Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study

Factors associated with risk behaviours towards hepatitis B among migrant workers: a cross-sectional study based on theory of planned behaviour

OBJECTIVES

Rural-to-urban migrant workers are susceptible to hepatitis B because of lack of self-protection awareness and social support. The aim of this study was to explore the factors influencing risk behaviours for hepatitis B among migrant workers based on the theory of planned behaviour (TPB).

DESIGN

A cross-sectional survey.

SETTING

Chongqing, China PARTICIPANT: Migrant workers PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were the TPB variables. The secondary outcomes were factors explored by logistic regressions which were associated with hepatitis B related risk behaviours and behavioural intentions (BI).

RESULTS

Of 1299 recruited migrant workers, 384 (29.56%) participants undertook risk behaviours related to hepatitis B virus infection in the 6 months prior to the survey, and 1111 (85.53%) migrant workers had the BI of doing so. Of 842 migrant workers who undertook sexual activities, 58.19% did not use condoms. Binary logistic regressions showed that migrant workers who were men (p<0.05), less educated (p<0.01), lacked hepatitis B knowledge (p<0.05) and of a young age (p<0.01), were more intent on conducting hepatitis B-related behaviours. Alcohol drinking (p<0.01) was also positively associated with hepatitis B risk. The scores of TPB variables, including attitude towards behaviour and subjective norms, were positively associated with BI when adjusted for sociodemographics (p<0.001). Meanwhile, experience of behaviour and regret feeling were positively associated with BI and actual behaviours (p<0.01 and p<0.05, respectively).

CONCLUSIONS

A considerable proportion of migrant workers undertake hepatitis B-related risk behaviours, and condoms are seldom used. Health education campaigns targeting the identified TPB variables may play a significant role in improving awareness of hepatitis B prevention among migrant workers, especially for those who are men, younger, alcohol drinkers, less educated and lacking hepatitis B knowledge.

Promoting labour migrant health equity through action on the structural determinants: A systematic review

BACKGROUND

Labour migrants, who represent over sixty per cent of international migrants globally, frequently have poorer health status than the population of host countries. These health inequities are determined in a large part by structural drivers including political, commercial, economic, normative and social factors, including living and working conditions. Achieving health equity for migrant workers requires structural-level interventions to address these determinants.

METHODS

We undertook a systematic review of peer-reviewed literature designed to answer the question "what is the evidence for the effectiveness of interventions to address the structural determinants of health for labour migrants?" using the Ovid Medline electronic database.

FINDINGS

We found only two papers that evaluated structural interventions to improve the health of labour migrants. Both papers evaluated the impact of insurance - health or social. In contrast, we found 19 evaluations of more proximal, small-scale interventions focused on changing the knowledge, attitudes and behaviours of labour migrants.

INTERPRETATION

Despite the rise in international migration, including for work, and evidence that labour migrants have some higher health risks, there is a paucity of research addressing the structural determinants of health inequities in labour migrants. The research community (including funders and academic institutions) needs to pay greater attention to the structural determinants of health - which generally requires working across disciplines and sectors and thinking more politically about health and health inequities.

FUNDING

Wellcome Trust (208712/Z/17/Z).

Mediating Effects of Coping Strategies on the Relationship Between Mental Health and Quality of Life Among Indonesian Female Migrant Workers in Taiwan

INTRODUCTION

Mental health is a major concern among migrant workers worldwide. More than 200,846 female migrant workers in Taiwan are from Indonesia. The study's purpose was to investigate mediating effects of coping strategies on the relationship between mental health problems and the quality of life (QoL).

METHOD

This cross-sectional study was conducted in Taiwan. In total, 500 Indonesian female migrant workers completed four questionnaires. A mediation test was conducted to estimate direct and indirect effects.

RESULTS

Coping strategies, namely substance use, behavioral disengagement, denial, and religious dedication, partially mediated the relationship between mental health problems (depression, anxiety, and stress) and QoL among Indonesian female migrant workers in Taiwan.

DISCUSSION

Health promotion programs should be developed for Indonesian female migrant workers in Taiwan to help them detect and overcome their mental health problems. Interventions that facilitate effective coping strategies should be administered to improve their QoL.

