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Stressors, Self-esteem, Social Activities, and Depression: A Sample of Patients at a Federally Qualified Health Center Who Experienced Homelessness

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This study examined the relationships between current stressors and depressive symptoms among Federally Qualified Health Center (FQHC) patients who experienced homelessness, with a particular focus on the role of self-esteem and social activities on these relationships. The sample included patients who visited any clinic site of a FQHC in the southern part of Mississippi and qualified for the Health Care for the Homeless (HCH) Program. Assessments included the Patient Health Questionnaire (PHQ-9), the DUKE Health Profile, and a checklist of stressors. Results of the multivariate analysis using structural equation modeling revealed that ambulation difficulties were related to depressive symptoms directly and indirectly through social activities. SES-related stressors were related to depressive symptoms directly and indirectly through self-esteem and social activities. Relational and legal/police-related stressors were linked to depressive symptoms only through self-esteem. These results indicate the importance of integrated community healthcare services to address the physical, social, and mental healthcare needs of the homeless population.

Abstract

This study examined the relationships between current stressors and depressive symptoms among Federally Qualified Health Center (FQHC) patients who experienced homelessness, with a particular focus on the role of self-esteem and social activities on these relationships. The sample included patients who visited any clinic site of a FQHC in the southern part of Mississippi and qualified for the Health Care for the Homeless (HCH) Program. Assessments included the Patient Health Questionnaire (PHQ-9), the DUKE Health Profile, and a checklist of stressors. Results of the multivariate analysis using structural equation modeling revealed that ambulation difficulties were related to depressive symptoms directly and indirectly through social activities. SES-related stressors were related to depressive symptoms directly and indirectly through self-esteem and social activities. Relational and legal/police-related stressors were linked to depressive symptoms only through self-esteem. These results indicate the importance of integrated community healthcare services to address the physical, social, and mental healthcare needs of the homeless population.

참고문헌 (61)

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