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Tag: Trauma, Stress & Recovery

  • Migrant-sensitive communication training was developed for paediatric oncologists

    What the study found

    The study found a need for ongoing training in communication for paediatric oncologists working in intercultural, family-centered settings. The authors report that experienced paediatric oncologists benefited from the multimodal training they developed.

    Why the authors say this matters

    The authors say communication barriers in intercultural healthcare can create substantial disadvantages, and they conclude that communication training should be part of specialised medical training to help overcome these barriers. They also note that migrant children with cancer are particularly affected by communication deficits.

    What the researchers tested

    This was a monocentric, single-blind, cluster randomised interventional feasibility trial in paediatric oncology. The researchers observed 16 conversations, then conducted 10 more observations and 20 interviews with 10 patient families and 10 paediatric oncologists, and used these findings along with a literature review and an advisory board workshop to develop a training programme.

    What worked and what didn't

    The observations and interviews identified a need for training in communication, cultural competence, and interpreter-assisted conversations. The resulting skills training included three modules on cultural competence, ethical issues, and interpreter-assisted conversations, plus conversation simulations with three scripted patient scenarios; the abstract states that participants benefited from the training.

    What to keep in mind

    The abstract does not give detailed outcome data, effect sizes, or follow-up results. It also describes a single-centre feasibility trial, so the findings are presented within that limited setting.

    • The study developed a multimodal skills training programme in migrant-sensitive communication for paediatric oncologists.
    • Intercultural conversations revealed needs in communication, cultural competence, and interpreter-assisted conversations.
    • The training included three modules: cultural competence, ethical issues, and interpreter-assisted conversations.
    • Conversation simulations were built around three scripted patient scenarios.
    • The authors conclude that ongoing communication training should be part of specialised medical training.

  • Ukrainian parents reported barriers and different expectations in German pediatric care

    What the study found

    The study found that Ukrainian parents’ expectations and perceptions of health care in Germany were influenced by Ukrainian medical culture, especially its more authoritarian communication style and stricter treatment of infectious diseases. Parents also described quick appointments in Ukraine as contrasting with long waits and barriers in Germany.

    Why the authors say this matters

    The authors conclude that discrepancies around self-treatment of infections and unintended discrimination point to a need for intercultural training of health staff. They also suggest that the treatment of future refugee populations may benefit from de-economization and inclusion of refugee health staff.

    What the researchers tested

    The researchers used a qualitative, participatory approach at the Children’s and Adolescents’ University Hospital of Leipzig. They conducted eight narrative interviews and one focus group with vulnerable Ukrainian parents, then thematically analyzed the material using a medical anthropology framework.

    What worked and what didn't

    The study reported that parents tended to return to Ukraine for medical appointments. It also noted that the high-quality care of chronically ill children in Germany was a relevant pull factor, while barriers and long waiting times in Germany were part of what parents found difficult.

    What to keep in mind

    The findings come from a small sample in one hospital setting, so the abstract does not show how broadly they apply. The available summary does not describe detailed participant characteristics beyond being vulnerable Ukrainian parents.

    • Ukrainian parents’ expectations of care in Germany were shaped by differences from health care in Ukraine.
    • Parents described Ukrainian care as faster and more directive, especially for infections.
    • Long waiting times and access barriers in Germany contrasted with quicker appointments in Ukraine.
    • Some families returned to Ukraine for medical appointments.
    • The authors call for intercultural training and possible inclusion of refugee health staff.

  • Likely undocumented patients had more self-pay ED visits after 2018

    What the study found

    The study found that self-pay emergency department visits increased among likely undocumented patients compared with U.S.-born patients after the September 2018 public charge announcement. The increase was 2.10 percentage points.

    Why the authors say this matters

    The authors conclude that anti-immigrant policies can alter payment patterns. They suggest this has implications for patient financial burden and for safety-net hospital fiscal sustainability.

    What the researchers tested

    The researchers analyzed emergency department encounters from major safety-net hospitals in Los Angeles County from May 1, 2017, to December 31, 2019. They used difference-in-differences and event study models to compare likely undocumented adult patients with U.S.-born adult patients before and after the September 22, 2018, public charge expansion announcement.