Trends and geographic variations in self-reported diabetes incidence: A prospective open cohort study of Chinese men and women, 1997-2015

AIM

This study aims to evaluate the trends and geographic variations of incident diabetes as well as the corresponding sex differences in China.

METHODS

The open cohort study derived data of 16,610 individuals from the China Health and Nutrition Survey 1997-2015. Direct standardisation was employed to calculate the age-standardised diabetes incidence. Mixed effects logistic regression models with interaction terms were performed to examine variations in incident diabetes. Socio-demographic (age, sex, marital status, racial compositions and educational attainment) and lifestyle attributes (smoking history, BMI and waist circumference) were sequentially included as covariates.

RESULTS

Overall age-standardised diabetes incidence increased from 2.94 per 1000 person-years (95% CI, 2.44-3.44) in 1997-2004 to 5.54 (95% CI, 4.94-6.14) in 2009-2015. Models with interaction terms suggest that the increase among men was higher than that among women (wave 2006-2009 × Female: OR = 0.45, 95% CI 0.28-0.72). Age-standardised incidence of diabetes varied across regions, ranging from 5.67 (95% CI, 4.95-6.40) in Eastern China to 2.69 (95% CI 2.19-3.19) in Western China. Subsequent modelling analyses suggest that the geographic variations could be mostly explained by the variations in the BMI and waist circumference across regions.

CONCLUSIONS

Results suggest that the incidence of self-reported diabetes approximately doubled during the study period. The increase among men was steeper than that among women. Public interventions reducing the population's obesity level hold promise to alleviate geographic variations and flatten the growth curve.

Migrant Workers and Psychological Health: A Systematic Review

Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.

Study on Status and Willingness towards Hepatitis B Vaccination among Migrant Workers in Chongqing, China: A Cross-Sectional Study

Background: Rural-to-urban migrant workers may serve as a bridge population for the cross-regional spread of hepatitis B vaccination (HBV) due to frequent shifts between their work areas and homelands, and they are less likely to be covered by the national hepatitis B (HB) immunization program. This study aimed to investigate the current inoculation status of HB vaccine among migrant workers and the willingness to be vaccinated among non-vaccinated ones. Methods: We conducted a cross-sectional survey using anonymous interviews with migrant workers selected by two-stage cluster sampling from July to December 2018. Binary logistic regression models were adopted to detect influencing factors associated with HB inoculation status and vaccination willingness. Results: 1574 respondents were recruited in the surveys, and 773 (49.11%) respondents reported that they had been inoculated with HB vaccine. Only 285 (35.58%) non-vaccinated respondents were willing to be inoculated. Logistic regression indicated that younger age, higher education level, less wearing of condoms, higher knowledge scores of HB, and higher risk perception of HBV infection were positively associated with inoculation of HB vaccine. Respondents who were more highly educated, and drinkers, with higher knowledge scores of HB and with higher risk perception of HBV infection were more willing to be vaccinated. Conclusions: the HB vaccination rate of migrant workers in Chongqing was relatively low and only a small section of non-vaccinated migrant workers had vaccination willingness. Health interventions and policies are needed to improve knowledge and cognition of HB among migrant workers, particularly for those who are older, less educated, poor in HB knowledge, less likely to wear condoms, and non-drinkers. Peer education, as well as the combination of traditional and new media, would be accessible and effective ways to disseminate HB related knowledge for migrant workers.

Calidad de vida relacionada con la salud en población general de Bucaramanga, Colombia

Objetivo Determinar la calidad de vida relacionada con la salud (CVRS) en población general del área urbana de Bucaramanga.Metodología Encuesta transversal, realizada entre septiembre y noviembre de 2013, donde se aplicó el cuestionario SF-36 para medir CVRS en población general residentes en cuatro barrios seleccionados por conveniencia. La información fue sistematizada en el programa Excel, se calcularon puntajes por cada dominio y se compararon por edad, sexo, ocupación, escolaridad y estrato socioeconómico de los participantes.Resultados Se entrevistaron 1 098 personas entre 15 y 99 años, 732 (66,7%) mujeres, con edad promedio de 46 años, mediana de escolaridad de 11 años, residentes en estratos socioeconómicos 1 a 4, dedicados principalmente a actividades de comercio/servicios y hogar. Los puntajes en todos los dominios fueron superiores a 60%, considerados indicadores de buena CVRS. Sin embargo, hay un decline de la CVRS con el aumento de la edad, en contraste, los hombres mostraron mejores puntajes de CVRS que las mujeres en todos los dominios, además los estudiantes y personas con mayor escolaridad presentaron niveles más altos de CVRS.Discusión La CVRS en ésta población fue reportada como buena, sin embargo, se identificaron diferencias por edad, sexo, escolaridad y ocupación; que pueden sugerir inequidades en el acceso y uso de los servicios de salud. Estos hallazgos orientan acciones de promoción de la salud tendientes a mejorar la CVRS en éstos grupos vulnerables, como parte de las estrategias del Plan Decenal de Salud Pública en la ciudad. 

