ORCID Profile
0000-0002-7440-7781
Current Organisations
University of Western Australia
,
Royal Australasian College of Physicians
,
London School of Hygiene and Tropical Medicine
,
Imperial College London
,
Baylor College of Medicine
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Publisher: BMJ
Date: 24-10-2018
DOI: 10.1136/ARCHDISCHILD-2017-313451
Abstract: Adolescent refugees encounter traumatic stressors and are at risk of developing psychosocial health problems limited research data exist internationally. This study aims to identify health risk behaviours among adolescent refugees resettling in Western Australia and assess the feasibility of using a standardised adolescent health questionnaire for this purpose. Refugees aged 12 years and above attending a tertiary Refugee Health Service (RHS) were recruited over 12 months. Sociodemographic data were collected. Psychosocial assessments based on the ‘ H ome, E ducation/Eating, A ctivities, D rugs, S exuality, S uicide/mental health’ (HEADSS) framework were undertaken utilising interpreters where required. Health concerns identified were managed through the RHS. A total of 122 adolescents (20 ethnicities) participated 65% required interpreters. Median age (range) was 14 (12–17) years. Most (80%) had nuclear family separation. Almost half (49%) had a deceased/missing family member. A third (37%) had lived in refugee c s and 20% had experienced closed detention. The median time (range) since arrival in Australia was 11 (2–86) months. Every adolescent had at least one health concern identified during the psychosocial assessment. Frequency of health concerns identified in each domain were 87% for home, 66% for education, 23% for eating, 93% for activities, 5% for drugs, 88% for sexuality and 61% for suicide/mental health. Most adolescents (75%) required intervention, consisting of counselling for health risk behaviours and/or referral to health or community services. It is feasible to use a standardised adolescent health questionnaire to identify health risk behaviours among a cohort of ethnically erse adolescent refugees. Use of the questionnaire identified a large burden of psychosocial health issues requiring multidisciplinary intervention.
Publisher: BMJ
Date: 15-10-2016
DOI: 10.1136/ARCHDISCHILD-2014-307221
Abstract: Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals.
Publisher: Wiley
Date: 22-06-2019
DOI: 10.1111/JPC.14550
Abstract: Adolescent refugees resettling in Australia are a vulnerable and marginalised population. Dedicated research to help better understand their health-care needs remains scarce. There are multiple complexities which may deter health professionals from conducting research with this population. Health-care system barriers, such as lack of adolescent- and refugee-specific health-care services, complicate comprehensive data collection. Limited investigator knowledge pertaining to culturally appropriate research in a population with limited English proficiency or a history of trauma can have an impact on adolescent participation and retention in research studies. Additional ethical and legal issues relating to adolescent consent and confidentiality, which include suicidality and physical or sexual abuse, can arise during research and cause potential harm to adolescents if not managed appropriately. This article highlights current knowledge and understanding relating to these issues along with recommendations to address barriers and safeguard adolescents, with the aim of promoting high-quality research that will benefit resettling adolescent refugees.
Publisher: BMJ
Date: 03-07-2018
DOI: 10.1136/ARCHDISCHILD-2018-315105
Abstract: To investigate the medical needs and socioeconomic determinants of health among adolescent refugees resettling in Western Australia. Comprehensive medical and socioeconomic health data of resettling adolescent refugees aged 12 years and above attending a Refugee Health Service over a 1-year period were analysed. Medical records of 122 adolescents, median (range) age of 14 (12–17) years, were reviewed. Socioeconomic vulnerabilities included dependence on government financial support (50%), housing issues (27%) and child protection service involvement (11%). Medical concerns included non-communicable disorders (85%), infectious diseases (81%), nutrition/growth (71%) and physical symptoms of non-organic origin (43%). One quarter (27%) of female adolescents had sexual/reproductive health issues. A median (range) of 5 (2–12) health concerns were identified for each adolescent with 49% requiring referral to subspecialty services. Resettling adolescent refugees are socioeconomically vulnerable with a range of medical issues that frequently require additional subspecialty health referrals.
Publisher: Informa UK Limited
Date: 27-09-2023
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Kajal Hirani.