Post migration stress among refugees development of a new scale and associations with wellbeing
Background: Trauma afflicted refugees often report low subjective wellbeing and mental ill health. In addition to ill health related to pre migration traumas, post migration stress may contribute to the poor mental health and low wellbeing of refugees. There are currently only a few instruments for assessing post migration stress. However, none of the existing instruments fully capture the wide variety of stressful experiences specifically faced by refugees. The current study describes the systematic development of a new measure for assessment of post migration stress among refugees and preliminary results regarding its associations with wellbeing. Methods: A mixed methods psychometric study comprising: construct conceptualization and initial item pool generation, linguistic and cultural adaptation, pre testing of the scale by cognitive interviewing, content validity ratings (CVR's) of items by an expert group, and correlational analysis with WHO 5 wellbeing index (n=41) Findings: Seven domains were conceptualized; perceived discrimination, lack of host country specific competences, economic strain, loss of home country, home country and family concerns, social strain, and family conflicts. Cognitive interviewing, inter item correlations and CVR's resulted in a 24 item scale. CVI for items ranged between 0.83 and 1.0, and for the entire scale (S CVI) was 0.95. 70.7 (n=29) reported wellbeing below 13 on WHO 5, indicating poor wellbeing. Wellbeing was negatively associated with economic strain (r 0.50, p 0.01) and social strain (r 0.46, p 0.01) Discussion: Findings indicate preliminary support for the scale's validity. Post migration stress stemming from social and economic strains appear as predominant adversities in regard to wellbeing for refugees.