Depression among immigrant Mexican women and Southeast Asian refugee women in the U. S.

Although immigrants and refugees share the experience of adapting to a new country, life experiences and circumstances surrounding leaving their homelands are vastly different. The most salient difference is their motivation for leaving. Immigrants typically leave their homeland to seek improved economic opportunities and/or to join other family members. Refugees leave their homeland under the threat of injury or loss of life due to political or religious persecution and severe deprivation of basic life necessities. Since the decision to migrate is often viewed as a positive change for immigrant women in comparison to refugee women, mental health problems may be under -detected. The researchers will describe the prevalence of depression in two of the largest groups of migrant women in the U.S., immigrant Mexican women (N=220) and refugee Southeast Asian women (N=163). The purpose of this paper is to compare and contrast life circumstances that may impact on the prevalence of depression in both groups of women. The issues presented are important for nurses internationally who assess and design interventions for immigrant and refugee populations of women.

Acculturation and breast self-examination among immigrant Latina women in the USA.

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.

Southeast Asian refugee children: violence experience and depression.

The United Nations High Commission for Refugees (UNHCR) reports that there were approximately 8.2 million refugees world wide in 1980. Estimates today place the number of refugees to be at least 44 million. Although most refugees remain within the boarders of their homelands, others who are granted asylum immigrate to host countries. The largest number of refugees to enter the United States during the past 20 years are from Southeast Asia, following the end of the Viet Nam War in 1975. The majority of immigrating Southeast Asian refugees were children and adolescents. Empirical study of refugee children, who are known to have experienced catastrophic violence during war, escape from homelands and in camps of asylum, is relatively scarce. Some studies that have addressed this issue document association between violence experience, depression and post traumatic stress disorder. Even so, the findings are not always clear. The purpose of this paper is to document the frequency of pre-migration and post-migration violence experiences reported by Southeast Asian refugee children in the U.S. and their relationship to depression. This study also addresses the emotional impact of violence experiences as described by the children. Previous studies have often neglected this important variable in accounting for variations in children' 5 mental health status. Nurses, internationally, will want to consider the multiple facets of violence experience when assessing children who may be at high risk for psycho-social adaptation problems following resettlement.

Breast care among Latino immigrant women in the U.S.

Although the U.S. is recognized as a developed country, knowledge of how to perform a breast self-examination (BSE) and the availability and accessibility screening mammography are not evenly distributed across ethnic, racial, and socioeconomic groups. Some U.S. organizations have decreased their emphases on BSE and are strongly promoting technological advances such as mammography. Disparities in obtaining breast health care are found worldwide. In this article we present the findings of a study that was conducted in a large urban area in the Midwest of the United States, to identify factors associated with breast care in Latino immigrant women (n = 111). Limited knowledge about breast care, unemployment, and short period of residence in the U.S. were all found to be related to inadequate breast care in this group of women. These findings have global implications for health care practitioners in directing attention toward discovering factors that promote and inhibit early breast cancer detection.

Southeast Asian refugee women and depression: a nursing intervention.

Globally, conflicts continue to result in large numbers of refugees and displaced persons, the majority are women. At present, there is scant literature on the mental health status of refugee women following resettlement in countries that grant asylum. We do know that adaptation following migration is a complex cultural, psychological and social process. Some studies have suggested a high prevalence of depression symptoms related to premigration and post-migration experiences. The purpose of this paper will be to describe the mental health status of Southeast Asian (S.E.A.) refugee women in the United States, before home visit interventions by school nurses and bilingual teachers, and at 10, 20 and 33 weeks following the intervention. A comparison group of S.E.A. refugee women, who did not receive the intervention, were evaluated for mental health status on two occasions ten weeks apart. The identified needs and problems identified by the women, the interventions implemented by the school nurses and the success of the interventions will also be discussed. The underlying problem for the majority of women was poverty and social isolation. The study demonstrates that indeed, refugee women in the U.S., are experiencing needs and problems related to basic survival issues in multiple areas of their lives. The findings suggest that home visit interventions by nurses may be a valuable means of reducing depression in S.E.A. refugee women.

Caring for Myanmar refugees in Thailand.

Massive refugee movements continue due to conflicts between and within nations. To combat the major causes of mortality in refugee camps--undernutrition, measles, diarrhoea, pneumonia and malaria13--nurses are following the principles of primary health care and are promoting adequate food, safe drinking water, shelter, environmental sanitation and immunization.

Effects of family disruption on Southeast Asian refugee women.

Identifying refugee women at a high risk of depression, anxiety and post-traumatic stress is an important role of the nurse, so that appropriate interventions--including family and community support--can be implemented. Below, an assessment of Southeast Asian refugee women experiencing emotional distress from the disruption of family ties that occurred during war, escape and resettlement.

The effects of violence on health and adjustment of Southeast Asian refugee children: an integrative review.

Public health nurses have historically been on the front line in meeting the needs of refugees in their practice communities. Little nursing research has been focused on the needs of refugees, however. The purpose of this integrative literature review was to clarify research focused on the needs of one refugee group, southeast Asian. The integrating factors reviewed were the instruments used, sampling procedures, statistical methods, and clarification of independent and dependent variables. Power analyses were computed on three of the studies to critique further the appropriateness of sample size. Findings indicate that premigration experiences, especially violence, play an important role in health status and adaptation after settling in the United States. Since health problems are often manifested in cultural ways different from Western norms, public health nurses would benefit from continued research clarifying the needs of individuals from other cultures.

Primary health care in an unsettled area of northern Thailand.

The implementation of primary health care by nurses in poor and geographically isolated areas of the world is a complex and difficult task. When the area is also unsettled and insecure the task becomes increasingly formidable. Under these conditions primary health care is bound by not only the allocation of resources and restricted mobility but also the instability of changing government policies that influence all parameters of life. Mounting evidence has demonstrated that self-determination--derived from community-based socio-economic development--is a prerequisite to the initiation of a successful health care system. In turn, socioeconomic development is possible only when people are secure from expulsion from their land and the country. In addition, they must also be protected against outside coercion and violence that undermines community stability. The following is a report on health care problems related to the socioeconomic instability of an unsettled area that has global implications for nurses in similar areas worldwide.

Stress related to family change among Vietnamese refugees.

Because life changes have been known to have consequences for emotional and physical well-being, this study demonstrates the need for community health nurses (CHNs) to assess structural and functional changes in Vietnamese refugee spousal relations as possible sources of stress following resettlement. The purpose of this study was to identify changes in the structural and functional dimensions of family life and assess their impact on spousal relations. The major variables considered in effecting change in spousal interactions were relocation, exposure to more liberal attitudes toward gender equality in the United States, and wife employment. Spousal power differentials and affectivity were used as measures of change. Intensive interviews, using a semistructured interview guide, were conducted with 30 Vietnamese refugee women; the sample was nonrandom and cross-sectional. Information was collected on sociodemographic characteristics and pre- and postresettlement spousal relations. Wife employment, associated with proficiency in English and longer length of residence in the U.S., was found to promote more egalitarian spousal relations and greater spousal affectivity. When wives were not employed, they tended to describe an increase in affectivity without an appreciable decrease in spousal power differentials. This effect was enhanced by isolation within the host society as a result of limited English skills, unemployment, and a shorter length of residence.

Empirical formula for 30Co axial depth doses.

An empirical formula has been developed to approximate the published axial depth doses of 60Co radiation with greater accuracy than available hitherto. With sets of nine constants, varying slightly with SSD, a total of 2100 percentage depth doses are reproduced with root-mean-square deviations ranging from 0.13 to 0.16 for four values of SSD from 50 to 100 cm.