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Achieving high acceptability of HIV testing in a population-based survey among immigrants in Finland.

https://arctichealth.org/en/permalink/ahliterature265149
Source
Scand J Public Health. 2015 Jun;43(4):393-8
Publication Type
Article
Date
Jun-2015
Author
Paula J Tiittala
Pia S Kivelä
Matti A Ristola
Heljä-Marja Surcel
Päivikki M S Koponen
Mulki Mölsä
Jukka Ollgren
Kirsi Liitsola
Source
Scand J Public Health. 2015 Jun;43(4):393-8
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Communication Barriers
Counseling - statistics & numerical data
Emigrants and Immigrants - psychology - statistics & numerical data
Employment - statistics & numerical data
Female
Finland
HIV Infections - diagnosis
Humans
Language
Male
Mass Screening - utilization
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Risk factors
Abstract
The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance.
The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study.
Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV.
The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys.
PubMed ID
25788469 View in PubMed
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Causal attributions of mental health problems and depressive symptoms among older Somali refugees in Finland.

https://arctichealth.org/en/permalink/ahliterature290086
Source
Transcult Psychiatry. 2017 04; 54(2):211-238
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2017
Author
Saija Kuittinen
Mulki Mölsä
Raija-Leena Punamäki
Marja Tiilikainen
Marja-Liisa Honkasalo
Author Affiliation
University of Tampere.
Source
Transcult Psychiatry. 2017 04; 54(2):211-238
Date
04-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Acculturation
Age Factors
Aged
Aged, 80 and over
Attitude to Health - ethnology
Depression - psychology
Female
Finland
Humans
Male
Mental health
Middle Aged
Refugees - psychology
Somalia - ethnology
Abstract
Causal attributions of mental health problems play a crucial role in shaping and differentiating illness experience in different sociocultural and ethnic groups. The aims of this study were (a) to analyze older Somali refugees' causal attributions of mental health problems; (b) to examine the associations between demographic and diagnostic characteristics, proxy indicators of acculturation, and causal attributions; and (c) to analyze the connections between causal attributions and the manifestation of somatic-affective and cognitive depressive symptoms. A sample of 128 Somali refugees aged 50-80 years living in Finland were asked to list the top three causes of mental health problems. Depressive symptoms were analyzed using the Beck Depression Inventory (BDI). The results showed that the most commonly endorsed causal attributions of mental health problems were jinn, jealousy related to polygamous relationships, and various life problems. We identified five attribution categories: (a) somatic, (b) interpersonal, (c) psychological, (d) life experiences, and (e) religious causes. The most common causal attribution categories were life experiences and interpersonal causes of mental health problems. Men tended to attribute mental health problems to somatic and psychological causes, and women to interpersonal and religious causes. Age and proxy indicators of acculturation were not associated with causal attributions. Participants with a psychiatric diagnosis and/or treatment history reported more somatic and psychological attributions than other participants. Finally, those who attributed mental health problems to life experiences (e.g., war) reported marginally fewer cognitive depressive symptoms (e.g., guilt) than those who did not. The results are discussed in relation to biomedical models of mental health, service use, immigration experiences, and culturally relevant patterns of symptom manifestation.
PubMed ID
28398194 View in PubMed
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The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland.