    What worked and what didn't

    There were 375,258 encounters in the study, including 174,406 likely undocumented encounters and 200,852 U.S.-born encounters. After the announcement, self-pay status increased by 2.10 percentage points among likely undocumented encounters compared with U.S.-born encounters, and the event study found the increase persisted from November 2018 through August 2019, peaking at 17.8%.

    What to keep in mind

    Likely undocumented status was identified using country of birth, lack of a valid Social Security Number, and insurance information, so it is an approximation rather than a direct legal classification. The summary does not describe other limitations beyond the study’s scope in Los Angeles County safety-net hospitals.

    • The study compared self-pay emergency department visits before and after the September 2018 public charge announcement.
    • Likely undocumented patients showed a 2.10 percentage point increase in self-pay visits versus U.S.-born patients.
    • The increase was estimated from 375,258 emergency department encounters at Los Angeles County safety-net hospitals.
    • Event study models found the increase persisted from November 2018 through August 2019.
    • The authors say the findings suggest anti-immigrant policies can change payment patterns.

  • CSIS employees reported mental health symptoms and unique stigma

    What the study found

    The study found that many Canadian Security Intelligence Service (CSIS) employees reported mental health symptoms or a diagnosis, and that employees also described hypervigilance, sleep disturbance, and stigma connected to working in secrecy. The authors present these as mental health concerns within a public safety organization.

    Why the authors say this matters

    The authors say the findings matter because CSIS is a public safety service responsible for national security, and the study suggests mental health needs in this setting deserve attention. The authors also conclude that the findings may help improve employee mental health in CSIS and other public safety sectors.

    What the researchers tested

    The researchers interviewed 38 CSIS employees to understand their mental health, the effects of their work, and the degree of mental health stigma in the organization. They also examined how secrecy, which is required in this work, shaped employees' experiences.

    What worked and what didn't

    Among interviewees, 61% reported being diagnosed with or having symptoms of a mental health disorder in adulthood or after starting the job. Employees without a diagnosis still described symptoms consistent with compromised mental health, and participants from both groups reported hypervigilance and disturbed sleep. The study also found unique forms of stigma tied to mandated secrecy.

    What to keep in mind

    The abstract does not describe a comparison group or provide details on how employees were selected. It also does not report whether the study measured changes over time, so the findings are limited to the interviewed employees and the information shared in the abstract.

    • The study interviewed 38 CSIS employees.
    • Sixty-one percent reported a mental health diagnosis or symptoms in adulthood or after employment began.
    • Employees described hypervigilance and sleep disturbance related to their work.
    • The abstract reports unique mental health stigma linked to mandated secrecy.
    • The authors suggest the findings may help improve mental health in CSIS and other public safety sectors.

  • School-based programs showed some effects for recently arrived immigrant youth

    What the study found

    The review found that about half of the school-based programs it examined had some effects on the outcomes they targeted for recently arrived immigrant adolescents. The programs mainly focused on social-emotional well-being, mental health problems, resilience, social support, or trauma-related symptoms.

    Why the authors say this matters

    The authors conclude that there are some promising findings, but the current literature is too limited to support robust conclusions. They say future research should examine why, how, and for whom programs lead, or do not lead, to intended outcomes, and should develop effective programs that can be implemented with available school resources.

    What the researchers tested

    The researchers conducted a scoping review following PRISMA-ScR guidelines. They searched five databases—Medline, PsycINFO, CINAHL, SCOPUS, and ERIC—for studies published since 2000 on interventions implemented in formal school settings for recently arrived adolescents.

    What worked and what didn't

    The review identified 15 studies that evaluated 17 programs. Around 50% of the programs showed some effects on their intended outcomes, but the abstract does not specify which programs worked best or which outcomes improved most consistently.

    What to keep in mind

    The abstract says the literature has several limitations, but it does not list them in detail. It also does not provide enough information to judge the size, durability, or comparative strength of the effects.

    • The review covered 15 studies and 17 school-based programs.
    • About 50% of the programs had some effects on intended outcomes.
    • Programs mainly targeted well-being, mental health, resilience, social support, or trauma-related symptoms.
    • The authors say the literature is limited and does not support robust conclusions.
    • Future research should examine why, how, and for whom these programs work.

