Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Conflict and Health
Published in: Conflict and Health 1/2022

Open Access 01-12-2022 | COVID-19 | Research

Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations

Authors: Gloria Seruwagi, Catherine Nakidde, Eric Lugada, Maria Ssematiko, Dunstan P. Ddamulira, Andrew Masaba, Brian Luswata, Eric A. Ochen, Betty Okot, Denis Muhangi, Stephen Lawoko

Published in: Conflict and Health | Issue 1/2022

Login to get access

Abstract

Background

Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic.

Methods

Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed in SPSS-version 22, and statistical significance was assumed at p < 0.05.

Results

Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress [F(2, 1011) = 47.91; p < 0.001], higher availability of social interaction [F(2, 1011) = 82.24; p < 0.001], lower adequacy of social interaction [F(2, 1011) = 54.11; p < 0.001], higher availability of social attachment [F(2, 1011) = 47.95; p < 0.001], and lower adequacy of social attachment [F(2, 1011) = 50.54; p < 0.001] than peers in urban settlements. Adequacy of social interaction significantly explained variations in psychological distress levels overall and consistently across settlements, after controlling for plausible confounders. Additionally, adequacy of social attachment significantly explained variations in psychological distress levels among refugees in rural settlements, after controlling for plausible confounders.

Conclusion

There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. To address psychological distress, Mental Health and Psychosocial Support Services (MHPSS) should focus on strategies which strengthen the existing social networks among refugees. Variations in social support are a key predictor of distress which should guide tailored need-adapted interventions instead of duplicating similar and generic interventions across diverse refugee settlements.
Literature
1.
2.
Public Health Act: Public Health (Control of COVID - 19) (No. 2) Rules, 2020.
3.
Hamza Shuja K, Aqeel M, Jaffar A, Ahmed A. COVID-19 pandemic and impending global mental health implications. Psychiatr Danub. 2020;32(1):32–5.CrossRef
4.
Josephson A, Kilic T, Michler JD. Socioeconomic impacts of COVID-19 in low-income countries. Nat Hum Behav. 2021;5(5):557–65.PubMedCrossRef
5.
Kansiime MK, Tambo JA, Mugambi I, Bundi M, Kara A, Owuor C. COVID-19 implications on household income and food security in Kenya and Uganda: Findings from a rapid assessment. World Dev. 2021;137: 105199.PubMedCrossRef
6.
7.
8.
UNDP. The socio-economic impact of COVID-19 in Uganda: short-term and long-term impact on poverty dynamics and SDGs using scenario analysis and system dynamics modelling. 2020. URL file:///Users/gloriaseruwagi/Downloads/Socio-Economic-Impact-COVID-19-Uganda-Brief-1-UNDP-Uganda-April-2020%20(1).pdf
9.
Kumar D, Saghir T, Ali G, Yasin U, Furnaz S, Karim M, Hussain M, Kumari R, Bai R, Kumar H. Psychosocial impact of COVID-19 on healthcare workers at a tertiary care cardiac center of Karachi Pakistan. J Occup Environ Med. 2021;63(2): e59.PubMedCrossRef
10.
Marazziti D, Pozza A, Di Giuseppe M, Conversano C. The psychosocial impact of COVID-19 pandemic in Italy: a lesson for mental health prevention in the first severely hit European country. Psychol Trauma Theory Res Pract Policy. 2020;12(5):531.CrossRef
11.
Ogrodniczuk JS, Rice SM, Kealy D, Seidler ZE, Delara M, Oliffe JL. Psychosocial impact of the COVID-19 pandemic: a cross-sectional study of online help-seeking Canadian men. Postgrad Med. 2021;133:750–9.PubMedCrossRef
12.
Saha K, Torous J, Caine ED, De Choudhury M. Psychosocial effects of the COVID-19 pandemic: large-scale quasi-experimental study on social media. J Med Internet Res. 2020;22(11): e22600.PubMedPubMedCentralCrossRef
