Strategies for supporting the implementation of a task-shared psychological intervention in South Africa's chronic disease services: qualitative insights from health managers' experiences of project MIND.
Strategies for supporting the implementation of a task-shared psychological intervention in South Africa's chronic disease services: qualitative insights from health managers' experiences of project MIND.
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DOI：
10.1080/16549716.2022.2123005
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发表时间：
2022-12-31
影响因子：
2.6
通讯作者：
Myers, Bronwyn
中科院分区：
文献类型：
--
作者：
Brooke-Sumner, Carrie;Petersen-Williams, Petal;Sorsdahl, Katherine;Kruger, James;Mahomed, Hassan;Myers, Bronwyn
关键词：
虽然有证据表明，任务分担的心理干预措施可以减少资源有限的环境中的心理健康治疗差距，系统性障碍限制了其广泛实施。关于如何维持和扩大这种做法的证据很少。本研究通过研究参与实施MIND项目任务分担咨询服务的南非卫生管理人员的经验来应对这一差距。定性描述管理人员实施MIND方案的经验及其对支持持续实施的潜在战略的见解。两个焦点小组讨论（FGD）和八个深入访谈（IDIS）进行了西开普省的城市和农村初级保健设施的管理人员。所有管理人员均为女性，年龄在30 - 50岁之间。FGD和IDIs使用了相同的半结构化主题指南，以探索MIND方案的经验和持续实施的感知障碍。规范化过程理论（NPT）指导的专题分析。出现了四个与《不扩散条约》构想相对应的主题。首先，管理人员指出，他们与工作人员开展关系工作，促进对干预措施的支持，减少阻力，是促进实施的关键。第二，管理人员强调，工作人员需要重新定位和提高技能，以促进对心理健康实践的开放，并有足够的时间进行高质量的咨询。第三，管理人员强调必须加强保健和社会服务部门之间的联系，以促进提供全面的精神保健服务。最后，管理人员建议持续监测服务并宣传其影响，作为支持纳入日常做法的战略。调查结果有助于新兴的文献战略，以支持在低收入和中等收入国家实施任务分担的干预措施。调查结果突出了管理人员在确定和采取行动这些战略的领导作用。投资于管理人员支持实施心理干预措施的能力，对于扩大这些心理健康创新至关重要。
Although evidence indicates that task-shared psychological interventions can reduce mental health treatment gaps in resource-constrained settings, systemic barriers have limited their widespread implementation. Evidence on how to sustain and scale such approaches is scant. This study responds to this gap by examining the experiences of South African health managers involved in the implementation of a task-shared counselling service for Project MIND. To qualitatively describe managers’ experiences of implementing the MIND programme and their insights into potential strategies for supporting sustained implementation. Two focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted with managers of urban and rural primary care facilities in the Western Cape province. All managers were female and 30–50 years old. FGDs and IDIs used an identical semi-structured topic guide to explore the experiences of the MIND programme and perceived barriers to sustained implementation. Normalisation process theory (NPT) guided the thematic analysis. Four themes emerged that mapped onto the NPT constructs. First, managers noted that their relational work with staff to promote support for the intervention and reduce resistance was key to facilitating implementation. Second, managers emphasised the need for staff reorientation and upskilling to foster openness to mental health practice and for adequate time for quality counselling. Third, managers underscored the importance of strengthening linkages between the health and social service sectors to facilitate delivery of comprehensive mental health services. Finally, managers recommended ongoing monitoring of the service and communication about its impacts as strategies for supporting integration into routine practice. Findings contribute to the emerging literature on strategies to support implementation of task-shared interventions in low- and middle-income countries. The findings highlight the leadership role of managers in identifying and actioning these strategies. Investing in managers’ capacity to support implementation of psychological interventions is critical for scale-up of these mental health innovations.
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影响因子：
2.8
作者：
Eyles J;Harris B;Fried J;Govender V;Munyewende P
通讯作者：
Munyewende P
影响因子：
3.2
作者：
Brooke-Sumner, Carrie;Petersen-Williams, Petal;Myers, Bronwyn
通讯作者：
Myers, Bronwyn
影响因子：
3.2
作者：
Ameh S;Klipstein-Grobusch K;D'ambruoso L;Kahn K;Tollman SM;Gómez-Olivé FX
通讯作者：
Gómez-Olivé FX
DOI：
10.3390/ijerph182111403
发表时间：
2021-10-29
影响因子：
--
作者：
Myers B;Browne FA;Carney T;Kline T;Bonner CP;Wechsberg WM
通讯作者：
Wechsberg WM
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S