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Determinantes de saúde mental dos imigrantes a viverem em Portugal
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INTRODUÇÃO: O número de migrantes ao redor do mundo continua a crescer e Portugal tornou-se um país receptor de pessoas. A migração tem sido associada a uma maior vulnerabilidade à doenças e a outros problemas de saúde, incluindo as perturbações mentais. De acordo com o Projeto Global Burden of Diseases, apoiado pelo Banco Mundial e pela Organização Mundial de Saúde, as perturbações mentais são tão graves como as patologias cardiovasculares e respiratórias, devido à incapacidade que provocam. Face a esta maior vulnerabilidade a que os imigrantes estão expostos, este estudo tem como objetivo identificar a proporção de imigrantes que reportam perturbações mentais e descrever os fatores associados.
MÉTODOS: Um estudo observacional transversal foi conduzido entre outubro de 2008 e maio de 2009. O método de amostragem utilizado foi o snowball (bola de neve). A amostra foi constituída por 1375 imigrantes oriundos do Brasil (38%), dos países Africanos de língua oficial portuguesa (32,5%) e dos países da Europa Oriental (29,5%), residentes em Lisboa, Portugal. Os dados foram coletados através de um questionário estruturado, aplicado por entrevistadores treinados. O modelo da regressão logística foi utilizado para identificar os fatores associados à depressão e à ansiedade e stress. Os coeficientes estimados foram interpretados através do odd ratio e para cada um foram apresentados intervalos de confiança a 95%.
RESULTADOS: A idade média dos participantes é de 35,74 anos. Do total, 51,1% são do sexo feminino. O principal motivo para emigrar, referido por 41,5% dos indivíduos, prende-se com questões económicas, o que pode caracterizar a imigração como sendo laboral. A depressão é reportada por 13,7% dos imigrantes, percentagem que se mantém semelhante nas três comunidades, Africana (12,3%), Brasileira (14,7%) e do Leste (13,8%). Em relação ao género, a depressão é mais evidente entre as mulheres (16,5%). A presença de ansiedade e stress é reportada por 39,3% dos imigrantes, sendo eles 40,5% Africanos, 41,9% Brasileiros e 34,4% do Leste. Esta perturbação também é mais evidente entre as mulheres (44,8%). Para além do género, outros determinantes de saúde mental foram identificados; ocupação profissional, cansaço psicológico, solidão e ansiedade.
CONCLUSÕES: A presença de ansiedade e stress é mais reportada do que a depressão. Estas duas perturbações mentais estão mais presentes entre as mulheres e são estatisticamente significativas em relação à saúde mental dos imigrantes, o que causa alguma preocupação, face a maior vulnerabilidade a que eles estão expostos. O processo de migração deve ser saudável e produtivo, através da promoção e educação para a saúde. Por isso, é necessário pensar em políticas e estratégias de acção que minimizem os danos causados na sociedade e no próprio imigrante, devido à incapacidade que estas perturbações provocam e do impacto que têm na vida diária das pessoas. Para além disso, deve-se promover a investigação científica na área da saúde mental, para que se obtenham resultados de maior qualidade, uma vez que a população em estudo é de difícil acesso.
INTRODUCTION: The number of migrants around the world has been growing and Portugal became a receiving country. Migration has been associated to a higher vulnerability to diseases and other health problems, including mental disorders. According to the Project Global Burden of Diseases, supported by the World Bank and the World Health Organization, mental disorders are as severe as cardiovascular and respiratory pathologies, because of the disability it causes. Considering the greater vulnerability to which immigrants are exposed, the aim of this study is to identify the proportion of immigrants who report mental disorders and describe the associated factors. METHODS: An observational cross-sectional study was conducted between October 2008 and May 2009. A snowball sampling method was used and the sample was constituted by 1375 immigrants from Brazil (38%), African Portuguese-speaking countries (32,5%) and Eastern European countries (29,5%), who resided in Lisbon, Portugal. Data were collected through a structured questionnaire applied by trained interviewers. Two stepwise logistic regressions were conducted to identify which factors were associated with depression and anxiety and stress. Both of them were estimated by calculating odds ratios and 95% confidence intervals. RESULTS: The participants' average age is 35,74 years. Of the total, 51,1% are female. The main reason mentioned by 41.5% of individuals to emigrate is related to economic issues, which may characterize immigration as being labor. Depression is reported by 13,7% of the immigrants, a percentage that remains similar in the three communities, African (12.3%), Brazilian (14.7%) and from Eastern countries (13.8%). In relation to gender, depression is more evident among women (16.5%). The presence of anxiety and stress is reported by 39,3% of the immigrants; 40.5% African, 41.9% Brazilian and 34.4% from Eastern countries. This condition is also more evident among women (44.8%). Apart from gender, other determinants of mental health were identified; occupation, psychological fatigue, loneliness and anxiety. CONCLUSIONS: The presence of anxiety and stress is more reported than depression. These mental disorders are more prevalent among women and are statistically significant in relation to mental health of immigrants, which causes some concern, given the greater vulnerability to which they are exposed. The migration process should be healthy and productive, through the promotion and health education. It is therefore necessary to consider policies and action strategies in order to minimize damage on society and the immigrant himself, due to the inability it causes and the impact it has in the migrants’ daily lives. Furthermore, it should promote scientific research on mental health in order to obtain higher quality results, once the population being studied is difficult to reach.
INTRODUCTION: The number of migrants around the world has been growing and Portugal became a receiving country. Migration has been associated to a higher vulnerability to diseases and other health problems, including mental disorders. According to the Project Global Burden of Diseases, supported by the World Bank and the World Health Organization, mental disorders are as severe as cardiovascular and respiratory pathologies, because of the disability it causes. Considering the greater vulnerability to which immigrants are exposed, the aim of this study is to identify the proportion of immigrants who report mental disorders and describe the associated factors. METHODS: An observational cross-sectional study was conducted between October 2008 and May 2009. A snowball sampling method was used and the sample was constituted by 1375 immigrants from Brazil (38%), African Portuguese-speaking countries (32,5%) and Eastern European countries (29,5%), who resided in Lisbon, Portugal. Data were collected through a structured questionnaire applied by trained interviewers. Two stepwise logistic regressions were conducted to identify which factors were associated with depression and anxiety and stress. Both of them were estimated by calculating odds ratios and 95% confidence intervals. RESULTS: The participants' average age is 35,74 years. Of the total, 51,1% are female. The main reason mentioned by 41.5% of individuals to emigrate is related to economic issues, which may characterize immigration as being labor. Depression is reported by 13,7% of the immigrants, a percentage that remains similar in the three communities, African (12.3%), Brazilian (14.7%) and from Eastern countries (13.8%). In relation to gender, depression is more evident among women (16.5%). The presence of anxiety and stress is reported by 39,3% of the immigrants; 40.5% African, 41.9% Brazilian and 34.4% from Eastern countries. This condition is also more evident among women (44.8%). Apart from gender, other determinants of mental health were identified; occupation, psychological fatigue, loneliness and anxiety. CONCLUSIONS: The presence of anxiety and stress is more reported than depression. These mental disorders are more prevalent among women and are statistically significant in relation to mental health of immigrants, which causes some concern, given the greater vulnerability to which they are exposed. The migration process should be healthy and productive, through the promotion and health education. It is therefore necessary to consider policies and action strategies in order to minimize damage on society and the immigrant himself, due to the inability it causes and the impact it has in the migrants’ daily lives. Furthermore, it should promote scientific research on mental health in order to obtain higher quality results, once the population being studied is difficult to reach.
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Saúde pública Saúde mental Depressão Ansiedade Stress Portugal
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical