世卫组织对有心理困扰的移徙者实施阶梯式心理干预的背景、实施和影响机制。

IF 3.3 2区 医学 Q2 PSYCHIATRY
Global Mental Health Pub Date : 2025-06-09 eCollection Date: 2025-01-01 DOI:10.1017/gmh.2025.10024
Beatrice Compri, Giulia Turrini, Marianna Purgato, Richard Bryant, Paula Cristobal, Josep Maria Haro, Raffael Kalisch, Vincent Lorant, David McDaid, Kerry R McGreevy, Roberto Mediavilla, Michela Nosè, A-La Park, Papoula Petri-Romão, Aurélia Roversi, Marit Sijbrandij, Andrea Tortelli, Anke Witteveen, Corrado Barbui
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引用次数: 0

摘要

由于迁移前、迁移中和迁移后的压力源,移徙者经常经历心理困扰。为了应对这些挑战,开发了可扩展的干预措施,如在压力时期做重要的事情(DWM)和问题管理Plus (PM+)。本研究评估了意大利移民DWM和PM+相结合的阶梯式护理项目,考察了其背景、实施情况和影响机制。遵循医学研究委员会(MRC)框架,在随机对照试验(RCT)的同时进行了混合方法过程评估。通过对干预参与者(n = 10)和利益相关者(n = 10)以及干预提供者焦点小组(n = 8)的个别访谈,收集试验后的定性数据。使用NVivo进行专题分析。文化耻辱和实际障碍影响了参与,而社区领导人则促进了信任和参与。干预措施是可行和可接受的。数字交付改善了一些人的可及性,但对技术素养低或缺乏私人空间的人构成了挑战。阶梯式护理方法支持逐步参与心理健康战略,增强自我保健和情感意识,而提供者关系是维持动机的关键。阶梯式护理模式减轻了患者的心理困扰,效果良好。调查结果强调需要文化敏感性、数字可及性和社区参与来优化移民心理健康支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress.

Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.

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来源期刊
Global Mental Health
Global Mental Health PSYCHIATRY-
自引率
5.10%
发文量
58
审稿时长
25 weeks
期刊介绍: lobal Mental Health (GMH) is an Open Access journal that publishes papers that have a broad application of ‘the global point of view’ of mental health issues. The field of ‘global mental health’ is still emerging, reflecting a movement of advocacy and associated research driven by an agenda to remedy longstanding treatment gaps and disparities in care, access, and capacity. But these efforts and goals are also driving a potential reframing of knowledge in powerful ways, and positioning a new disciplinary approach to mental health. GMH seeks to cultivate and grow this emerging distinct discipline of ‘global mental health’, and the new knowledge and paradigms that should come from it.
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