title: Activity of daily living performance amongst Danish asylum seekers: a cross-sectional study.
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.
  
  
  METHODS
  Forty-three newly arrived asylum seekers aged 20-50 years, from Iran, Afghanistan and Syria, were consecutively included in the study.
  
  
  METHODS
  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 nontortured 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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;
authors.forename: Anne-Le
authors.initials: AL
authors.lastname: Morville
authors.forename: Lena-Karin
authors.initials: LK
authors.lastname: Erlandsson
authors.forename: Mona
authors.initials: M
authors.lastname: Eklund
authors.forename: Bente
authors.initials: B
authors.lastname: Danneskiold-Samsøe
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
authors.forename: Kirstine
authors.initials: K
authors.lastname: Amris
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007492:Iran / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012036:Refugees / Q000523:psychology*; D057566:Self Report; D013593:Syria / Q000208:ethnology; D014104:Torture / Q000523:psychology