The Mediating Role of Resilience in the Relationship between Social Exclusion and Sleep Parameters in Refugee Children

Mehmet Emin Düken; Veysel Kaplan; Fethiye Kılıçaslan

doi:10.35440/hutfd.1463713

Research Article

The Mediating Role of Resilience in the Relationship between Social Exclusion and Sleep Parameters in Refugee Children

Year 2024, Volume: 21 Issue: 1, 123 - 130, 29.04.2024

Mehmet Emin Düken Veysel Kaplan Fethiye Kılıçaslan

https://doi.org/10.35440/hutfd.1463713

Abstract

Background: This study was conducted to examine the mediating role of resilience in the relationship between social exclusion and sleep status of refugee children.
Materials and Methods: This study is a descriptive and relational study. The data were obtained through “Child Information Form”, “Ostracism Experience Scale for Adolescents”, “Sleep Disturbance Scale for Children” and “Child and Youth Resilience Measure”. A total of 791 refugee children were included in the study. The mediating role of resilience in the relationship between social exclusion and sleep status of refugee children was examined with Process Macro programme.
Results: Social exclusion has a statistically significant positive effect on sleep disturbance (β1=0.960; p<0.001). 92% of the change in sleep disturbance score is explained by social exclusion score (R2=0.920). The resilience is significantly negatively correlated with social exclusion (β1=-0.920; p<0.001). The social exclusion explains 84% of the resilience score (R2=0.840). If social exclusion increases by one point, there will be a 0.430 increase in sleep disturbance scores β1=0.430; p<0.001). If resilience increases by one point, there will be a 0.570 decreases in sleep disturbance scores β1=-0.570; p<0.001). The social exclusion and resilience scores explain 98% of sleep disturbance scores (R2 = 0.980).
Conclusions: In our study, it was found that children’s resilience status played an important mediating role in the relationship between social exclusion and sleep status. It was detected that children with good adaptation skills and coping capacities had less impairment in sleep quality and duration. It was found that refugee children who were isolated and excluded from the society were negatively affected with respect to their sleep patterns whereas children who were not excluded and ignored in the society they lived in had better coping skills and fewer sleep disturbances.

Keywords

refugee children, sleep, social exclusion, resilience

Ethical Statement

There is no conflict of interest between the authors. No support was received from any organisation or company.

