**3. Results**

Descriptive statistics of all respondents are shown in Table 1, as well as the proportion of respondents reporting at least 'slight' problems within each of the five dimensions of the EQ–5D–5L. Dimensions four (pain/discomfort) and five (anxiety/depression) were the two dimensions with the highest number of respondents reporting problems (over half in each dimension). Respondents with higher levels of post-migration stress reported problems in each of the five dimensions more frequently and had lower index scores. This occurred for all post-migration stressors. Furthermore, there was a clear dose-response pattern for each stressor. The high stress group reported more problems and had a lower mean index score than the medium stress group, which had more problems/a lower index score than the low stress group.

Table 2 presents unadjusted and adjusted logistic models of each dimension of the EQ–5D–5L regressed on post-migration stressors, controlling for pre- and peri-migration

stress and sociodemographic variables. There was strong and consistent evidence in both the unadjusted and partially adjusted models that all post-migration stressors were associated with increased odds of reporting problems in all five dimensions of the EQ–5D–5L, with the exception of discrimination. In general, there were small to moderate attenuations of the ORs after controlling for sociodemographic variables, indicating that the confounding by these variables was not substantial. In the fully adjusted models with all post-migration stressors included together with pre- and peri-migration stress, the evidence for associations changed notably. Self-care (dimension 2) was no longer associated with any of the post-migration stressors, and the associations between competency strain and the EQ–5D–5L dimensions were markedly attenuated or no longer significant. A similar attenuation pattern was seen for social strain, though the association between social strain and dimension 4 (pain/discomfort) and 5 (anxiety/depression) remained highly significant. The strongest evidence was found for financial strain, which was strongly associated with all EQ–5D–5L dimensions except for self-care, with the odds of experiencing problems three- to fourfold higher in the high financial strain group compared to the low strain group (all *p*-values < 0.001).

In Table 3, unadjusted and adjusted linear regression models of the EQ–5D–5L index score are presented. There was strong evidence in both unadjusted and partly adjusted models that all four post-migration stressors were associated with a lower index score and there were clear dose-response patterns. When comparing standardized regression coefficients in partly adjusted models, financial strain and social strain were the two stressors associated with the greatest change in the standardized index score. In the fully adjusted model, there was very strong evidence that respondents reporting the highest level of financial and social strain had lower index scores compared to the lowest strain groups, with the standardized regression coefficient for financial strain much larger than that for social strain (*β* = −0.296 vs. *β* = −0.166, respectively). There was also evidence that respondents in the medium strain group for these two stressors had lower index scores compared to the low strain group, though the evidence was weaker. Respondents reporting high levels of competency strain and discrimination had lower index scores compared to their respective reference categories, though the standardized regression coefficients were notably smaller than for financial strain (*β* = competency strain = −0.108; *β* = discrimination = −0.094) and we found no evidence for an association for the medium strain group. Lastly, high exposure to potentially traumatic experiences before or during flight was associated with a lower HRQoL index score at the *p* < 0.01 level.

=




**Table 2.** Unadjusted and adjusted logistic regression models of having problems in domain-specific EQ–5D–5L.

*IJERPH* **2022**, *19*, 2509


= 'no problem' (code = 0); OR = odds ratio. Reference category = low strain. PTE = potentially traumatic experiences; bold indicates statistically significant

association at the *p* < 0.05 level; Med = medium.

**Table 2.** *Cont.*


**Table 3.** Unadjusted and adjusted linear regression models of EQ−5L−5D index score based on Swedish time trade-off value sets.

≥0.40 *−***0.066 (***−***0.088–***−***0.045)** *−***0.030 (***−***0.050–***−***0.009)** † Model 1 = univariate linear regression (i.e., models included only one predictor variable); ‡ Model 2 = multivariate linear regression, each post-migration stressor adjusted for gender, age, education, civil status and immigration year, but not the other post-migration stressors; § Model 3 = multivariate linear regression, all four post-migration stressors and gender, age, education, civil status and immigration year in same model; † R squared for the fully adjusted model = 0.28; PTE = potentially traumatic experiences. B = unstandardized regression coefficient. Reference categories: low (post-migration stressors), male (gender), 18–29 (age), 0–9 years (education), married (civil status), 2008–2011 (immigration year), <0.20 (PTE adversity ratio); bold indicates statistically significant association at the *p* < 0.05 level.