  • Integrated refugee mental health depends on trust and coordination

    What the study found

    The study found that trust, connection, proactivity, and moral commitment were key mechanisms that supported better integrated mental health care for refugee clients, providers, and services. It also found that alienation, stagnation, burnout, and fragmentation hindered integration.

    Why the authors say this matters

    The authors suggest that, because refugees face complex mental health and social needs, integrating mental health services across settlement organizations and primary health care is important. They conclude that funding settlement programs can support cross-cultural brokers, community health workers, and navigators, which may help address social determinants of refugee mental health and support more equitable, just policy approaches.

    What the researchers tested

    The researchers used a participatory realist approach in a Canadian context. They held deliberative dialogues with multidisciplinary interest holders from settlement services, primary health care, mental health, a survivor advocacy group, and policy analysis, with 24 participants in total, to build an initial program theory about integration of refugee mental health across services.

    What worked and what didn't

    Trust, connection, proactivity, and moral commitment were identified as helping integration across services. In contrast, alienation, stagnation, burnout, and fragmentation were identified as getting in the way of integration.

    What to keep in mind

    The abstract describes a theory-building study in Canada, so the findings are based on that context and approach. It does not provide outcome measures, and it does not describe limitations beyond the scope of the available summary.

    • The study identified trust, connection, proactivity, and moral commitment as mechanisms supporting integrated refugee mental health care.
    • Alienation, stagnation, burnout, and fragmentation were reported as mechanisms that hindered integration.
    • The work used a participatory realist approach to build an initial program theory.
    • Twenty-four multidisciplinary interest holders took part in deliberative dialogues.
    • The authors say settlement funding can support brokers, community health workers, and navigators.

  • Scoping review finds gaps in intergenerational trauma research

    What the study found

    The review found that research on intergenerational trauma in forcibly displaced populations from Latin America and the Caribbean is limited and inconsistent. It identified gaps in how intergenerational trauma is defined and measured.

    Why the authors say this matters

    The authors conclude that greater methodological rigor and consistency in trauma reporting are needed to support future evidence-based research. They say this would help inform supportive systems that promote the health of forcibly displaced populations and their descendants in the Americas.

    What the researchers tested

    The researchers conducted a scoping review, which is a type of literature review used to map what is known and where evidence is lacking. They searched 20 online databases for English- and Spanish-language articles on intergenerational trauma, transmission mechanisms, and coping strategies in forcibly displaced Latinx groups originating in Latin America and the Caribbean, then used narrative analysis to describe themes in the included studies.

    What worked and what didn't

    Six articles were included in the review. The authors identified three broad themes: intergenerational trauma operationalizations, transmission mechanisms and coping strategies, and gaps in research and evidence; they also noted two subthemes within operationalizations, concerning measures and samples, and forced displacement motives.

    What to keep in mind

    The available evidence base was small, with only six English- and Spanish-language articles included. The abstract also notes wide variation in how intergenerational trauma, transmission mechanisms, and coping strategies are operationalized, and it reports evidence gaps in the literature.

    • The review included six English- and Spanish-language articles.
    • Research on intergenerational trauma in forcibly displaced groups from Latin America and the Caribbean was described as scarce.
    • The authors identified gaps in definitions and operationalizations of intergenerational trauma.
    • Three broad themes were found: operationalizations, transmission mechanisms and coping strategies, and research gaps.
    • The authors call for more methodological rigor and consistency in trauma reporting.

  • Displaced households reported more unmet child mental health needs

    What the study found

    The study found that households displaced by a natural disaster were more likely to report that children in the household needed mental health treatment. Among households with reported pediatric mental health needs, displaced households were also more likely to report inadequate or no treatment.

    Why the authors say this matters

    The authors conclude that these unmet mental health needs may negatively affect children's long-term development. They also say that, as climate change progresses, targeted research is urgently needed to understand how best to meet these needs.

    What the researchers tested

    The researchers used repeated cross-sectional data from the U.S. Census Household Pulse Survey collected from June 1, 2023, through September 31, 2024. They analyzed adult reports about all children in the household and used multivariable logistic regression models to compare displaced households with other households.