The effect of intervention using the PRECEDE-PROCEED model based on quality of life in diabetic patients

BACKGROUND

Poor quality of life is common among diabetic patients, and educational intervention is one of the most effective strategies to improve the quality of life for chronic patients.

OBJECTIVES

To determine the effect of an educational intervention based on PRECEDE-PROCEED in quality of life of diabetic patients, in 2016.

METHODS

In this quasi-experimental study, 86 patients referred to diabetic centers of Ardabil participated. We used the components PRECEDE-PROCEED model for planning, implementation and evaluation of the program. Data collection tools were Diabetes Quality of Life questionnaire (DQOL) and a researcher-made questionnaire. Eight training sessions were conducted for the intervention group for self-efficiency, self- management, attitude, knowledge, and enabling reinforcing factors. Quality of life was followed one and three months after intervention. Data were analyzed through SPSS 16 software using descriptive and analytical tests.

RESULTS

The mean age of patients was 55.88 (±12.1) years. The result showed that before intervention, no significant difference was observed among the mean scores of quality of life, self-management, knowledge, attitude, enabling and reinforcing factors, and self-efficiency in two groups. But one and three months after intervention a significant difference was observed (p<0.001).

CONCLUSION

Educational intervention with PRECEDE-PROCEED model improved the diabetic patient's quality of life.

Predictors of health-related quality of life among industrial workers: A descriptive correlational study

Assessment and evaluation of the health-related quality of life of industrial workers is an important research focus. This descriptive correlational study identifies the predictors of health-related quality of life using a random sampling of industrial workers (n = 640) from construction factories in Amman Governorate in Jordan using demographic characteristics, a health and work-related factors questionnaire, and the World Health Organization Quality of Life-Brief scale. Results showed that industrial workers had good physical health but a poor working environment. There was a statistically significant relationship between educational level, conflict between work and individual life and work and social life, working hours, and workload, and all domains of health-related quality of life. Overall, educational level was the main predictor for all domains of health-related quality of life. Such results confirm the need to develop appropriate interventions and strategies to improve workers' health-related quality of life. Furthermore, developing an integrated approach among policymakers, employers, and work organizations to enhance industrial workers' occupational health programs could be effective.

Qualidade de vida no trabalho: avaliação de estudos de intervenção

RESUMO Objetivo: analisar a produção de conhecimento sobre intervenções em qualidade de vida no trabalho. Método: estudo de revisão integrativa. Para seleção dos estudos, utilizou-se as bases de dados: SciELO, Medline e PubMed. Resultados: a amostra incluiu 25 artigos nacionais e internacionais que descreveram programas e maneiras de adquirir hábitos saudáveis no ambiente laboral e amenizar as demandas mentais decorrentes do mesmo. Conclusão: diante da quantidade de empresas em todo o mundo, verifica-se número inexpressivo de programas voltados para a saúde e bem-estar dos trabalhadores, e a implantação de políticas eficientes nas instituições poderia minimizar tal situação.

Measuring the effects of socioeconomic factors on mental health among migrants in urban China: a multiple indicators multiple causes model

Objectives

Since 1978, rural–urban migrants mainly contribute Chinese urbanization. The purpose of this paper is to examine the effects of socioeconomic factors on mental health of them. Their mental health was measured by 12-item general health questionnaire (GHQ-12).

Methods

The study sample comprised 5925 migrants obtained from the 2009 rural-to-urban migrants survey (RUMiC). The relationships among the instruments were assessed by the correlation analysis. The one-factor (overall items), two-factor (positive vs. negative items), and model conducted by principal component analysis were tested in the confirmatory factor analysis (CFA). On the basis of three CFA models, the three multiple indicators multiple causes (MIMIC) models with age, gender, marriage, ethnicity, and employment were constructed to investigate the concurrent associations between socioeconomic factors and GHQ-12.

