Lay-delivered talk therapies for adults affected by humanitarian crises in low- and middle-income countries.
Lay-delivered talk therapies for adults affected by humanitarian crises in low- and middle-income countries.
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DOI：
10.1186/s13031-021-00363-8
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发表时间：
2021-04-23
影响因子：
3.6
通讯作者：
Bass JK
中科院分区：
文献类型：
--
作者：
Ryan GK;Bauer A;Endale T;Qureshi O;Doukani A;Cerga-Pashoja A;Brar SK;Eaton J;Bass JK
世界卫生组织（WHO）和联合国难民事务高级专员办事处（UNHCR）于2015年发布的《心理健康差距行动计划人道主义干预指南》（mhGAP-HIG）建议为有常见精神障碍症状的人提供结构化心理干预的简要版本。mhGAP-HIG承认，越来越多的证据表明，这些干预措施可以由非专业人员向中低收入国家受人道主义危机影响的人提供。然而，尚未对这些证据进行系统的审查和综合。本文报告了定性，定量和混合方法的研究评估的实施和/或有效性的谈话疗法的CMD时，由外行工人在LMICs的成年人谁幸存下来，或目前生活在人道主义局势的系统评价的结果。检索了7个电子数据库：MEDLINE、Embase、PsycINFO、PsycEXTRA、Global Health、科克伦图书馆和ClinicalTrials. gov。我们还手工检索了3种学术期刊的目录页、30篇系统评价的参考文献列表和2个精神卫生网络的在线资源目录。将纳入研究的初步列表分发给专题专家进行审查，并对所有纳入的研究进行向后和向前检索。所有标题、摘要和全文都经过独立的双重筛选。质量评估和数据提取由一名审查员进行，并由第二名审查员使用标准化工具进行检查。讨论了任何分歧，并根据需要将其提交给第三位评审员。我们确定了23项独特的研究，并对患者和实施结果数据进行了叙述性综合。对中低收入国家受人道主义危机影响的成年人进行的非专业谈话疗法的有效性的每一次评估都显示出至少对一种CMD，通常是多种CMD的治疗效果。实施研究普遍发现，这些干预措施是可以接受的，适当的和可行的实施，具有良好的保真度手动治疗。虽然结果是有希望的，特别是基于认知行为治疗技术的个人提供的谈话疗法，有一个高度的异质性，在这方面的文献。我们就如何提高这一主题研究的质量和普遍性提出了一些建议，以促进进一步的证据合成。PROSPERO注册号：CRD 42017058287。在线版本包含补充材料，可通过10.1186/s13031-021-00363-8获取。
Published by the World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) in 2015, the mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) recommends brief versions of structured psychological interventions for people experiencing symptoms of common mental disorders (CMDs). mhGAP-HIG acknowledges a growing body of evidence suggesting these interventions can be delivered by lay workers to people affected by humanitarian crises in low- and middle-income countries (LMICs). However, there has not yet been a systematic review and synthesis of this evidence. This paper reports the results of a systematic review of qualitative, quantitative, and mixed-methods studies assessing the implementation and/or effectiveness of talk therapies for CMDs when provided by lay workers in LMICs to adults who have survived or are currently living in humanitarian situations. Seven electronic databases were searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library, and ClinicalTrials.gov. We also hand-searched the contents pages of three academic journals, reference lists of 30 systematic reviews, and online resource directories of two mental health networks. A preliminary list of included studies was circulated to topical experts for review, and all included studies were backward and forward searched. All titles, abstracts, and full-texts were independently double-screened. Quality appraisal and data extraction were carried out by a single reviewer and checked by a second reviewer, using standardised tools. Any disagreements were discussed and referred to a third reviewer as needed. We identified 23 unique studies and carried out a narrative synthesis of patient and implementation outcome data. Every evaluation of the effectiveness of lay-delivered talk therapies for adults affected by humanitarian crises in LMICs showed some treatment effect for at least one CMD, and often multiple CMDs. Implementation research generally found these interventions to be acceptable, appropriate and feasible to implement, with good fidelity to manualised therapies. Although results are promising, particularly for individually-delivered talk therapies based on cognitive behavioural therapy techniques, there is a high degree of heterogeneity in this literature. We make several recommendations on how to improve the quality and generalisability of research on this topic, to facilitate further evidence synthesis. PROSPERO registration number: CRD42017058287. The online version contains supplementary material available at 10.1186/s13031-021-00363-8.
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影响因子：
3.6
作者：
Souza R;Yasuda S;Cristofani S
通讯作者：
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DOI：
10.1016/j.bpobgyn.2013.08.013
发表时间：
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作者：
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