Supporting Institution

References

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2. United Nations High Commissioner for Refugees (UNHCR). 2022. Migration. (Cited 15. March 2023). Available from: https://www.unhcr.org/globaltrends
3. Blackmore R, Gray KM, Boyle JA, Fazel M, Ranasinha S, Fitzgerald G, Misso M, Gibson-Helm M. Systematic re-view and meta-analysis: the prevalence of mental ıll-ness in child and adolescent refugees and asylum see-kers. J Am Acad Child Adolesc Psychiatry. 2020;59(6):705–14.
4. United Nations Refugee Agency (UNHCR). 2023. Refu-gee. (Cited 15. March 2023). Available from: https://www.unhcr.org/tr/turkiyedeki-multeciler-ve-siginmacilar
5. Flood C, Coyne I. A literature review of the psychological status of asylum-seeking children: implications for nur-sing practice. Br J Nurs. 2019;11(28/7):461–6.
6. Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry. 2022;33:667-670.
7. Höhne E, Van der Meer AS, Kamp-Becker I, Christiansen H. A systematic review of risk and protective factors of mental health in unaccompanied minor refugees. Eur Child Adolesc Psychiatry. 2022; 9(31/8):1–15.
8. Jensen TK, Skårdalsmo EM, Fjermestad KW. Develop-ment of mental health problems - a follow-up study of unaccompanied refugee minors. Child Adolesc Psychi-atry Ment Health. 2014;8(1):29.
9. Montgomery E. Trauma and resilience in young refu-gees: a 9-year follow-up study. Dev Psychopathol. 2010; 28(22/2):477–89.
10. Yayan EH. Post-traumatic stress disorder and mental health states of refugee children. Arch Psychiatr Nurs. 2018;32(6):885–9.
11. Yayan EH, Düken ME, Özdemir AA, Çelebioğlu A. Mental health problems of syrian refugee children: post-traumatic stress, depression and anxiety. J Pediatr Nurs. 2020; 51:27-32.
12. Yayan EH, Düken ME. Determination of psychosocial conditions of refugee children living in society. Perspect Psychiatr Care. 2019;26(55/4):644–51.
13. Reed R V, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resett-led in low-income and middle-income countries: risk and protective factors. Lancet. 2012;379(9812):250–65.
14. Wiese EB-P. Culture and migration: psychological trau-ma in children and adolescents. Traumatology. 2010;16(4):142–52.
15. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental he-alth of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012; 379(9812):266–82.
16. Gilman R, Carter-Sowell A, DeWall CN, Adams RE, Car-boni I. Ostracism experience scale for adolescents. Psychol Assess. 2013;25(2):319-330.
17. Bäärnhielm S, Laban K, Schouler-Ocak M, Rousseau C, Kirmayer LJ. Mental health for refugees, asylum seekers and displaced persons: a call for a humanitarian agenda. Transcult Psychiatry. 2017;11(54/5–6):565–74.
18. Hassan G, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychi-atr Sci. 2016;1(25/2):129–41.
19. Imran N, Aamer I, Sharif MI, Bodla ZH, Naveed S. Psyc-hological burden of quarantine in children and adoles-cents: a rapid systematic review and proposed solutions. Pakistan J Med Sci. 2020;26(36/5):1106-1116.
20. Kline RB. Principles and practice of structural equation modeling. New York: Guilford Publisher, 2023:1-494.
21. Schumacker RE, Lomax RG. A beginner’s guide to struc-tural equation modeling. London: Sheridan Books, 2004:1-376.
22. Kilic S. Sampling methods. J Mood Disord. 2013;3(1):44.
23. Mercan ÇS. Ostracism experience scale for adolescents: turkish validity and reliability. Hasan Ali Yücel Eğitim Fakültesi Derg. 2016;13(25):175–86.
24. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F. The sleep disturbance scale for children (sdsc) construction and validation of an inst-rument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251–61.
25. Akçay D, Akçay B, Bozkurt Ö. Reliability and validity of turkish sleep disturbance scale for children. Anatol J Psychiatry. 2019;21(1):1-7.
26. Liebenberg L, Ungar M, LeBlanc JC. The CYRM-12: a brief measure of resilience. Can J Public Heal. 2013;1(104/2):e131–5.
27. Arslan G. Çocuk ve genç psikolojik sağlamlık ölçeği’nin (çgpsö) psikometrik özellikleri: geçerlilik ve güvenirlik çalışması. Ege Eğitim Derg. 2015;15(16/1):1.
28. İnceoğlu F, Demir P, Aydoğdu H. Adaptation of fear of missing out scale (FoMOs) to dentistry. Selcuk Dent J. 2021;31(8/2):530–7.
29. Batmaz H. Siber mağduriyet ve siber zorbalık arasındaki ilişkide dijital oyun bağımlılığının aracı rolü. Soc Sci Stud J. 2020;1(6/73):5093–108.
30. Hanes G, Sung L, Mutch R, Cherian S. Adversity and resi-lience amongst resettling western australian paediatric refugees. J Paediatr Child Health. 2017;53(9):882–8.
31. Correa-Velez I, Gifford SM, Barnett AG. Longing to be-long: social inclusion and wellbeing among youth with refugee backgrounds in the first three years in melbour-ne, australia. Soc Sci Med. 2010;71(8):1399–408.
32. Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, Keane T, Saxe GN. Review of child and ado-lescent refugee mental health. J Am Acad Child Adolesc Psychiatry. 2004;43(1):24–36.
33. Mahamid FA. Collective trauma, quality of life and resi-lience in narratives of third generation palestinian refu-gee children. Child Indic Res. 2020;22(13/6):2181–204.
34. Jensen TK, Skar A-MS, Andersson ES, Birkeland MS. Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors. Eur Child Adolesc Psychiatry. 2019;19(28/12):1671–82.
35. Bronstein I, Montgomery P. Psychological distress in re-fugee children: a systematic review. Clin Child Fam Psychol Rev. 2011;4(14/1):44–56.
36. Arakelyan S, Ager A. Annual research review: a multile-vel bioecological analysis of factors influencing the mental health and psychosocial well‐being of refugee children. J Child Psychol Psychiatry. 2021;5(62/5):484– 509.
37. Turrini G, Purgato M, Acarturk C, Anttila M, Au T, Ballet-te F, Bird M, Carswell K, Churchill K, Cuijpers P, Hall J, Hansen LJ, Kösters M, Lantta T, Nose M, Ostuzzi G, Sijbrandij M, Tedschi F, Valimaki M, Wancata J, Whiye R, Van-Ommeren M, Barbui C. Efficacy and acceptability of psychosocial interventions in asylum seekers and re-fugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2019; 11(28/04):376–88.
38. Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Cuijpers P, Aker T. EMDR for Syrian refugees with postt-raumatic stress disorder symptoms: results of a pilot randomized controlled trial. Eur J Psychotraumatol. 2015;1(6/1):1-9.
39. Wells R, Steel Z, Abo-Hilal M, Hassan AH, Lawsin C. Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs as-sessments. Br J Psychiatry. 2016; 2(209/2):99–106.
40. Mental health of asylum-seekers in Serbia (UNHCR). 2023. Migration. (Cited 15. March 2023). Available from: https://www.unhcr.org/rs/en/15907-mental-health-of-asylum-seekers-in-serbia.html

