School-based group interpersonal therapy for adolescents with depression in rural Nepal: a mixed methods study exploring feasibility, acceptability, and cost.
School-based group interpersonal therapy for adolescents with depression in rural Nepal: a mixed methods study exploring feasibility, acceptability, and cost.
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DOI：
10.1017/gmh.2022.46
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Luitel, Nagendra P.
中科院分区：
文献类型：
--
作者：
Rose-Clarkel, Kelly;Prakash, B. K.;Magar, Jananee;Pradhan, Indira;Shrestha, Pragya;Hassan, Eliz;Abou Jaoude, Gerard J.;Haghparast-Bidgoli, Hassan;Devakumar, Delan;Carrino, Ludovico;Floridi, Ginevra;Kohrt, Brandon A.;Verdeli, Helen;Clougherty, Kathleen;Rafaeli, Alexandra Klein;Jordans, Mark;Luitel, Nagendra P.
患有抑郁症的青少年需要获得与文化相关的心理治疗。在许多低收入和中等收入国家，只有少数人才能获得治疗。我们将针对青少年的团体人际治疗(IPT)改为通过尼泊尔的学校进行。在这里，我们报告了IPT的可行性、可接受性和成本。我们招募了32名男孩和30名女孩(年龄13-19岁)，他们的抑郁症筛查呈阳性。IPT由两次个人会议和12次小组会议组成，由护士或非专业人员主持。采用前后设计，我们在基线、治疗后(IPT后0-2周)和随访(IPT后8-10周)对青少年进行评估。我们用抑郁自评量表(DSRs)测量抑郁症状，并用当地工具测量功能障碍。为了评估干预忠诚度，主管使用标准化的核对表，在27/90个课程中对辅导员的IPT技能进行了评级。我们对干预后的16名青少年和6名辅导员进行了定性访谈，并从提供者的角度进行了基于活动的成本分析。青少年参加了82.3%的小组会议(标准差18.9)。所有人都接受了随访。抑郁和功能损害在基线和随访期间有所改善：DSRs评分下降了81%(95%可信区间70-95)；功能障碍下降了288%(249-351)。总体而言，95.3%的辅导员IPT技能被评为优秀/满意。青少年认为这种干预是有用的，也是可以接受的，尽管一些人担心学校里的隐私。在主持人满负荷运作的情况下，干预单位费用估计为96.9美元。在尼泊尔，以学校为基础的团体IPT是可行和可接受的。研究结果支持进行随机对照试验，以评估有效性和成本效益。
Adolescents with depression need access to culturally relevant psychological treatment. In many low- and middle-income countries treatments are only accessible to a minority. We adapted group interpersonal therapy (IPT) for adolescents to be delivered through schools in Nepal. Here we report IPT's feasibility, acceptability, and cost. We recruited 32 boys and 30 girls (aged 13–19) who screened positive for depression. IPT comprised of two individual and 12 group sessions facilitated by nurses or lay workers. Using a pre-post design we assessed adolescents at baseline, post-treatment (0–2 weeks after IPT), and follow-up (8–10 weeks after IPT). We measured depressive symptoms with the Depression Self-Rating Scale (DSRS), and functional impairment with a local tool. To assess intervention fidelity supervisors rated facilitators' IPT skills across 27/90 sessions using a standardised checklist. We conducted qualitative interviews with 16 adolescents and six facilitators post-intervention, and an activity-based cost analysis from the provider perspective. Adolescents attended 82.3% (standard deviation 18.9) of group sessions. All were followed up. Depression and functional impairment improved between baseline and follow-up: DSRS score decreased by 81% (95% confidence interval 70–95); functional impairment decreased by 288% (249–351). In total, 95.3% of facilitator IPT skills were rated superior/satisfactory. Adolescents found the intervention useful and acceptable, although some had concerns about privacy in schools. The estimate of intervention unit cost was US $96.9 with facilitators operating at capacity. School-based group IPT is feasible and acceptable in Nepal. Findings support progression to a randomised controlled trial to assess effectiveness and cost-effectiveness.
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DOI：
10.1080/17542863.2016.1226372
发表时间：
2016
影响因子：
--
作者：
Burkey MD;Ghimire L;Adhikari RP;Kohrt BA;Jordans MJ;Haroz E;Wissow L
通讯作者：
Wissow L
DOI：
10.2190/3ycx-h0mt-49dk-c61q
发表时间：
2006-01-01
影响因子：
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