Traditional healers working with primary care and mental health for early intervention in psychosis in young persons: protocol for the feasibility cluster randomised controlled trial.
Traditional healers working with primary care and mental health for early intervention in psychosis in young persons: protocol for the feasibility cluster randomised controlled trial.
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DOI：
10.1136/bmjopen-2023-072471
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发表时间：
2023-07-14
期刊：
影响因子：
2.9
通讯作者：
Lewis, Martyn
中科院分区：
文献类型：
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作者：
Farooq, Saeed;Sheikh, Saima;Dikomitis, Lisa;Ul Haq, Mian Mukhtar;Khan, Abdul Jalil;Sanauddin, Noor;Ali, Malik Wajid;Ali, Johar;Khan, Muhammad Firaz;Chaudhry, Imran;Husain, Nusrat;Gul, Muhammad;Irfan, Muhammad;Andrews, Gabrielle;Kaistha, Prachi;Shah, Syed Muhammad Uzair;Azeemi, Ishfaq;Hamid, Shumaila;Minhaz, Aaliya;Mallen, Christian;Lewis, Martyn
关键词：
在低收入/中等收入国家，超过一半的首发精神病患者最初寻求传统和宗教治疗师的治疗，作为他们的第一护理。这导致精神病（DUP）持续时间过长。有必要采取文化上适当的干预措施，让传统和精神治疗师与初级保健医生和精神科医生合作，通过任务转移，及早发现、转诊和治疗首次发作的精神病。为了防止中低收入国家青少年长期DUP的后果，我们的目标是开发和试点测试一种文化上适当和情境定制的干预措施。将利用民族志和定性方法与传统治疗师和护理人员一起开发从事初级保健和精神卫生工作的传统治疗师，以便对年轻人精神病进行早期干预（THE HOPE）。我们将进行随机对照集群可行性试验，并进行嵌套定性研究，以评估研究招募情况和干预措施的可接受性。巴基斯坦白沙瓦地区的93个联邦委员会将按1:1的比例随机分配到干预组（THE HOPE）或常规强化治疗组，并按城市/农村环境分层。将在基线和后续阶段收集可行性结果的数据。将对患者、护理人员、临床医生和政策制定者进行访谈，以确定他们对干预措施的看法。是否进行III期试验的决定将基于预先规定的停-走标准。已获得基尔大学伦理审查小组（编号：MH210177）、开伯尔医科大学伦理审查委员会（编号：DIR/KMU-EB/IG/001005）和巴基斯坦国家生物伦理委员会（编号：MH210177）的伦理批准。4 - 87 / NBC-840/22/621)。“希望”可行性试验的结果将在同行评议的期刊和学术会议上报告，并分发给当地的利益攸关方和决策者。ISRCTN75347421。
In low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional and spiritual healers to work collaboratively with primary care practitioners and psychiatrists through task-shifting for early detection, referral and treatment of first episode of psychosis. To prevent the consequences of long DUP in adolescents in LMICs, we aim to develop and pilot test a culturally appropriate and context-bespoke intervention. Traditional HEalers working with primary care and mental Health for early interventiOn in Psychosis in young pErsons (THE HOPE) will be developed using ethnographic and qualitative methods with traditional healers and caregivers. We will conduct a randomised controlled cluster feasibility trial with a nested qualitative study to assess study recruitment and acceptability of the intervention. Ninety-three union councils in district Peshawar, Pakistan will be randomised and allocated using a 1:1 ratio to either intervention arm (THE HOPE) or enhanced treatment as usual and stratified by urban/rural setting. Data on feasibility outcomes will be collected at baseline and follow-up. Patients, carers, clinicians and policymakers will be interviewed to ascertain their views about the intervention. The decision to proceed to the phase III trial will be based on prespecified stop–go criteria. Ethical approval has been obtained from Keele University Ethical Review Panel (ref: MH210177), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/IG/001005) and National Bioethics Committee Pakistan (ref no. 4-87/NBC-840/22/621). The results of THE HOPE feasibility trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers. ISRCTN75347421.
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