Results

Of the sample, only 1.94% were of ethnic origin and mean age was 31.63 (SD = ±10.43) years. The one-factor, two-factor, and three-factor structure (i.e. semi-positive/negative/independent usefulness) had good model fits in the CFA analysis and gave order (i.e. 2 factor>3 factor>1 factor), which suggests that the three models can be used to assess psychological symptoms of migrants in urban China. All MIMIC models had acceptable fit and gave order (i.e. one-dimensional model>two-dimensional model>three-dimensional model).

Conclusions

There were weak associations of socioeconomic factors with mental health among migrants in urban China. Policy discussion suggested that improvement of socioeconomic status of rural–urban migrants and mental health systems in urban China should be highlighted and strengthened.

Electronic supplementary material

The online version of this article (doi:10.1186/s13033-016-0118-y) contains supplementary material, which is available to authorized users.

A PRECEDE-PROCEED based educational intervention in quality of life of women-headed households in Iran

Background: Women-headed households are more exposed to social damages than other women. Such condition remarkably influences the women's health-related life quality. The present study is aimed to investigate the effect of an educational intervention in quality of life of women-headed households under protection of Tehran Welfare Organization, in 2015. Methods: In this quasi-experimental study with control group, 180 women-headed households participated. Sampling method was random allocation. Data collection tools were Life Quality standard questionnaire (WHOQOL-BREF) and a researcher-made questionnaire about structures of ecological and educational diagnosis phase of PRECEDE-PROCEED model. Validity and reliability of the questionnaire approved in a primary study. Based on the results obtained from the primary study, the intervention was performed in the case group only. Participants were followed one and three months after intervention. Data were analyzed through SPSS v. 15 software using descriptive and analytical tests. Results: Before intervention no significant difference was observed among the mean scores of life quality, behavioral factors, and knowledge, enabling, and reinforcing factors in the two groups. But, one month and three months after intervention a significant difference was observed between the mean scores of these variables (in five instances p<0.001). Conclusion: Intervention through the PRECEDE-PROCEED model improved the women-headed households' quality of life. The innovation of this study is using such intervention on quality of life in women-headed households for the first time.

Health-related quality of life and self-reported long-term conditions: a population-based survey

Objective:

To estimate and compare the effect of self-reported long-term health conditions and sociodemographic factors on perceived health-related quality of life (HRQoL).

Methods:

A population-based survey of adults (18 to 65 years) living in Brasilia, Brazil, was conducted in 2012. Descriptive and multivariate analyses using a Tobit model were performed with data on sociodemographic variables, self-reported conditions, and the European Quality of Life-5 Dimensions (EQ-5D) health states, providing utility scores (preferred health state) between 0 and 1 for HRQoL estimates.

Results:

The mean utility of 1,820 adults interviewed (mean age: 38.4±12.6 years) was 0.883 (95%CI 0.874-0.892), with 76.2% in the highest utility range (0.8 to 1.0). EQ-5D dimensions with moderate problems were pain/discomfort (33.8%) and anxiety/depression (20.5%). Serious problems were reported by only 0.3% of the sample in the mobility and self-care domain and by 3.1% in the pain/discomfort domain. Multivariate analysis revealed reduced HRQoL in individuals with depression, diabetes, and hypertension. Living in satellite towns (outside the city core), belonging to a lower economic class, or not being formally employed were also associated with decreased HRQoL. Beta coefficients for these impacts ranged from -0.033 (not formally employed) to -0.141 (depression), reflecting the strongest impact.

Conclusion:

Of the long-term health conditions studied, depression had the greatest impact on HRQoL. Social class, employment status, and place of residence also affected HRQoL.

Determinants of tobacco smoking among rural-to-urban migrant workers: a cross-sectional survey in Shanghai

Background

Although there are several studies to investigate the smoking behaviors among rural-to-urban Chinese migrants, no study has focused individually on this population in Shanghai. This study was performed to estimate the prevalence and identify the determinants of tobacco smoking among rural-to-urban migrants in Shanghai.

