Prevalence and predictors of mental health among farmworkers in Southeastern Anatolia of Turkey.

Zeynep Simsek, Ayşana Zehra Keklik, Canan Demir, Kerim M Munir
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Abstract

Background: Mental health problems represent a major component of the global burden of disease. The primary objective of this study was to assess the prevalence and predictors of psychological wellbeing among farmworkers and to evaluate their mental health services need for in rural primary health care settings.

Methods: The study sample comprised 1855 farmworkers (918 women, and 937 men) who were selected using probability cluster sampling method at 95% confidence interval (87.6 % response rate). The 12-item General Health Questionnaire (GHQ-12) and socio-demographic information form were used to data collection.

Results: The overall prevalence of mental health problems was 31.5%; the prevalence among women was 1.4 times that of men (35%, females; 28.2%, males). Logistic regression analyses revealed that poor general health, as well as presence of chronic diseases and exposure to traumatic life events predicted mental ill health among both sex. Poor economic situation, being seasonal migrant farmworker, and pesticide exposure history affected male mental health problems; while type of settlement, history of having disabled child at birth, and not having a family physician were significant predictors of female mental ill health (P < 0.05).

Conclusions: These findings highlight the need for systematic development of community-based mental health services in conjunction with rural primary health care center and an integrated approach to health care of farmworkers. These include screening, early identification and treatment of mental health problems, development of non-communicable disease (NCD) control program, maternal health services and urgent measures to improve farmworkers' work safety and pesticide applications.

土耳其安纳托利亚东南部农场工人心理健康状况及预测因素
背景:精神卫生问题是全球疾病负担的一个主要组成部分。本研究的主要目的是评估农场工人心理健康的患病率和预测因素,并评估他们在农村初级卫生保健机构的心理健康服务需求。方法:采用概率整群抽样方法,以95%置信区间(有效率为87.6%)对1855名农工进行抽样调查,其中女性918人,男性937人。采用12项一般健康问卷(GHQ-12)和社会人口信息表进行数据收集。结果:心理健康问题总体患病率为31.5%;女性的患病率是男性的1.4倍(35%,女性;28.2%,男性)。逻辑回归分析显示,总体健康状况不佳、慢性疾病的存在和创伤性生活事件的暴露预示着两性的精神健康状况不佳。经济状况不佳、季节性农工、农药接触史影响男性心理健康问题;而居住类型、出生时是否有残疾儿童、是否有家庭医生是女性精神疾病的显著预测因素(P < 0.05)。结论:这些发现强调了系统地发展社区精神卫生服务,与农村初级卫生保健中心和农业工人的综合保健方法的必要性。这些措施包括筛查、早期发现和治疗精神健康问题,制定非传染性疾病控制方案,提供孕产妇保健服务,以及采取紧急措施改善农场工人的工作安全和农药应用。
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