人道的な環境における精神保健と心理社会的支援:実践と研究を結びつける
Wietse A Tol1, Corrado Barbui, Ananda Galappatti
1Global Health Initiative, MacMillan Center, Yale University, New Haven, CT 06520-8206, USA. wietse.tol@yale.edu
Lancet (London, England)
|October 20, 2011
まとめ
人道的な環境におけるメンタルヘルスと心理的社会的支援は,多くの場合,国家システム外で行われます. いくつかの介入は,PTSDの成人と内在的な症状を持つ子供にとって有望なことを示していますが,一般的に使用される慣行には厳格な証拠がありません.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 精神科医は精神病を患っている.
- 公衆衛生は公衆衛生である.
背景:
- 精神的健康と心理的社会福祉の介入は,人道的状況において極めて重要です.
- これらの介入のための現在の実践,資金調達,証拠は,包括的なレビューを必要とします.
研究 の 目的:
- 人道的な文脈における精神衛生と心理社会的支援の介入の実践,資金調達,エビデンスベースをリンクする.
- 共同で実施されている介入を特定し,体系的なレビューとメタ分析を通じてその有効性を評価する.
主な方法:
- メンタルヘルスと心理社会的支援活動に関する160件の報告書のレビュー (2007年−2010年)
- 金融トラッキングサービスと債権者報告システム (2007年-2009年) の資金提供データ分析.
- ランダム化制御試験 (RCT) 13件を含む32件の制御試験の体系的レビューとメタ解析.
主要な成果:
- 一般的に報告されている活動には,基本的なカウンセリング,コミュニティサポートの促進,そして子供に優しいスペースが含まれています.
- 7つのRCTのメタ解析は,成人PTSD症状に対する有益な効果を示した (SMD -0.38).
- 6つのRCTのメタアナリシスは,子どもの内在的な症状 (SMD -0.24) に対して有益な効果を示したが,子供のPTSD症状についてはそうではなかった.
結論:
- 最も頻繁に実施されている介入と,強力な科学的根拠を持つ介入の間には,大きなギャップが存在します.
- 人道的な環境で広く使われている精神衛生と心理社会的支援の実践を厳密に評価するために,さらなる研究が必要である.
- 調査結果は,研究努力を実践的な実施と資金調達の優先事項と調和させる必要性を強調しています.
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