背景:认识到健康的社会决定因素之间已建立的联系,比如社会支持,善政,和感知到的歧视,和个人心理健康,本研究旨在更深入地研究伊朗成年人口中的具体关系.它旨在阐明生活质量在心理健康障碍(MHD)与这些社会因素之间的关联中的潜在中介作用。
方法:这项横断面研究采用路径分析来调查大不里士725名伊朗成年人的健康社会决定因素与MHD之间的关系,伊朗西北部。数据收集发生在2022年3月至9月之间,采用多阶段和整群抽样方法。善政,社会支持,感知到的歧视,MHD,使用有效问卷评估生活质量。采用SPSS-24和Lisrel-8软件进行统计分析。显著性水平设置为p<0.05。
结果:这项研究发现,近70.0%的参与者报告经历过心理健康问题。路径分析显示,良好治理通过生活质量对MHD有显著的间接和负面影响(β=-0.05;P<0.05)。主要种族歧视在直接和间接路径上呈正相关(β=0.24;P<0.01)。同时,社会支持是MHDs降低的直接和间接显著预测因子(β=-0.17,p<0.01)。此外,生活质量在间接路径上与MHDs呈负相关(β=-0.24,P<0.01)。
结论:这项研究揭示了伊朗成年人心理健康问题的重大负担。它强调了善政等社会因素的关键作用,社会支持,以及通过对生活质量的影响来塑造心理健康的感知歧视。因此,通过改善治理来解决这些因素,加强社会支持系统,积极努力减少歧视对于促进心理健康至关重要。
BACKGROUND: Recognizing the established link between social determinants of health, such as social support, good governance, and perceived discrimination, and individual mental health, this study aims to delve deeper into the specific relationships within the Iranian adult population. It seeks to elucidate the potential mediating role of quality of life in the association between mental health disorders (MHDs) and these social factors.
METHODS: This cross-sectional study employed path analysis to investigate the relationships between social determinants of health and MHDs among 725 Iranian adults in Tabriz, Northwest Iran. Data collection occurred between March and September 2022, utilizing a multi-stage and cluster sampling approach. Good governance, social support, perceived discrimination, MHDs, and quality of life were assessed using valid questionnaires. Statistical analysis was conducted using SPSS-24 and Lisrel-8 software, with a significance level set at p < 0.05.
RESULTS: This study found that nearly 70.0% of the participants reported experiencing mental health problems. The path analysis showed that good governance had a significant indirect and negative effect on MHDs via quality of life (β = -0.05; P < 0.05). Major racial discrimination had a positive relationship in the direct and indirect paths (β = 0.24; P < 0.01). While, social support was a directly and indirectly significant predictor of decreased MHDs (β = -0.17, p < 0.01). Furthermore, quality of life had a negative relationship on the indirect path with MHDs (β = -0.24, P < 0.01).
CONCLUSIONS: This study reveals a significant burden of mental health issues among Iranian adults. It highlights the crucial role of social factors like good governance, social support, and perceived discrimination in shaping mental health through their impact on quality of life. Consequently, addressing these factors through improved governance, strengthened social support systems, and active efforts to reduce discrimination is essential for promoting mental well-being.