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Introduction
This project is concerned with the quality of life and health of Japanese people who live in Australia. The study is conducted by the Centre for Mental Health Research (formerly the NHMRC Psychiatric Epidemiology Research Centre) which is located at The Australian National University. Dr. Koichi Takada, a Visiting Fellow from the WHO Collaborating Centre for Research and Training in Mental Health at the Department of Neuropsychiatry, Nagasaki University, School of Medicine, Japan, is responsible to this project.
Aims
The aims of the research are to examine the quality of life and physical/mental health in adult Japanese living in Australia. People who live overseas are generally considered to have more stressors and risks of health problems than people in their home country. We want to find out how various factors (such as education, occupation, reasons for coming to Australia, duration of stay, support from friends and family) influence people's quality of life and health, especially mental health.
The Study
This study (QMJA) is the first population-based mental health survey in the Japanese community in Australia. It covers self-reported perceptions of quality of life, mental health status, culture shock and acculturation, prevalence of psychiatric symptoms, mental health literacy, and attitudes towards and utilisation of mental health resources.
Subjects and Definition
Study subjects were randomly selected by the following method from the Japanese general population in Sydney and Melbourne. Respondents had to be 18 years old or over. In this study 'Japanese' refers to either permanent or temporary residents of Australia who had their origin in Japan or had been born in Australia, regardless of their legal nationality or place of birth. Those who had difficulty in reading Japanese language were excluded.
Method
Sampling See a Poster Presentation?
In 1999 a method for locating Japanese people living in Australia was developed using an electronic residential telephone directory together with a database of surnames based on a large study conducted in Tokyo. This study identified approximately 50,000 different surnames with the commonest 1,000 accounting for 72% of the population. Paying careful attention to homonyms, these 1,000 surnames were transliterated into the Roman alphabet and classified into 889 categories - the Japanese Surname List (JSL). Using the full JSL, 887 households with Japanese sounding surnames were identified in Melbourne. In Sydney, 1,278 were identified using the 222 commonest surnames in the JSL that constitute 50% of the population. Only 39 (3.0%) of all those approached were not Japanese. Although this method has not yet been fully validated, the very low proportion of false positives (non-Japanese with Japanese names) and concordance with certain census data, suggest it is a pragmatic method of likely high veracity.
Questionnaires
A set of questionnaires was mailed to potential respondents with pre-paid return envelopes. This 24-page questionnaire includes WHOQOL-BREF, the GHQ-12, Culture Shock Questionnaire, Social Support Questionnaire, AUDIT, Mental Health Literacy Questionnaire, Acculturation and Settlement Questionnaire (ASQ), Questionnaire for Identification of Depressive Symptoms (QuIDS), Stressors, Coping, Utilisation of Resources Questionnaire (ScoUR). All of them were written in Japanese or translated into Japanese under appropriate permission. See About Copyright
Pilot Study in Sydney
To test the feasibility of this identification method and to determine an appropriate length for questionnaires, a pilot study was conducted in Sydney of 414 randomly selected households from the 1,278 identified as having Japanese sounding surnames. This was followed by a larger study of all 887 households identified in Melbourne. In the Sydney pilot study participants were divided into three groups to compare response rates across 8-, 16-, and 24-page questionnaires. With reminders, an overall response rate of 35.5% was achieved. Response rates of 38.5%, 32.6% and 35.5% for each length of questionnaire respectively were not significantly different and contrasted with response rates of around 15% for similar surveys in Japan. As 30% of surveys were undeliverable, addresses of participants in the Melbourne study whose questionnaires were also undeliverable were confirmed by telephone.
Melbourne Study
A larger QMJA study in Melbourne used the 24-page version of the questionnaire which included a full range of mental health, quality of life and cultural items. As stated above, a total of 887 households were identified in Melbourne. The response rate was 38.1% after reminders. Further results are due for publication in 2001.