Objectives

  In Sub-Saharan Africa, acquired immunodeficiency syndrome (AIDS) orphans account for a large proportion; however, their mental health problems have been overlooked. We presented an investigation of literature to provide a comprehensive overview of associated factors of mental health among AIDS orphans in Sub-Saharan Africa.

Methods

  Databases (PubMed and Japan Medical Abstracts Society) were searched by using relevant keywords including AIDS orphans, Sub-Saharan Africa, mental health, psychological support, education, and poverty. A total of nine papers met the inclusion criteria and were included in this literature review.

Results

  AIDS orphans were at high risk of various mental disorders relevant to low self-esteem, anxiety, and depression. Associated factors of the mental health of AIDS orphans were classified into the following three categories: psycho-social-cultural factors such as social discrimination, abuse, and bullying etc.; physical environmental and economic factors such as education, lack of foster care, and poverty etc; and family and community relevant factors such as lack of connection and social support from family and school etc. Regarding psycho-social-cultural factors, AIDS orphans experienced more abuse, social discrimination, and social stigma, especially those who were living in poverty. AIDS orphans living in the urban experienced severe bullying. Regarding family and community factors, due to the loss of parents and changes in living environment, AIDS orphans who were living in households headed by children tend to experience depression, anxiety, fear, and stigma. The loss of a parent resulted in lower academic performance and limited access resources including inadequate mental health services, which consequently led to poor development and adverse health outcomes in AIDS orphans including poor psychosocial well-being. Regarding environmental and economic factors. Lack of care from caregivers and parental mental health were also shown to be related to child development and mental health in AIDS orphans. Regarding physical environmental and economic factors, limited available social support in the physical environment where AIDS orphans lived was associated with impaired development and mental health. Poverty led to AIDS orphans being affected by food shortage and malnutrition (e.g., stunting), child labor, as well as risky sexual behaviors towards female AIDS orphans. Better social support from caregivers and teachers had a positive impact on the mental health of AIDS orphans. With regard to education, AIDS orphans have a high school dropout rate, resulting in fewer school connections. School connections have been shown to be an important protective factor for AIDS orphans’ mental health.

Conclusions

  This review identified risk and protective factors of mental health among AIDS orphans in sub-Saharan Africa. Our results, especially the positive influence of social support, encourage the development of effective mental health care programs for AIDS orphans in sub-Saharan Africa. The results suggest looking at various problems that AIDS orphans are facing from multiple perspectives.

Introduction

  The demographic composition of the ethnic Korean population in Japan (often referred to as zainichi) shows a declining birthrate. However, zainichi who live in zainichi Korean communities have more children than zainichi living in predominantly Japanese communities. Social capital (SC) can increase societal efficiency by promoting cooperative behavior within communities. This study clarified the family formation and SC that supports childcare for zainichi mothers living in zainichi Korean communities.

Methods

  We conducted semi-structured interviews with 10 zainichi mothers living in zainichi Korean communities in Japan. We qualitatively and descriptively analyzed the family formation and SC that support childcare in this population. The Ethical Committee of Osaka Prefecture University approved this study and the participants gave their written informed consent.

Results

  We extracted three categories and 12 subcategories for “thoughts on current family formation” and four categories and 11 subcategories for “SC supporting childcare.” Zainichi mothers living in Korean communities “think consciously about marriage” and “think positively about having multiple children and family formation,” but they have “concerns about childbearing and child-rearing.” “People who support childcare practically and mentally” and “childcare services” were also identified as important factors. Although zainichi mothers felt dissatisfied with “support that they wanted to use but found difficult to use,” they considered childcare support as human and physical SC. As an additional resource, they felt that “the zainichi community fosters security and bonding,” and thus promotes SC for child-rearing.

Discussion

  Networks with common norms, values, and understanding facilitated cooperation among zainichi mothers. “The zainichi community, which fosters security and bonding,” may support family formation through engendering a positive perception of child-rearing.

Introduction

  With the increase in the number of foreign residents in Japan and the aging of the population, it is expected that there will be more opportunities to provide home-visit rehabilitation to foreign residents are increasing. The purpose of this study was to clarify the difficulties that physical therapists (PTs) face when providing home-visit rehabilitation to elderly foreign residents.

Methods

  A qualitative descriptive study using semi-structured interviews was conducted with PTs who have experience in providing home-visit rehabilitation to elderly foreign residents.

Results

  The subjects were 11 PTs (9 males and 2 females), with an average age of 39.3 years and the average years of PT experience 13.7 years. The analysis revealed that the difficulties faced by PTs included 10 categories; [Differences in rehabilitation concepts with foreign elderly], [Difficulty in goal setting], [Lack of multilingual support and access to information on support], [Burden of dealing with non-rehabilitation work], [Building trust through daily communication], [Detailed communication in different languages], [Dealing with cultural differences], [Differences in religion and sensitivity to this topic], [Dealing with elderly foreign residents who are hesitant to contact with Japanese people] and [Anxiety about conducting home-visit rehabilitation due to PT’s preconceived notions about foreigners].

Conclusions

  Differences in the rehabilitation concepts between Japan and some foreign countries were found as a difficulty faced by PTs. Difficulties due to language differences were significant, and institutional difficulties also existed, such as lack of multilingual support and access to information on support. In addition, by visiting private homes and providing individualized services, PTs sometimes had to deal with problems faced by elderly foreign people other than rehabilitation work. These were considered to make it difficult to implement goal-oriented rehabilitation.