Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): a 12 month mixed methods pilot study.
Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): a 12 month mixed methods pilot study.
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DOI：
10.1186/s12888-018-1818-4
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发表时间：
2018-08-03
期刊：
影响因子：
4.4
通讯作者：
De Silva M
中科院分区：
文献类型：
--
作者：
Asher L;Hanlon C;Birhane R;Habtamu A;Eaton J;Weiss HA;Patel V;Fekadu A;De Silva M
基于社区的康复（CBR），或基于社区的包容性发展，是一种解决低收入和中等收入国家精神分裂症患者复杂的健康，社会和经济需求的方法。以前进行了形成性工作，为埃塞俄比亚的精神分裂症患者设计文化上适当的CBR干预措施。目前的研究探讨了CBR在实践中的可接受性和可行性，以及CBR如何改善精神分裂症患者的功能。这项混合方法试点研究于2014年12月至2015年12月在埃塞俄比亚农村地区进行。10名对单独药物治疗无反应的精神分裂症患者及其护理人员参加了CBR。社区康复由非专业工作人员领导，他们接受了五周的培训，并进行家访（教育、家庭干预和支持重返工作岗位）和社区动员。变革理论被用来指导试点评估。在基线、6个月和12个月时收集定性和定量数据。对31名精神分裂症患者、护理人员、社区康复工作者、主管、卫生官员和社区成员进行了40次深入采访和2次焦点小组讨论。RISE CBR干预措施可能通过加强家庭支持、改善获得医疗保健的机会、增加收入和提高自尊等途径对功能产生积极影响。社区康复工作者、社区领袖和卫生官员都可以接受社区康复。一些CBR工作人员发现，接受精神分裂症患者的选择是一项挑战。这些问题被认为可以通过对社区康复工作人员的补充培训来解决。干预措施是可行的，但需要在更大范围内进行进一步评估。在低收入和中等收入国家，社区康复可能是一种可接受的和可行的辅助方法，以设施为基础的照顾精神分裂症患者。然而，贫困和无法获得抗精神病药物等背景因素仍然是重大挑战。有迹象表明，CBR可以影响功能，但RISE试验将确定有效性。本文的在线版本（10.1186/s12888-018-1818-4）包含补充材料，可供授权用户使用。
Community-based rehabilitation (CBR), or community-based inclusive development, is an approach to address the complex health, social and economic needs of people with schizophrenia in low and middle-income countries. Formative work was undertaken previously to design a culturally appropriate CBR intervention for people with schizophrenia in Ethiopia. The current study explored the acceptability and feasibility of CBR in practice, as well as how CBR may improve functioning among people with schizophrenia. This mixed methods pilot study took place in rural Ethiopia between December 2014 and December 2015. Ten people with schizophrenia who were unresponsive to treatment with medication alone, and their caregivers, participated in CBR. CBR was led by lay workers with five weeks training and involved home visits (education, family intervention and support returning to work) and community mobilisation. Theory of change was used to guide the pilot evaluation. Qualitative and quantitative data were collected at baseline, six months and 12 months. Forty in-depth interviews and two focus group discussions were conducted with 31 individuals comprising people with schizophrenia, caregivers, CBR workers, supervisors, health officers and community members. The RISE CBR intervention may have a positive impact on functioning through the pathways of enhanced family support, improved access to health care, increased income and improved self-esteem. CBR was acceptable to CBR workers, community leaders and health officers. Some CBR workers found it challenging to accept the choices of people with schizophrenia. These concerns were felt to be resolvable with supplementary training for CBR workers. The intervention was feasible but further evaluation is needed on a larger scale. In low and middle-income countries, CBR may be an acceptable and feasible adjuvant approach to facility-based care for people with schizophrenia. However, contextual factors, including poverty and inaccessible anti-psychotic medication, remain substantial challenges. There were indications that CBR can impact on functioning but the RISE trial will determine effectiveness. The online version of this article (10.1186/s12888-018-1818-4) contains supplementary material, which is available to authorized users.
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DOI：
10.1136/bmj.h1258
发表时间：
2015-03-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moore GF;Audrey S;Barker M;Bond L;Bonell C;Hardeman W;Moore L;O'Cathain A;Tinati T;Wight D;Baird J
通讯作者：
Baird J
影响因子：
2.8
作者：
Balaji M;Chatterjee S;Koschorke M;Rangaswamy T;Chavan A;Dabholkar H;Dakshin L;Kumar P;John S;Thornicroft G;Patel V
通讯作者：
Patel V
影响因子：
4.4
作者：
Brooke-Sumner C;Petersen I;Asher L;Mall S;Egbe CO;Lund C
通讯作者：
Lund C
埃塞俄比亚农村严重精神障碍患者的概念化和情境化功能：一项定性研究。
影响因子：
4.4
作者：
Habtamu K;Alem A;Hanlon C
通讯作者：
Hanlon C
影响因子：
--
作者：
Pankhurst, A;Mariam, D H
通讯作者：
Mariam, D H