Abstract

PurposeTo examine health-related quality of life (HRQoL) in refugee minors resettled in Sweden and compare results to a European reference population, while exploring associations between sociodemographic factors and HRQoL dimensions.MethodsA cross-sectional, nation-wide study was conducted with a stratified sample of refugee minors ages 12–15 and 16–18 from Afghanistan, Iraq and Syria, resettled in Sweden between 2014 and 2018. HRQoL was measured using KIDSCREEN-27. HRQoL dimension scores of the sample were compared to mean scores of European age and gender-matched reference population. Associations between sociodemographic factors and HRQoL dimensions were investigated with independent t tests and ANOVA. A multivariable regression analysis was performed to identify the sociodemographic factors associated with HRQoL.ResultsThe questionnaire was sent to 10,000 potential respondents. The response rate was 26%, yielding n = 2559 refugee minors (boys 55%, girls 45%) in the study sample. Compared to European references, minors in the present study had significantly lower scores of HRQoL within psychological wellbeing and peers and social support, whereas levels for autonomy and parent/guardian relations and school environment were higher. Several sociodemographic factors were significantly associated with all HRQoL dimensions, with those 16–18 years old, having average or poor family economy, and living with an unrelated adult or family reporting lower levels of HRQoL. Minors from Afghanistan had significantly lower scores of HRQoL for all dimensions compared to those from Iraq and Syria.ConclusionRefugee minors had significantly lower levels of HRQoL for psychological wellbeing and peers and social support compared to European references. Future research should further investigate this potential HRQoL gap further.

Highlights

  • In recent years, children and adolescents have been forced to flee their home countries in increasing numbers due to various and complex reasons and circumstances

  • Respondents in the present study reported significantly higher health-related quality of life (HRQoL) compared to European minors for two dimensions, relation to parents and autonomy and school environment, and significantly lower levels for two dimensions, psychological wellbeing and peers and social support

  • Previous research focusing on forced migration, mental health, and psychosocial adjustment in young refugees has indicated a heightened risk of mental ill health, no study to date has examined health-related quality of life (HRQoL) within this population

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Summary

Introduction

Children and adolescents have been forced to flee their home countries in increasing numbers due to various and complex reasons and circumstances. These range from conflict and war to natural disasters and poverty. Minors under the age of 18 represent above one-third of all asylum-seekers worldwide, with 153,000 reported as unaccompanied in 2019 [1]. In 2019, one-third of asylum applicants to Europe were minors aged less than 18 years [5]. During the increase in forced migration to Europe in 2015, Sweden accepted more refugees, including unaccompanied refugee minors, than any

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