Activity of Daily Living Performance amongst Danish Asylum Seekers: A cross-sectional study

Authors

  • Anne-Le Morville The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Denmark; Metropolitan University College, Institute of Rehabilitation and Nutrition, Dept. of Occupational Therapy, Copenhagen, Denmark;
  • Lena-Karin Erlandsson Department of Health Sciences, Lund University, Sweden
  • Mona Eklund Department of Health Sciences, Lund University, Sweden
  • Bente Danneskiold-Samsøe The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Denmark;
  • Robin Christensen The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Denmark
  • Kirstine Amris The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Denmark;

DOI:

https://doi.org/10.7146/torture.v24i1.109720

Keywords:

ADL ability, AMPS, torture survivors, pain

Abstract

Objective: The aim of this study was to evaluate the extent of Activities of Daily Living (ADL) ability impairment in newly arrived Danish asylum seekers. It was hypothesized that exposure to trauma and torture would negatively influence ADL performance and that measures of ADL ability would be lower in individuals exposed to torture as compared to the non-tortured. Subjects: Forty-three newly arrived asylum seekers aged 20-50 years, from Iran, Afghanistan, and Syria, were consecutively included in the study.

Method: ADL ability was assessed with the observation-based test Assessment of Motor and Process Skills (AMPS). Interviews were based on questionnaires about torture exposure, WHO-5 Wellbeing Index, Major Depression Inventory and Pain Detect Questionnaire. All participants were interviewed and tested using a linguistic interpreter. Results: Thirty-three (77%) participants reported exposure to torture. The tortured did not differ significantly from the non-tortured on measures of ADL ability (two-sample t-tests: Motor, p= 0.36; Process, p= 0.82). ADL performance impairment was observed in the overall study sample. Twelve had motor and 15 process ability measures below age norms and 2 below both AMPS motor and process cut-offs for effortless and efficient ADL performance. There were statistically significant - weak to moderate - correlations between self-reported psychological distress, VAS average pain, pain distribution, and the AMPS measures. Conclusion: The study results supported significant ADL ability impairment in tortured as well as non-tortured newly arrived asylum seekers. Implementation of performance-based evaluation of ADL ability as part of the initial medical screening of this particular population should be considered.

