title: Quality of life among immigrants in Swedish immigration detention centres: a cross-sectional questionnaire study.
abstract: BACKGROUND
  Detention of immigrants negatively affects their health and well-being. Quality of life (QOL) is a broad concept incorporating the self-evaluation of one's own health and well-being that can provide an understanding of the health and well-being of immigrant detainees. The aim of this study was to estimate QOL among immigrant detainees in Sweden and to assess its relationship with the services provided in detention centres and with the duration of detention.
  
  
  METHODS
  All immigrants in all five existing Swedish detention centres (N=193) were invited to participate in the study (n=127). In this cross-sectional study, QOL was measured using the WHOQOL-BREF questionnaire, which was administered by the first author. The questionnaire contained four additional questions measuring participants' satisfaction with the services provided in detention. Associations between QOL domain scores and service satisfaction scores were assessed using regression analysis. The Spearman's rank correlation coefficient was calculated to measure the degree of association between the duration of detention and QOL scores.
  
  
  RESULTS
  The mean QOL domain scores (out of 100) were 47.0, 57.5, 41.9, and 60.5 for the environmental, physical, psychological, and social domains, respectively. The level of support detainees received from detention staff was significantly positively associated with detainees' physical (βadjusted 3.93, confidence interval [CI] 0.06-7.80) and psychological (βadjusted 5.72, CI 1.77-9.66) domain scores. There was also significant positive association between detainees' satisfaction with the care they received from detention staff and the domain scores. The general health score in the WHOQOL-BREF was significantly associated with the detainees' ability to understand the Swedish or English languages. Although not statistically significant, a longer duration of detention was negatively correlated with QOL scores.
  
  
  CONCLUSIONS
  Immigrant detainees report low QOL. Services provided at the centres, especially the support received from detention staff, is positively associated with their QOL. A review of detention guidelines addressing language barriers, staff training, and duration of detention is highly recommended.
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden; soorej.jose@kbh.uu.se.
authors.forename: Soorej J
authors.initials: SJ
authors.lastname: Puthoopparambil
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Bjerneld
authors.affiliation: Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Källestål
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology*; D004777:Environment; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D013548:Sweden; D013997:Time Factors; D055815:Young Adult
keywords: QOL; Sweden; immigrant detainee; immigration detention; quality of life; refused asylum seekers