Acceptability and fidelity of a psychosocial intervention (PROACTIVE) for older adults with depression in a basic health unit in São Paulo, Brazil: a qualitative study.
Acceptability and fidelity of a psychosocial intervention (PROACTIVE) for older adults with depression in a basic health unit in São Paulo, Brazil: a qualitative study.
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DOI：
10.1186/s12889-021-12402-3
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发表时间：
2021-12-14
影响因子：
4.5
通讯作者：
Scazufca M
中科院分区：
文献类型：
--
作者：
Henrique MG;de Paula Couto MCP;Araya R;Mendes AV;Nakamura CA;Hollingworth W;van de Ven P;Peters TJ;Scazufca M
抑郁症是老年人的一种常见疾病，通常在初级保健中被发现和治疗。协作护理模式，包括，例如，任务转移和分步护理方法已被调查，以克服目前缺乏的战略和训练有素的心理健康专业人员来治疗抑郁症。PROACTIVE研究开发了一种心理社会干预措施，该措施主要由非专家提供，广泛使用技术来治疗老年抑郁症。本定性研究的目的是评估：1。卫生工作者对干预方案的忠诚度; 2.从老年参与者的角度来看，心理社会干预的可接受性; 3。卫生工作者对心理社会干预的认知。定性方法被用来实现我们的目标。样本包括在试点试验中接受干预的参与者（N = 31）和在巴西圣保罗北方地区基本卫生单位工作的卫生工作者（N = 11）。研究方法包括焦点小组、非参与式观察和结构化访谈。采用专题分析方法对数据进行了分析。1.卫生工作者对干预方案的忠诚：培训、监督和结构化干预是至关重要的，并保证了卫生工作者对方案的忠诚。2.从老年人参与者的角度来看，心理社会干预的可接受性：协作护理，任务转移和分步护理方法得到了很好的接受。干预的结构化协议，包括不同的活动和视频是重要的老年人参与者的遵守3。卫生工作者对心理社会干预的看法：由非心理健康专家并接受3天培训的卫生工作者进行家庭心理社会会议是可行的。培训和监督被认为是至关重要的，以支持卫生工作者之前和期间的干预。技术作为一种工具来组织会议，获取和存储患者数据，呈现多媒体内容，保证对协议的忠实性，并促进团队成员之间的沟通。然而，卫生工作者提到了额外的负担，表明需要调整他们的日常职责。PROACTIVE干预被证明是可行的，并接受卫生工作者和老年人参与者。定性评估表明，应改进培训和监督，以确保遵守方案。为了评估有效性，将进行一项干预的随机对照试验，并增加本定性研究提出的改善措施。本研究支持的初步研究于2018年9月26日在巴西临床试验注册，UTN代码：U1111-1218-6717。在线版本包含补充材料，可通过10.1186/s12889-021-12402-3获得。
Depression is a common condition in older adults, being often detected and treated initially in primary care. Collaborative care models including, for example, task-shifting and stepped-care approaches have been investigated to overcome the current scarcity of strategies and trained mental health professionals to treat depression. The PROACTIVE study developed a psychosocial intervention, which makes extensive use of technology in an intervention delivered mainly by non-specialists to treat older adults with depression. The aim of this qualitative study is to assess: 1. Health workers’ fidelity to the intervention protocol; 2. Acceptability of the psychosocial intervention from the viewpoint of older adult participants; and 3. Perceptions of the psychosocial intervention by the health workers. Qualitative methods were used to achieve our aims. The sample included participants (N = 31) receiving the intervention in the pilot trial and health workers (N = 11) working in a Basic Health Unit in the northern area of São Paulo, Brazil. Focus group, non-participant observation and structured interviews were used. Data were analysed using a thematic analysis approach. 1. Health workers’ fidelity to the intervention protocol: training, supervision and the structured intervention were crucial and guaranteed health workers’ fidelity to the protocol. 2. Acceptability of the psychosocial intervention from the viewpoint of older adult participants: Collaborative care, task-shifting, and stepped-care approaches were well accepted. The structured protocol of the intervention including different activities and videos was important to adherence of older adult participants 3. Perceptions of the psychosocial intervention by the health workers: It was feasible to have the home psychosocial sessions conducted by health workers, who are non-mental health specialists and received 3-day training. Training and supervision were perceived as crucial to support health workers before and during the intervention. Technology served as a tool to structure the sessions, obtain and store patient data, present multi-media content, guarantee fidelity to the protocol and facilitate communication among members of the team. However, extra burden was mentioned by the health workers indicating the need of adjustments in their daily duties. The PROACTIVE intervention was demonstrated to be feasible and accepted by both health workers and older adult participants. The qualitative assessments suggested improvements in training and supervision to ensure fidelity to protocol. To assess effectiveness a randomised controlled trial of the intervention will be conducted with the addition of improvements suggested by this qualitative study. The pilot study of which the present study gives support to was registered at the Brazilian Clinical Trials, UTN code: U1111-1218-6717 on 26/09/2018. The online version contains supplementary material available at 10.1186/s12889-021-12402-3.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
3.8
作者：
Acharya, Bibhav;Ekstrand, Maria;Chwastiak, Lydia A.
通讯作者：
Chwastiak, Lydia A.
影响因子：
6.9
作者：
Levav, I;Kohn, R;Sartorius, N
通讯作者：
Sartorius, N
影响因子：
4.4
作者：
Matsuzaka CT;Wainberg M;Norcini Pala A;Hoffmann EV;Coimbra BM;Braga RF;Sweetland AC;Mello MF
通讯作者：
Mello MF
DOI：
10.2471/blt.12.104133
发表时间：
2012-11-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Buttorff, Christine;Hock, Rebecca S;Patel, Vikram
通讯作者：
Patel, Vikram