Mülteci Çocuklarda Sosyal Dışlanma ve Uyku Parametreleri Arasındaki İlişki-de Dayanıklılığın Aracı Rolü

Year 2024, Volume: 21 Issue: 1, 123 - 130, 29.04.2024

Mehmet Emin Düken Veysel Kaplan Fethiye Kılıçaslan

https://doi.org/10.35440/hutfd.1463713

Abstract

Amaç: Bu çalışma, mülteci çocukların sosyal dışlanma ve uyku durumları arasındaki ilişkide dayanıklılığın aracı rolünü incelemek amacıyla yapılmıştır.
Yöntem: Tanımlayıcı ve ilişkisel bir çalışmadır: Tanımlayıcı ve korelasyonel olan bu çalışmada veriler "Çocuk Bilgi Formu", "Ergenler için Dışlanma Deneyimi Ölçeği", "Çocuklar için Uyku Bozukluğu Ölçeği" ve "Çocuk ve Genç Dayanıklılık Ölçeği" aracılığıyla elde edilmiştir. Sosyal dışlanma ve uyku durumu arasındaki ilişkide mülteci çocukların dayanıklılık durumlarının aracı rolü Process Macro programı ile incelenmiştir.
Bulgular: Sosyal dışlanma ve uyku durumu arasındaki ilişkide çocukların dayanıklılık durumunun önemli bir aracı rol oynadığı bulunmuştur. Toplumdan izole edilen ve dışlanan çocukların uyku düzenlerinin olumsuz etkilendiği bulunmuştur. Sosyal dışlanmanın uyku bozukluğu üzerinde istatistiksel olarak anlamlı pozitif bir etkisi vardır (β1=-0,966; p<0,001). Uyku bozukluğu skorundaki değişimin %92'si sosyal dışlanma skoru tarafından açıklanmaktadır (R2=0,920). Uyku bozukluğu ile dayanıklılık arasında istatistiksel olarak anlamlı bir negatif korelasyon vardır (β1= 0.92; p<0.001). Dayanıklılık 1 puan artarsa, uyku bozukluğu puanı 3.840 puan azalacaktır (β2=-3.840). Uyku bozukluğu puanının %84'ü dayanıklılık tarafından açıklanmaktadır (R2 = 0,840).
Sonuç: Uyum becerileri ve başa çıkma kapasiteleri iyi olan çocukların uyku kalitesi ve süresinde daha az bozulma olduğu tespit edilmiştir. Yaşadıkları toplumda dışlanmayan ve göz ardı edilmeyen mülteci çocukların baş etme becerilerinin daha iyi olduğu ve daha az uyku bozukluğu yaşadıkları tespit edilmiştir.

Keywords

mülteci çocuklar, uyku, sosyal dışlanma, dayanıklılık

Ethical Statement

Yazarlar arasında herhangi bir çıkar çatışması bulunmamaktadır. Herhangi bir kurum veya şirketten destek alınmamıştır.