Methods

In this cross-sectional study, multi-stage quota sampling was used to select 5,856 rural-to-urban migrants aged 18 years or older from seven districts in Shanghai between July and October 2012. A structured questionnaire was administered to assess smoking knowledge, attitude, behavior and demographic characteristics. Mental health was assessed by the self-reported SCL-90. Multiple logistic regression analysis was used to determine the risk factors of smoking behavior.

Results

A total of 5,380 of the 5,856 migrants enrolled completed the questionnaire, among whom 45.0% of male and 2.0% of female participants reported current smoking. Multivariate analysis revealed current smoking in female migrants to be significantly associated with working at construction (OR, 8.08; 95% CI, 1.80-36.28), hotels/restaurants (OR, 5.06; 95% CI, 1.68-15.27), entertainment sector (OR, 6.79; 95% CI, 2.51-18.42), with monthly income > 3500 yuan (OR, 2.69; 95% CI, 1.21-5.98), number of migratory cities of 2 (OR, 2.39; 95% CI, 1.23-4.65), and SCL-90 total score > 160 (OR, 2.03; 95% CI, 1.03-3.98), while the male migrants working at construction (OR, 1.30; 95% CI, 1.04-1.62), entertainment sector (OR, 1.86; 95% CI, 1.36-2.56), being divorced/widowed (OR, 2.20; 95% CI, 1.02-4.74), with duration of migration of 4 or more than 4 years (OR, 1.42; 95% CI, 1.06-1.91), number of migratory cities of 3 or more than 3 (OR, 1.42; 95% CI, 1.13-1.80), and SCL-90 total score > 160 (OR,1.39; 95% CI, 1.07-1.79) showed an excess smoking prevalence.

Conclusion

Migration lifestyle and mental status were associated with current smoking behaviors. The identifications of risk factors for current smoking may help to target health promotion interventions.

Health-related quality-of-life of coal-based sponge iron plant workers in Barjora, India: a cross-sectional study

OBJECTIVES

During the last decade, coal-based sponge iron plants, a highly polluted industry, have grown rapidly in Barjora, India. Understanding their workers' perception of health is essential in people-centered healthcare. The aim of the study was to assess their health-related quality-of-life (HRQoL), and to determine factors that independently predict their HRQoL.

DESIGN

Cross-sectional study.

SETTING

Coal-based sponge iron plants in Barjora, India.

PARTICIPANTS

258 coal-based sponge iron plant workers.

PRIMARY OUTCOME MEASURE

HRQoL was measured using the EuroQol-5D-5L.

RESULTS

The response rate was 100%. Participants with problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 23.3%, 5.1%, 10.9%, 39.5% and 45.5%, respectively. 36.8% of participants reported health state 11111 (no problem in any EQ-5D dimension). The mean visual analogue scale (EQ-VAS) was 69.8 (18.5 SD). The odds of mobility problems decreased with age (OR 0.95, 95% CI 0.91 to 0.99, p=0.016), were lower in participants with presence/history of any respiratory disease (0.27, 0.13 to 0.55, p<0.001), scheduled caste/scheduled tribe/other backward class workers (0.44, 0.22 to 0.89, p=0.021), manual workers (0.40, 0.16 to 0.99, p=0.047) and non-smokers (2.63, 1.27 to 5.46, p=0.009). The odds of pain/discomfort and anxiety/depression were lower in participants with any respiratory disease (0.44, 0.24 to 0.79, p=0.006; and 0.52, 0.29 to 0.92, p=0.026, respectively). The EQ-VAS was worse in manual participants (coefficient -6.91, 95% CI -12.40 to -1.41, p=0.014), with any respiratory disease (-8.13, -13.12 to -3.13, p=0.002), alcohol drinkers (-4.81, -9.47 to -0.15, p=0.043), literates (7.70, 0.97 to 14.43, p=0.025) and Hindus (13.41, 2.62 to 24.20, p=0.015).

CONCLUSIONS

Many coal-based sponge iron plant workers in Barjora have problems in their HRQoL, and the predictors of different aspects of HRQoL were identified. The study findings could be taken into consideration in future interventional studies aimed at improving the HRQoL of these workers.

Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? A study on the effect of social security policies for Chinese landless farmers on their health-related quality of life

Background

The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL.

Methods

This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM).

Results

First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively.

Conclusions

The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers.