Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review.
Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review.
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DOI：
10.1192/bjp.bp.114.158899
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Szczepura A
中科院分区：
文献类型：
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作者：
Bhui KS;Aslam RW;Palinski A;McCabe R;Johnson MR;Weich S;Singh SP;Knapp M;Ardino V;Szczepura A
背景沟通可能是获得、参与和受益于精神病服务的不平等的一个有影响力的决定因素。旨在审查旨在改善黑人和少数民族患者与精神病服务提供者之间治疗沟通的干预措施的证据。方法系统评价和证据综合（PROSPERO注册号：CRD 42011001661）。数据来源包括已发表的文献和“灰色”文献。对专家的调查以及与患者和护理人员的协商都有助于证据的综合、解释和建议。结果共纳入21篇文献。这些试验主要显示了抑郁症状，护理经验，知识，耻辱，坚持处方药物，洞察力和联盟的好处。质量较好的试验（范围为0.18-0.75 d）的效应量小于中等或较低质量的研究（范围为0.18-4.3 d）。审查发现只有两项研究提供了薄弱的经济证据。结论文化适应的心理治疗，民族志和动机评估导致心理治疗是有效的，病人和照顾者的青睐。需要在英国和美国以外进行进一步的试验，以及对常规精神病护理实践的经济评估和研究。
Background Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services. Aims To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services. Method Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the ‘grey’ literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations. Results Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18–0.75) than for moderate- or lower-quality studies (range of d 0.18–4.3). The review found only two studies offering weak economic evidence. Conclusions Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.