Evaluating clinical outcomes of routinely delivered task-shared care for depression in rural Haiti.
Evaluating clinical outcomes of routinely delivered task-shared care for depression in rural Haiti.
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DOI：
10.1017/gmh.2021.17
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Raviola G
中科院分区：
文献类型：
--
作者：
Rose AL;McBain R;Wilson J;Coleman SF;Mathieu E;Fils-Aimé JR;Affricot E;Thérosmé T;Dubuisson W;Eustache E;Smith SL;Raviola G
越来越多的文献支持在全球资源有限的环境中任务分担心理健康干预措施的有效性。然而，尽管有证据表明研究中的效果比实际护理更大，但关于常规护理中此类干预措施的影响的文献却很少。在本文中，我们研究了 2010 年地震后国际医疗保健组织 Partners In Health 与海地卫生部合作在海地农村建立的任务分担精神卫生系统中常规抑郁症护理的临床结果。对于 2016 年 1 月至 2019 年 12 月期间寻求抑郁症护理的患者，我们进行了混合效应纵向回归，以量化抑郁症就诊剂量对症状的影响，并结合相互作用效应来检查基线严重程度和剂量之间的关系。 306 名患者就诊 2052 次。控制性别、年龄和治疗天数后，每次就诊与抑郁评分平均降低 1.11（范围 0-39）相关（95% CI -1.478 至 -0.91；p < 0.001）。症状更严重的患者随着就诊次数的增加而获得更大的改善（p = 0.04）。对于中度症状的患者，心理治疗的频率较低，药物治疗的频率高于预期。我们的研究结果支持在低收入和中等收入国家扩大常规精神卫生服务的潜在积极影响，尽管服务提供的差异大于预期，并且了解在资源有限的环境中发生的潜在护理障碍和促进因素的重要性。
There is a growing literature in support of the effectiveness of task-shared mental health interventions in resource-limited settings globally. However, despite evidence that effect sizes are greater in research studies than actual care, the literature is sparse on the impact of such interventions as delivered in routine care. In this paper, we examine the clinical outcomes of routine depression care in a task-shared mental health system established in rural Haiti by the international health care organization Partners In Health, in collaboration with the Haitian Ministry of Health, following the 2010 earthquake. For patients seeking depression care betw|een January 2016 and December 2019, we conducted mixed-effects longitudinal regression to quantify the effect of depression visit dose on symptoms, incorporating interaction effects to examine the relationship between baseline severity and dose. 306 patients attended 2052 visits. Each visit was associated with an average reduction of 1.11 in depression score (range 0–39), controlling for sex, age, and days in treatment (95% CI −1.478 to −0.91; p < 0.001). Patients with more severe symptoms experienced greater improvement as a function of visits (p = 0.04). Psychotherapy was provided less frequently and medication more often than expected for patients with moderate symptoms. Our findings support the potential positive impact of scaling up routine mental health services in low- and middle-income countries, despite greater than expected variability in service provision, as well as the importance of understanding potential barriers and facilitators to care as they occur in resource-limited settings.
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影响因子：
2.9
作者：
Rathod SD;Roberts T;Medhin G;Murhar V;Samudre S;Luitel NP;Selohilwe O;Ssebunnya J;Jordans MJD;Bhana A;Petersen I;Kigozi F;Nakku J;Lund C;Fekadu A;Shidhaye R
通讯作者：
Shidhaye R
针对社区住宅抑郁症韩国妇女的文化量身定制的治疗干预计划的功效：一项非随机的准实验设计研究。
影响因子：
2.3
作者：
Bernstein K;Park SY;Hahm S;Lee YN;Seo JY;Nokes KM
通讯作者：
Nokes KM
DOI：
10.1097/wtf.0000000000000070
发表时间：
2014-12
期刊：
Intervention (Amstelveen, Netherlands)
影响因子：
--
作者：
Murray LK;Tol W;Jordans M;Zangana GS;Amin AM;Bolton P;Bass J;Bonilla-Escobar FJ;Thornicroft G
通讯作者：
Thornicroft G
影响因子：
2.3
作者：
Clouse, Kristen M.;Williams, Kimberly A.;Harmon, Jane M.
通讯作者：
Harmon, Jane M.
影响因子：
1.6
作者：
Flett, GL;Vredenburg, K;Krames, L
通讯作者：
Krames, L