13.
Saladino V, Algeri D, Auriemma V. The psychological and social impact of Covid-19: new perspectives of well-being. Front Psychol. 2020;11:2550.
14.
Tol WA, Patel V, Tomlinson M, Baingana F, Galappatti A, Panter-Brick C, Silove D, Sondorp E, Wessells M, Van Ommeren M. Research priorities for mental health and psychosocial support in humanitarian settings. PLoS Med. 2011;8(9): e1001096.PubMedPubMedCentralCrossRef
15.
Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, Golaz A, Van Ommeren M. Mental health and psychosocial support in humanitarian settings: linking practice and research. The Lancet. 2011;378(9802):1581–91.CrossRef
16.
San Lau L, Samari G, Moresky RT, Casey SE, Kachur SP, Roberts LF, Zard M. COVID-19 in humanitarian settings and lessons learned from past epidemics. Nat Med. 2020;26(5):647–8.CrossRef
17.
Blanchet K, Sistenich V, Ramesh A, Frison S, Warren E, Hossain M, Knight A, Lewis C, Smith J, Woodward A, Dahab M. An evidence review of research on health interventions in humanitarian crises. London: London School of Hygiene & Tropical Medicine; 2013.
18.
Williams RE, Black CL, Kim HY, Andrews EB, Mangel AW, Buda JJ, Cook SF. Determinants of healthcare-seeking behaviour among subjects with irritable bowel syndrome. Aliment Pharmacol Ther. 2006;23(11):1667–75.PubMedCrossRef
19.
Barnes DM, Almasy N. Refugees’ perceptions of healthy behaviors. J Immigr Health. 2005;7(3):185–93.PubMedCrossRef
20.
Turrini G, Purgato M, Acarturk C, Anttila M, Au T, Ballette F, Bird M, Carswell K, Churchill R, Cuijpers P, Hall J. Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiol Psychiatric Sci. 2019;28(4):376–88.CrossRef
21.
Tribe RH, Sendt KV, Tracy DK. A systematic review of psychosocial interventions for adult refugees and asylum seekers. J Ment Health. 2019;28(6):662–76.PubMedCrossRef
22.
Nwadiora E, McAdoo H. Acculturative stress among Amerasian refugees: gender and racial differences. Adolescence. 1996;31(122):477.PubMed
23.
Bapolisi AM, Song SJ, Kesande C, Rukundo GZ, Ashaba S. Post-traumatic stress disorder, psychiatric comorbidities and associated factors among refugees in Nakivale camp in southwestern Uganda. BMC Psychiatry. 2020;20(1):1.CrossRef
24.
Feyera F, Mihretie G, Bedaso A, Gedle D, Kumera G. Prevalence of depression and associated factors among Somali refugee at melkadida camp, southeast Ethiopia: a cross-sectional study. BMC Psychiatry. 2015;15(1):1–7.CrossRef
25.
Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310.PubMedCrossRef
26.
Hobfoll SE. Limitations of social support in the stress process. In: Social support: theory, research and applications. Dordrecht: Springer; 1985. p. 391–414.CrossRef
27.
Hirsch BJ. Natural support systems and coping with major life changes. Am J Community Psychol. 1980;8(2):159–72.CrossRef
28.
Roskies E, Lazarus RS. Coping theory and the teaching of coping skills. Behavioral medicine: changing health lifestyles. 1980; 38–69.
29.
Rabin BS, Rabin BC. Stress, immune function, and health: the connection. New York: Wiley; 1999.
30.
Rankin SH, Monahan P. Great expectations: perceived social support in couples experiencing cardiac surgery. Fam Relat. 1991;1:297–302.CrossRef
31.
Wortman CB, Lehman DR. Reactions to victims of life crisis: support attempts that fail. In: Sarason IG, Sarason BR, editors. Social support: theory, research and applications. The Hague: Martinus Nijhoff; 1985. p. 463–89.CrossRef
32.
Hobfoll SE, Leiberman Y. Personality and social resources in immediate and continued stress resistance among women. J Pers Soc Psychol. 1987;52:18–26.PubMedCrossRef
33.
34.
35.
36.