References

1. The Danish Immigration Service. Conditions for asylum seekers [Internet]. 2013 [updated 2013 June; cited 2013 Apr 29]. Available from: http://www.nyidanmark.dk/en-us/coming_to_dk/
asylum/conditions_for_asylum_applicants/conditions_for_asylum_applicants.htm
2. Danish Red Cross. Asylum [In Danish: Asyl] 2013 [cited 2013 Apr 29]. Available from: http:// www.rodekors.dk/det-goer-vi/asyl/asylarbejdet-idanmark/dagligdagen-som-asylansoeger
3. Sveaass, N. Gross human rights violations and reparation under international law: approaching rehabilitation as a form of reparation. European journal of psychotraumatology 2013, 4.
4. United Nations Commission Against Torture (CAT). General Comment No. 3. Geneva 2012. Available from: http://docstore.ohchr. org/SelfServices/FilesHandler.ashx?enc=6QkG1d%2fPPRiCAqhKb7yhskvE%2bTuw1mw%2 fKU18dCyrYrZkEy%2fFL18WFrnjCrilKQJsGK Tk4ahjqjet%2bDd1I6EaK00bugJwE2JY%2bYdP JjTZnS4TICxPO2OCjQAQvYuMtmAA
5. Fisher AG, Jones KB. Assessment of Motor and Process Skills. Volume 1: Development, Standardization, and Administration Manual. (7th ed.) Fort Collins, CO: Three Star Press; 2010.
6. World Health Organisation. International Classification of Function, Disability and Health. (resolution WHA 54.21). World Health Organisation. May 2011. Available from: http://www.who. int/classifications/icf/en/
7. Prip K, Persson AL, Sjølund BH. Self-reported activity in tortured refugees with long-term sequelae including pain and the impact of foot pain from falanga - a cross-sectional study. Disabil Rehabil. 2011;33(7):569-78.
8. Morville AL, Erlandsson LK. The Experience of Occupational Deprivation in an Asylum Centre: The Narratives of Three Men. J Occup Sci. 2013 June 14;20(3):212-223.
9. Kielhofner G, Borell L, Holzmueller R, Jonsson H, Josepsson S, Keponen R, et al. Crafting Occupational Life. In: Kielhofner G, editor. Model Of Human Occupation. Baltimore, Maryland: Lippincott Williams & Wilkins; 2008. p. 110-25.
10. Townsend E, Stanton S, Law M, Polatajko H, Baptiste S, Thompson-Franson T. et al. Enabling Occupation: An occupational Therapy Perspective. Ottawa: CAOT; 1999.
11. Månsson E, Lexell J. Performance of activities of daily living in multiple sclerosis. Disabil Rehabil. 2004 May 20;26(10):576-85.
12. Eklund M, Leufstadius C. Relationships between occupational factors and health and well-being in individuals with persistent mental illness living in the community. Can J Occup Ther. 2007 Oct 4;74(4).
13. Masmas TN, Møller E, Buhmannr C, Bunch V, Jensen JH, Hansen TN, et al. Asylum seekers in Denmark-a study of health status and grade of traumatization of newly arrived asylum seekers. Torture. 2008; 18(2):77-86.
14. Nørredam M, Garcia-Lopez A, Keiding N, Krasnik A. Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study. Soc Psychiatry Psychiatr Epidemiol. 2009 Dec;44(12):1023-9.
15. Jaranson JM, Butcher J, Halcon L, Johnson DR, Robertson C, Savik K, et al. Somali and Oromo refugees: correlates of torture and trauma history. Am J Public Health. 2004 April;94(4):591-8. DOI: 10.1016/j.jadohealth.2003.08.00.
16. Williams AC, Amris K. Pain from torture. Pain. 2007 Dec 15;133(1-3):5-8. (PubMed PMID: 18006232. Epub 2007/11/17. eng. DOI: 10.1016/j.pain.2007.10.001).
17. Danneskiold-Samsøe B, Barthels EM, Genefke I. Treatment of torture victims-a longitudinal clinical study. Torture. 2007; 17(1):11-7.
18. Thomsen AB, Eriksen J, Smidt-Nielsen K. Chronic pain in torture survivors. Forensic Sci Int. 2000 Feb 28;108(3):155-163.
19. Olsen DR, Montgomery E, Bøjholm S, Foldspang A. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: A ten-year follow-up study. Disabil Rehabil. 2007 Jan 30;29(2):163-71.
20. Persson D, Erlandsson L, Eklund M, Iwarsson S. Value Dimensions, meaning and Complexity in Human Occupation – A Tentative Structure for Analysis. Scand J Occup Ther. 2001; 8(1):718.
21. Amris K, Waehrens EE, Jespersen A, Bliddal H, Danneskiold-Samsoe B. Observation-based assessment of functional ability in patients with chronic widespread pain: a cross-sectional study. Pain. 2011 Nov; 152(11):2470-6. DOI.
22. WMA Declaration of Tokyo - Guidelines for Physicians Concerning Torture and other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment. Tokyo, Japan: World Medical Assembly; October 1975 (updated May 2006). Available from: http:// www.wma.net/en/30publications/10policies/c18/ index.html.
23. Bech P. Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsletter. 2004; 32: 15-16.
24. Bech P, Rasmussen NA, Olsen LR, Nørholm V, Abildgaard W. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord. 2001 Oct;66(2-3):15964.
25. Ware JE, Sherbourne CD. The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992 Jun;30(6):473-83.
26. Bowling A. Just one question: If one question works, why ask several? J Epidemiol Community Health. 2005 May;59(5):342-5.
27. Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006 Oct;22(10):1911-20.
28. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Ann Intern Med. 2007 Oct;147(8):573-7.
29. Gurr R, Quiroga J. Approaches to torture rehabilitation: a desk study covering effects, costeffectiveness, participation, and sustainability. Torture. 2001 March; 11(1a).
30. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009 Aug 5;302(5):537-49.
31. Edston E. The epidemiology of falanga--incidence among Swedish asylum seekers. Torture. 2009;19(1):27-32.
32. Crooks VA. Exploring the altered daily geographies and lifeworlds of women living with fibromyalgia syndrome: A mixed-method approach. Soc Sci Med. 2007 Feb;64(3):577-88.
33. Cohen J. Statistical power analysis for the behavioural sciences. New York: Academic Press; 1988.
34. Asmundson GJ, Coons MJ, Taylor S, Katz J. PTSD and the experience of pain: Research and clinical implications of shared vulnerability and mutual maintenance models. Can J Psychiatry. 2002 Dec;47(10):930-7.
35. Bryant RA, Marosszeky JE, Crooks J, Baguley IJ, Gurka JA. Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury. J Head Trauma Rehabil. 1999 Dec;14(6):588-94.
36. Moreno A, Grodin MA. Torture and its neurological sequelae. Spinal Cord. 2002 May;40(5):213-23. 37. Prip K, Persson AL. Clinical findings in men with chronic pain after falanga torture. Clin J Pain. 2008 Feb;24(2):135-41.

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Published

2018-10-08

How to Cite

Morville, A.-L., Erlandsson, L.-K., Eklund, M., Danneskiold-Samsøe, B., Christensen, R., & Amris, K. (2018). Activity of Daily Living Performance amongst Danish Asylum Seekers: A cross-sectional study. Torture Journal, 24(1), 16. https://doi.org/10.7146/torture.v24i1.109720

Issue

Vol. 24 No. 1 (2014): Torture Journal: Journal on Rehabilitation of Torture Victims and Prevention of Torture

Section

Research and Scientific articles

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