Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study / 소아과

PURPOSE: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. METHODS: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. RESULTS: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. CONCLUSION: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.

Association of Pain with Suicidality in Depressed Elderly

OBJECTIVE: We aimed to investigate the factors associated with suicidality among the elderly, focusing pain as the potential correlate. METHODS: This study was a community-based, cross-sectional study that included 413 elderly subjects aged 60 years and over with depression. Suicidality and pain were evaluated using Suicidal Ideation Scale and Geriatric Pain Measure, respectively. Participants were classified into two groups : 1) those with mild-to-moderate pain ; 2) those with severe pain. The risk of suicidality was determined using logistic regression, adjusting for age, sex, education, literacy status, marital status, living arrangement, the type of medical insurance, employment status, and the number of chronic medical illnesses. RESULTS: Among all subjects with depression, fifty-one (12.3%) presented clinically significant levels of suicidality. Those with severe pain were more likely to have suicidal idea (adjusted odds ratio : 20.49 ; 95% confidence interval : 8.15-51.51 ; p value : < 0.001) than those with mild-to-moderate pain, after adjusting for other variables. Other sociodemographic and clinical variables were not associated with the risk of suicide after adjustment. CONCLUSION: The severity of pain was strongly and independently associated with suicidality in the elderly individuals. This study suggests that the pain management should be emphasized to lower the rate of suicide in those experiencing depression in the late-adulthood.