Supporting Institution

Yok

References

1. International Organization for Migration (IOM). 2022. Migration. (Cited 15. March 2023). Available from: https://publications.iom.int/books/world-migration-report-2022-chapter-2.
2. United Nations High Commissioner for Refugees (UNHCR). 2022. Migration. (Cited 15. March 2023). Available from: https://www.unhcr.org/globaltrends
3. Blackmore R, Gray KM, Boyle JA, Fazel M, Ranasinha S, Fitzgerald G, Misso M, Gibson-Helm M. Systematic re-view and meta-analysis: the prevalence of mental ıll-ness in child and adolescent refugees and asylum see-kers. J Am Acad Child Adolesc Psychiatry. 2020;59(6):705–14.
4. United Nations Refugee Agency (UNHCR). 2023. Refu-gee. (Cited 15. March 2023). Available from: https://www.unhcr.org/tr/turkiyedeki-multeciler-ve-siginmacilar
5. Flood C, Coyne I. A literature review of the psychological status of asylum-seeking children: implications for nur-sing practice. Br J Nurs. 2019;11(28/7):461–6.
6. Mattelin E, Paidar K, Söderlind N, Fröberg F, Korhonen L. A systematic review of studies on resilience and risk and protective factors for health among refugee children in Nordic countries. Eur Child Adolesc Psychiatry. 2022;33:667-670.
7. Höhne E, Van der Meer AS, Kamp-Becker I, Christiansen H. A systematic review of risk and protective factors of mental health in unaccompanied minor refugees. Eur Child Adolesc Psychiatry. 2022; 9(31/8):1–15.
8. Jensen TK, Skårdalsmo EM, Fjermestad KW. Develop-ment of mental health problems - a follow-up study of unaccompanied refugee minors. Child Adolesc Psychi-atry Ment Health. 2014;8(1):29.
9. Montgomery E. Trauma and resilience in young refu-gees: a 9-year follow-up study. Dev Psychopathol. 2010; 28(22/2):477–89.
10. Yayan EH. Post-traumatic stress disorder and mental health states of refugee children. Arch Psychiatr Nurs. 2018;32(6):885–9.
11. Yayan EH, Düken ME, Özdemir AA, Çelebioğlu A. Mental health problems of syrian refugee children: post-traumatic stress, depression and anxiety. J Pediatr Nurs. 2020; 51:27-32.
12. Yayan EH, Düken ME. Determination of psychosocial conditions of refugee children living in society. Perspect Psychiatr Care. 2019;26(55/4):644–51.
13. Reed R V, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resett-led in low-income and middle-income countries: risk and protective factors. Lancet. 2012;379(9812):250–65.
14. Wiese EB-P. Culture and migration: psychological trau-ma in children and adolescents. Traumatology. 2010;16(4):142–52.
15. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental he-alth of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012; 379(9812):266–82.
16. Gilman R, Carter-Sowell A, DeWall CN, Adams RE, Car-boni I. Ostracism experience scale for adolescents. Psychol Assess. 2013;25(2):319-330.
17. Bäärnhielm S, Laban K, Schouler-Ocak M, Rousseau C, Kirmayer LJ. Mental health for refugees, asylum seekers and displaced persons: a call for a humanitarian agenda. Transcult Psychiatry. 2017;11(54/5–6):565–74.
18. Hassan G, Ventevogel P, Jefee-Bahloul H, Barkil-Oteo A, Kirmayer LJ. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiol Psychi-atr Sci. 2016;1(25/2):129–41.
19. Imran N, Aamer I, Sharif MI, Bodla ZH, Naveed S. Psyc-hological burden of quarantine in children and adoles-cents: a rapid systematic review and proposed solutions. Pakistan J Med Sci. 2020;26(36/5):1106-1116.
20. Kline RB. Principles and practice of structural equation modeling. New York: Guilford Publisher, 2023:1-494.
21. Schumacker RE, Lomax RG. A beginner’s guide to struc-tural equation modeling. London: Sheridan Books, 2004:1-376.
22. Kilic S. Sampling methods. J Mood Disord. 2013;3(1):44.
23. Mercan ÇS. Ostracism experience scale for adolescents: turkish validity and reliability. Hasan Ali Yücel Eğitim Fakültesi Derg. 2016;13(25):175–86.
24. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F. The sleep disturbance scale for children (sdsc) construction and validation of an inst-rument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251–61.