https://arctichealth.org/en/permalink/ahliterature275748
Source
Scand J Public Health. 2016 May;44(3):281-90
Publication Type
Article
Date
May-2016
Author
Shadia Rask
Jaana Suvisaari
Seppo Koskinen
Päivikki Koponen
Mulki Mölsä
Riikka Lehtisalo
Carla Schubert
Antti Pakaslahti
Anu Emilia Castaneda
Source
Scand J Public Health. 2016 May;44(3):281-90
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety - ethnology
Cross-Sectional Studies
Depression - ethnology
Female
Finland - epidemiology
Health Status Disparities
Health Surveys
Humans
Iran - ethnology
Iraq - ethnology
Male
Middle Aged
Prevalence
Russia - ethnology
Socioeconomic Factors
Somalia - ethnology
Transients and Migrants - psychology - statistics & numerical data
Young Adult
Abstract
Research demonstrates that migrants are more vulnerable to poor mental health than general populations, but population-based studies with distinct migrant groups are scarce. We aim to (1) assess the prevalence of mental health symptoms in Russian, Somali and Kurdish origin migrants in Finland; (2) compare the prevalence of mental health symptoms in these migrant groups to the Finnish population; (3) determine which socio-demographic factors are associated with mental health symptoms.
We used data from the Finnish Migrant Health and Wellbeing Study and Health 2011 Survey. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25), and 1.75 was used as cut-off for clinically significant symptoms. Somatization was measured using the Symptom Checklist-90 (SCL-90) somatization scale. The age-adjusted prevalence of mental health symptoms in the studied groups was calculated by gender using predicted margins. Logistic regression analysis was used to determine which socio-demographic factors are associated with mental health symptoms in the studied population groups.
The prevalence of depressive and anxiety symptoms was higher in Russian women (24%) and Kurdish men (23%) and women (49%) than in the Finnish population (9-10%). These differences were statistically significant (p
PubMed ID
26647096 View in PubMed
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Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland.

https://arctichealth.org/en/permalink/ahliterature266958
Source
Transcult Psychiatry. 2014 Aug;51(4):499-525
Publication Type
Article
Date
Aug-2014
Author
Mulki Mölsä
Raija-Leena Punamäki
Samuli I Saarni
Marja Tiilikainen
Saija Kuittinen
Marja-Liisa Honkasalo
Source
Transcult Psychiatry. 2014 Aug;51(4):499-525
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anxiety - epidemiology - psychology
Depression - epidemiology - psychology
Emigration and Immigration
Female
Finland - epidemiology
Health status
Humans
Male
Middle Aged
Quality of Life - psychology
Refugees - psychology - statistics & numerical data
Somalia - ethnology
Stress, Psychological - epidemiology - psychology
Abstract
Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50-80 years of age were selected from the Somali older adult population living in the Helsinki area (N?=?307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations.
PubMed ID
24648488 View in PubMed
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Mental health among older refugees: the role of trauma, discrimination, and religiousness.

https://arctichealth.org/en/permalink/ahliterature290460
Source
Aging Ment Health. 2017 Aug; 21(8):829-837
Publication Type
Journal Article
Date
Aug-2017
Author
Mulki Mölsä
Saija Kuittinen
Marja Tiilikainen
Marja-Liisa Honkasalo
Raija-Leena Punamäki
Author Affiliation
a Department of Public Health , University of Helsinki , Helsinki , Finland.
Source
Aging Ment Health. 2017 Aug; 21(8):829-837
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Acculturation
Adult Survivors of Child Adverse Events - statistics & numerical data
Aged
Aged, 80 and over
Female
Finland - ethnology
Humans
Male
Middle Aged
Racism - ethnology
Refugees - statistics & numerical data
Religion and Psychology
Somalia - ethnology
Stress Disorders, Post-Traumatic - ethnology
Warfare
Abstract
The aim of this study was to examine, first, how past traumatic stress and present acculturation indices, and discrimination are associated with mental health; and, second, whether religiousness can buffer the mental health from negative impacts of war trauma.
Participants were 128 older (50-80 years) Somali refugees living in Finland. They reported experiences of war trauma and childhood adversities, and filled-in questionnaires of perceived ethnic discrimination, religiousness (beliefs, attendance, and observance of Islamic faith), and symptoms of posttraumatic stress disorder (PTSD), depressive (BDI-21), psychological distress (GHQ-12), and somatization (SCL-90).
Symptom-specific regression models showed that newly arrived refugees with non-permanent legal status and severe exposures to war trauma, childhood adversity, and discrimination endorsed greater PTSD symptoms, while only war trauma and discrimination were associated with depressive symptoms. Results confirmed that high religiousness could play a buffering role among older Somalis, as exposure to severe war trauma was not associated with high levels of PTSD or somatization symptoms among highly religious refugees.
Health care should consider both unique past and present vulnerabilities and resources when treating refugees, and everyday discrimination and racism should be regarded as health risks.
PubMed ID
27080403 View in PubMed
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