Taylor SE, Sherman DK, Kim HS, Jarcho J, Takagi K, Dunagan MS. Culture and social support: who seeks it and why? J Pers Soc Psychol. 2004;87(3):354.PubMedCrossRef
37.
38.
39.
Kaiser T. Between a camp and a hard place: rights, livelihood and experiences of the local settlement system for long-term refugees in Uganda. J Mod African Stud. 2006;1:597–621.CrossRef
40.
41.
42.
43.
Bukuluki P, Mwenyango H, Katongole SP, Sidhva D, Palattiyil G. The socio-economic and psychosocial impact of Covid-19 pandemic on urban refugees in Uganda. Social Sci Humanit Open. 2020;2(1): 100045.
44.
Guadagno L. Migrants and the COVID-19 pandemic: an initial analysis. Geneva: International Organization for Migration; 2020. p. 60.
45.
Truelove S, Abrahim O, Altare C, Lauer SA, Grantz KH, Azman AS, Spiegel P. The potential impact of COVID-19 in refugee camps in Bangladesh and beyond: a modeling study. PLoS Med. 2020;17(6): e1003144.PubMedPubMedCentralCrossRef
46.
Tsamakis K, Tsiptsios D, Ouranidis A, Mueller C, Schizas D, Terniotis C, Nikolakakis N, Tyros G, Kympouropoulos S, Lazaris A, Spandidos DA, Smyrnis N, Rizos E. COVID-19 and its consequences on mental health. Exp Ther Med. 2021;21(3):1–1.CrossRef
47.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.PubMedCrossRef
48.
Henderson S, Duncan-Jones P, Byrne DG, Scott R. Measuring social relationships the interview schedule for social interaction. Psychol Med. 1980;10(4):723–34.PubMedCrossRef
49.
Norbeck JS, Lindsey AM, Carrieri VL. The development of an instrument to measure social support. Nurs Res. 1981;30:264–9.PubMed
50.
51.
Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol. 1979;109(2):186–204.PubMedCrossRef
52.
Ahimbisibwe F. Uganda and the refugee problem: Challenges and opportunities. Institute of Development Policy and Management (IOB), University of Antwerp, Working Paper No. 2018 May.
53.
Monteith W, Lwasa S. The participation of urban displaced populations in (in) formal markets: contrasting experiences in Kampala, Uganda. Environ Urban. 2017;29(2):383–402.CrossRef
54.
Peltzer K. Trauma and mental health problems of Sudanese refugees in Uganda. Cent Afr J Med. 1999;45(5):110–4.PubMed
55.
Hovil L. Self-settled refugees in Uganda: an alternative approach to displacement? J Refug Stud. 2007;20(4):599–620.CrossRef
56.
Schmidt AF, Finan C. Linear regression and the normality assumption. J Clin Epidemiol. 2018;1(98):146–51.CrossRef
57.
Metadata
Title
Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations
Authors
Gloria Seruwagi
Catherine Nakidde
Eric Lugada
Maria Ssematiko
Dunstan P. Ddamulira
Andrew Masaba
Brian Luswata
Eric A. Ochen
Betty Okot
Denis Muhangi
Stephen Lawoko
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
COVID-19
Published in
Conflict and Health / Issue 1/2022
Electronic ISSN: 1752-1505
DOI
https://doi.org/10.1186/s13031-022-00451-3

Other articles of this Issue 1/2022

Conflict and Health 1/2022 Go to the issue

Review

Models of care for non-communicable diseases for displaced populations in Iraq: a scoping review

Research

Assessing gender responsiveness of COVID-19 response plans for populations in conflict-affected humanitarian emergencies

Research

Community-based referral transportation system for accessing emergency obstetric services in the Rohingya refugee camp during the COVID-19 pandemic in Bangladesh: facilitators and barriers through beneficiaries’ and providers’ lens using a mixed-method design

Correction

Correction to: Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study

Review

A literature review exploring how health systems respond to acute shocks in fragile and conflict-affected countries

Research

Facilitating hand hygiene in displacement camps during the COVID-19 pandemic: a qualitative assessment of a novel handwashing stand and hygiene promotion package