25. Akçay D, Akçay B, Bozkurt Ö. Reliability and validity of turkish sleep disturbance scale for children. Anatol J Psychiatry. 2019;21(1):1-7.
26. Liebenberg L, Ungar M, LeBlanc JC. The CYRM-12: a brief measure of resilience. Can J Public Heal. 2013;1(104/2):e131–5.
27. Arslan G. Çocuk ve genç psikolojik sağlamlık ölçeği’nin (çgpsö) psikometrik özellikleri: geçerlilik ve güvenirlik çalışması. Ege Eğitim Derg. 2015;15(16/1):1.
28. İnceoğlu F, Demir P, Aydoğdu H. Adaptation of fear of missing out scale (FoMOs) to dentistry. Selcuk Dent J. 2021;31(8/2):530–7.
29. Batmaz H. Siber mağduriyet ve siber zorbalık arasındaki ilişkide dijital oyun bağımlılığının aracı rolü. Soc Sci Stud J. 2020;1(6/73):5093–108.
30. Hanes G, Sung L, Mutch R, Cherian S. Adversity and resi-lience amongst resettling western australian paediatric refugees. J Paediatr Child Health. 2017;53(9):882–8.
31. Correa-Velez I, Gifford SM, Barnett AG. Longing to be-long: social inclusion and wellbeing among youth with refugee backgrounds in the first three years in melbour-ne, australia. Soc Sci Med. 2010;71(8):1399–408.
32. Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, Keane T, Saxe GN. Review of child and ado-lescent refugee mental health. J Am Acad Child Adolesc Psychiatry. 2004;43(1):24–36.
33. Mahamid FA. Collective trauma, quality of life and resi-lience in narratives of third generation palestinian refu-gee children. Child Indic Res. 2020;22(13/6):2181–204.
34. Jensen TK, Skar A-MS, Andersson ES, Birkeland MS. Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors. Eur Child Adolesc Psychiatry. 2019;19(28/12):1671–82.
35. Bronstein I, Montgomery P. Psychological distress in re-fugee children: a systematic review. Clin Child Fam Psychol Rev. 2011;4(14/1):44–56.
36. Arakelyan S, Ager A. Annual research review: a multile-vel bioecological analysis of factors influencing the mental health and psychosocial well‐being of refugee children. J Child Psychol Psychiatry. 2021;5(62/5):484– 509.
37. Turrini G, Purgato M, Acarturk C, Anttila M, Au T, Ballet-te F, Bird M, Carswell K, Churchill K, Cuijpers P, Hall J, Hansen LJ, Kösters M, Lantta T, Nose M, Ostuzzi G, Sijbrandij M, Tedschi F, Valimaki M, Wancata J, Whiye R, Van-Ommeren M, Barbui C. Efficacy and acceptability of psychosocial interventions in asylum seekers and re-fugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2019; 11(28/04):376–88.
38. Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Cuijpers P, Aker T. EMDR for Syrian refugees with postt-raumatic stress disorder symptoms: results of a pilot randomized controlled trial. Eur J Psychotraumatol. 2015;1(6/1):1-9.
39. Wells R, Steel Z, Abo-Hilal M, Hassan AH, Lawsin C. Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs as-sessments. Br J Psychiatry. 2016; 2(209/2):99–106.
40. Mental health of asylum-seekers in Serbia (UNHCR). 2023. Migration. (Cited 15. March 2023). Available from: https://www.unhcr.org/rs/en/15907-mental-health-of-asylum-seekers-in-serbia.html

There are 40 citations in total.

Details

Primary Language	English
Subjects	Child and Adolescent Psychiatry, Adolescent Health, Paediatrics (Other)
Journal Section	Research Article
Authors	Mehmet Emin Düken 0000-0002-1902-9669 Veysel Kaplan 0000-0001-9082-1379 Fethiye Kılıçaslan 0000-0002-8131-8859
Early Pub Date	April 22, 2024
Publication Date	April 29, 2024
Submission Date	April 2, 2024
Acceptance Date	April 22, 2024
Published in Issue	Year 2024 Volume: 21 Issue: 1

Cite

Vancouver	Düken ME, Kaplan V, Kılıçaslan F. The Mediating Role of Resilience in the Relationship between Social Exclusion and Sleep Parameters in Refugee Children. Harran Üniversitesi Tıp Fakültesi Dergisi. 2024;21(1):123-30.

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Harran Üniversitesi Tıp Fakültesi Dergisi _/Journal of Harran University Medical Faculty