    What worked and what didn't

    Households that had been displaced in the past year because of a natural disaster had higher odds of reporting that children needed mental health counseling or medication (odds ratio, 1.29; 95% CI, 1.12-1.48; P < .001). Among households with reported mental health needs, displaced households had higher odds of inadequate or no treatment even after adjustment for socioeconomic hardships (odds ratio, 0.55; 95% CI, 0.38-0.66; P < .001).

    What to keep in mind

    This was a cross-sectional study, so it shows associations rather than cause and effect. The abstract does not describe other limitations beyond the available survey-based design.

    • Displaced households were more likely to report that children needed mental health counseling or medication.
    • Among households with pediatric mental health needs, displaced households were more likely to report inadequate or no treatment.
    • The analysis used U.S. Census Household Pulse Survey data from June 2023 through September 2024.
    • The sample included 277,081 respondents representing about 35 million U.S. households with children.
    • The authors say the unmet needs may affect long-term child development.

  • Study estimates mortality in U.S. Immigration and Customs Enforcement detention

    What the study found

    The study estimates annual mortality rates among people detained in U.S. Immigration and Customs Enforcement facilities. It also summarizes patterns by age and cause of death from 2004 through January 2026.

    Why the authors say this matters

    The abstract does not describe broader implications beyond presenting mortality estimates and patterns in detention. The authors say the study provides a summary of mortality rates, age, and cause of death in this setting.

    What the researchers tested

    The researchers conducted a study of mortality in U.S. Immigration and Customs Enforcement detention facilities. They estimated annual mortality rates and summarized age and cause of death patterns for the period from 2004 through January 2026.

    What worked and what didn't

    The abstract states that annual mortality rates were estimated and that age and cause of death patterns were summarized. It does not provide specific numerical results in the text provided.

    What to keep in mind

    The available summary does not include the detailed methods, numerical findings, or limitations. No additional caveats are described in the abstract.

    • The study estimates annual mortality rates in U.S. Immigration and Customs Enforcement detention facilities.
    • It summarizes age patterns among people who died while detained.
    • It summarizes causes of death from 2004 through January 2026.
    • The abstract does not provide specific mortality numbers.
    • No limitations are described in the available summary.

  • Probable PTSD was common among Sudanese refugees in Cairo

    What the study found

    The study found a high prevalence of probable posttraumatic stress disorder (PTSD) among Sudanese refugees in Cairo. It also found that prior psychiatric history and caregiving responsibilities were associated with meeting the threshold for probable PTSD.

    Why the authors say this matters

    The authors conclude that these preliminary findings show a high psychological burden among Sudanese refugees in Egypt and underscore the acute nature of the crisis. They say this indicates a need to integrate culturally sensitive mental health screening and psychosocial interventions into refugee response frameworks.

    What the researchers tested

    The researchers conducted a pilot cross-sectional survey of 397 Sudanese refugees recruited in Cairo through convenience snowball sampling. They used the Arabic version of the PTSD Checklist for DSM-5 (PCL-5), a symptom questionnaire for posttraumatic stress disorder, and collected information on displacement history and sociodemographic factors.

    What worked and what didn't

    The prevalence of probable PTSD in this sample was 70.8%. Multivariate analysis showed significant associations with prior psychiatric history and caregiving responsibilities, while younger adults reported higher symptom scores. Age was not a significant predictor in the adjusted model, and there were no significant differences in prevalence between refugees who entered Egypt legally and those who entered through unauthorized routes.

    What to keep in mind

    This was a pilot study with a convenience snowball sample, so the findings are preliminary. The abstract does not describe other limitations beyond the call for further longitudinal research to examine long-term effects of displacement.

    • Probable PTSD was found in 70.8% of the sampled Sudanese refugees in Cairo.
    • Prior psychiatric history and caregiving responsibilities were associated with probable PTSD.
    • Younger adults had higher symptom scores, but age was not significant in the adjusted model.
    • No significant prevalence difference was seen between legal and unauthorized entry routes.
    • The authors call for culturally sensitive mental health screening and psychosocial interventions.