Impact of the War in Ukraine on the Mental Health of Refugees Residing in Spain

February 23, 2026 updated by: OlgaFil, Institut Investigacio Sanitaria Pere Virgili

Background: Following the outbreak of war in Ukraine on 24 February 2022, thousands of Ukrainians are crossing the borders every day in search of a place that offers them stability and security. Studies have concluded that the war has affected the mental health of Ukrainian refugees and led to the emergence of psycho-emotional disorders.

Hypothesis: The migration process and/or exposure to news related to the war in Ukraine negatively affect the mental health of refugees.

Objectives: To explore the impact on mental health caused by the war in Ukraine on the refugee population residing in the province of Tarragona after the start of the Russian invasion in 2022.

Methodology: Descriptive observational study of a quantitative and qualitative cross-sectional nature with structured surveys and semi-structured interviews. Statistical analysis will be performed using the SPSS programme and the ATLAS.ti programme or similar will be used for data analysis using qualitative methodology.

Expected results: The conditions associated with exposure to war, migration, the search for a home, and the influence of the media on mental health contribute to Ukrainian refugees exhibiting psycho-emotional disturbances and difficulties in adapting to their new location.

Applicability and relevance: The lack of scientific evidence developed in Spain on Ukrainian refugees and the need to raise awareness of this situation, as well as the possibility of contributing to the improvement of social and health policies on migration and the reception of refugees.

Study Overview

Status

Completed

Conditions

Detailed Description

A mixed-methods study will be conducted, combining qualitative methodology through phenomenological analysis and semi-structured interviews with quantitative methodology through structured surveys. The study will be conducted in accordance with the guidelines established by the STROBE (STrenghtening the Reporting of OBservational studies in Epidemiology) statement.

The study will be conducted over a minimum period of three months, which may be extended if it is necessary to expand the sample.

The reference population will be Ukrainian refugees who, due to the start of the Russian invasion of Ukraine in 2022, were forced to flee the country and are currently residing in Spain.

The study population will be Ukrainian refugees who arrived in Spain after the start of the war in Ukraine and are currently residing in the province of Tarragona.

The sample will be selected according to inclusion and exclusion criteria, using non-probability convenience sampling, without dividing participants by gender.

The first part of the study will be conducted through semi-structured interviews with the aim of understanding the experiences of Ukrainian refugees during the war, covering the days leading up to the war, the day it began and the entire period thereafter, as well as the migration process and arrival at their new place of residence. A maximum limit of 10 interviews has been set, although this number may be lower if information saturation is reached.

At the beginning of the interview, the objective of the study will be explained, and participants will be informed that the interview will be recorded in audio format and subsequently transcribed by the principal investigator. Ethical considerations regarding confidentiality will be respected at all times. Informed consent will be signed, and personal data will be coded.

In the second part of the study, structured anonymous surveys will be conducted, with a total of 40 questions divided into 5 sections and lasting approximately 10-15 minutes. The anonymity of the responses will be preserved, and personal identification will not be required to access the survey at any time. The level of anxiety and depression will be assessed using validated scales (PHQ-9 and GAD-7) and the level of adaptation in the host country and exposure to war-related news will be assessed using ad hoc questionnaires.

Analysis: The interview data will be grouped by topics of interest using the ATLAS.ti programme or manually following a process of structuring, categorisation and analysis. The data obtained in the surveys will be analysed using the SPSS programme. Qualitative variables will be described using percentages and quantitative variables using the mean and standard deviation. To determine the relationship between the different variables, the Chi-square test will be applied for qualitative variables and the Student's t-test for quantitative variables. A confidence level of 95% will be assumed, considering a statistical difference between variables p ≤ 0.05 to be significant.

Study Type

Observational

Enrollment (Actual)

123

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Spain
- - Barcelona, Spain
    - IDIAP Jordi Gol

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult
Older Adult

Accepts Healthy Volunteers

Sampling Method

Non-Probability Sample

Study Population

Ukrainian refugees who arrived in Spain after the start of the war in Ukraine and are currently residing in the province of Tarragona.

Description

Inclusion Criteria:

Ukrainian nationals who arrived in Spain following the outbreak of war in Ukraine in February 2022.
Have reached the age of majority before participating in the study.
Have been recognized by the competent Spanish authority as applicants for temporary protection due to the outbreak of war in Ukraine.
Reside in the province of Tarragona at the time of participation in the study.
Have given written consent to participate in the study.

Exclusion Criteria:

Presence of physical or mental limitations that interfere with the person's ability to participate in the study, such as sensory deficits (visual, auditory), disorders related to motor coordination, cognitive disorders, or disorders that hinder language (comprehension and/or speech).
Not having electronic devices (computer, mobile phone, etc.) to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive symptoms Time Frame: Baseline	Depressive symptoms will be assessed using the 9-item Patient Health Questionnaire (PHQ-9). Items are rated on a 4-point Likert scale from 0 to 3, generating a total score between 0 and 27. Higher total scores reflect greater depressive symptom severity.	Baseline
Anxiety symptoms Time Frame: Baseline	The 7-item Generalized Anxiety Disorder scale (GAD-7) is a self-reported measure of anxiety severity. Each item is rated on a 4-point scale from 0 to 3, resulting in a total score ranging from 0 to 21, with higher scores indicating greater anxiety severity.	Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Institut Investigacio Sanitaria Pere Virgili

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2024

Primary Completion (Actual)

February 1, 2025

Study Completion (Actual)

February 1, 2026

Study Registration Dates

First Submitted

February 15, 2026

First Submitted That Met QC Criteria