre Study on Suicidal Behaviour | • Iranians displayed high suicide attempt rate in European countries despite low suicide rates in Iran | Quantitative |
• Immigration process in itself and the difficulties in acculturation can result in high- suicide attempt rates | |||||
Haasen et al. 2008 [22] Germany | To find evidence for a relationship between acculturation stress and mental health problems, mainly depressive symptomatology | N = 100 Iranians | • Acculturation-stress-index (ASI) | • 28 % of Iranian immigrants suffer from mental disorders without treatment | Quantitative |
• SCL-90-R | • Depression score was high amongst Iranian immigrant | ||||
• Hamilton Depression scale (HAM-D) | • Inaccessibility of mental care centres | ||||
Gerristen et al. 2006 Netherlands | To estimate the prevalence rates of physical and mental health | N = 410 Iranians, Afghan and Somali N = 117 Iranians | • medical outcome study (MOS) | • 43.4 % of Iranian asylum seekers suffer from depression and anxiety | Quantitative |
• SF-36 | |||||
• Harvard trauma questionnaire | • Iranians suffer from dental and eye problems, back pain, neck/shoulder complaints, headache | ||||
• HSCL-25 | |||||
Akhavan 2007 [24] Sweden | To analyse females’ perceptions of various factors that influence their health | N = 10 Iranian women | • Semi-structured interview | • Discrimination is the greatest threat for health | Qualitative |
• Unemployment and financial issues result is mental problems | |||||
• Domestic violence, depression, and divorce as immigration adverse effects | |||||
Bayard 2001 [34] Sweden | To examine the association between ethnicity among migrants born in Iran and psychiatric illness and intake of psychotropic drugs | N = 1980 Iranian, Kurd, Turkish, Polish, Chilean N = 293 Iranians | • Swedish Survey of Living Conditions questionnaire plus immigrant specific questions | • Iranian had more risk of mental illness and intake drugs 6 and 5fold more than swedes respectively. | Mixed(Qualitative and Quantitative) |
• Face to face interview | • Feeling discrimination by Iranians was higher than other ethnic minorities | ||||
Momeni et al. 2011 Sweden | To investigate the self-reported mental health among two Iranian groups; in Sweden and Iran | N = 208 Iranians | • An author-made questionnaire | • 21 % of elder Iranian immigrants suffer from depression same as their counterparts in Iran | Quantitative |
• depression rate was higher among Iranian women compared to men | |||||
Tinghog et al. 2010 Sweden | To investigate the association of immigrant and non-immigrant-specific factors with mental ill health within a diverse immigrant population | N = 720 from Iran, Iraq and Finland N = 250 Iranians | • The Hopkins symptom checklist-25 | • 48 % of Iranian immigrants suffer from depression | Quantitative |
• The WHO (World Health Organization) Well-being Index | • 19 % of Iranian immigrants suffer from discrimination | ||||
• Unemployment and poor social network can lead to depression | |||||
• being female is a risk factor for mental disorders | |||||
Wiking 2004 [36] Sweden | To analyse the association between ethnicity and poor health | N = 2160 From Poland, Iran and Turkey N = 480 Iranians | • Standardized & translated questionnaire for assessing the socioeconomic status (SES) | • Discrimination and acculturation are two important mediators between ethnicity and health. | Quantitative |
• High discrimination is felt by 34 % & 51 %, respectively, by men and women | |||||
• 41 % of women reported poor health status | |||||
Lipson 1992 [28] The United States | To examine the immigration experiences of a sample of Iranians in the USA | N = 35 Iranians | • Semi-structured interview | • Lack of social support | Mixed(Qualitative and Quantitative) |
• Health opinion survey (HOS) | • Communication problems because of language insufficiency | ||||
• culture shock | |||||
• difficulty to find a good job | |||||
• Financial problems | |||||
• Ethnic bias (discrimination) | |||||
Martin 2012 [37] The United States | To explore elderlies’ experience of discrimination in American health care system | N = 15 Iranians | • In-depth interview (in person) | • There was no discrimination | Qualitative |
• Open ended questions | • Highly positive impression of American health care providers | ||||
• Language barrier as a factor for underestimating possible discrimination | |||||
Meleis et al. 1992 The United States | To investigate the nature of the relationship between demographic characteristics, ethnicity, length of time in the USA and physical and mental health/illness status, psychological well-being, and perceived health | N = 88 Egyptian, Yemeni, Iranian, Armenian, and Arab immigrant N = 16 Iranians | • Socio-demographic questionnaire | • unavailability of an ethnic community in overseas can result in depression and isolation among elderlies | Quantitative |
• Ethnic identity questionnaire | |||||
• 10-point rating scale | • Iranians usually enjoy from high integration and assimilation in host countries | ||||
• Cornell Medical Index (CMI) | |||||
• Revised Bradburn Morale Scale | • integration increases along with increasing the length of stay in the host country | ||||
• 10-point Cantril ladder scale | • increasing the length of stay in the host country doesn’t improve the immigrants’ health situation | ||||
Saechao et al. 2012 [29] The United States | To examine stressors and barriers to using mental health services among first-generation | N = 30 from Cambodia, Iran, Iraq, Vietnam, Africa, eastern European N = 4 Iranians | • Six focus groups | • Barriers: Language, cost, lack of information about mental health services | Qualitative |
• Stressors: discrimination, economic status, difficulty to find suitable job | |||||
Ghaffarian 1998 The United States | To explore the relationship of acculturation and mental health | N = 238 Iranians | A five section questionnaire including: | • Acculturation increased = score of mental health decreased (better) | Quantitative |
• Demographic Questions | • Men are healthier than women mentally | ||||
• Warheit & Buhl's Anxiety, depression and Psychological dysfunction scale | |||||
• Iranian version of Mendoza ‘s Cultural Life Style Inventory | |||||
Ghaffarian 1987 The United States | To examine Iranian immigrants, their acculturation to the American culture, and specifically, the acculturative differences between males and females | N = 110 Iranians | • Demographic Questionnaire | • Less adjustment to host culture = stress and depression | Quantitative |
• Warheit & Buhl's Anxiety scale | • Men are more able to adjust themselves with new societies and cultures | ||||
• Traditional family ideology designed by Levinson and Huffman (1955) | |||||
• Acculturation scale designed by Cuellar, Harris, and Jasso (1980) |