在巴西,将抑郁症治疗纳入结核病计划和初级护理中的障碍和促进因素
Annika Claire Sweetland1, Claudio Gruber Mann2, Maria Jose Fernandes3
1Columbia University, New York, NY, USA.
Health promotion practice
|July 21, 2023
概括
将抑郁症治疗纳入结核病护理是可行的. 尽管存在诸如贫困和耻辱等结构性障碍,但卫生工作者和患者对非专业人士进行的人际辅导 (IPC) 培训和交付是容易接受的.
科学领域:
- 公共卫生 公共卫生
- 心理健康服务研究 心理健康服务研究
- 实施科学 实施科学
背景情况:
- 结核病 (TB) 和抑郁症经常同时发生,对结核病治疗结果产生负面影响.
- 世界卫生组织的结核病终结战略强调结核病和心理健康服务的整合.
- 人际辅导 (IPC) 是一种简短的,基于证据的抑郁症治疗,可以由非专家提供.
研究的目的:
- 确定培训非专业提供者在结核病控制和初级保健机构内提供IPC的障碍和促进者.
- 探索将心理健康支持纳入现有医疗保健结构的可行性.
主要方法:
- 使用六个焦点小组与医疗保健专业人员,项目协调员和结核病患者进行定性研究.
- 数据使用开放和演编码与Chaudoir多层框架进行分析.
主要成果:
- 关键障碍包括贫困,有限的治疗机会,政治不稳定,暴力,社会耻辱,以及资源不足的医疗系统和高员工流动.
- 促进者包括对心理健康培训的高需求,强大的社区联系,以及提供者和患者接受IPC.
- 没有发现干预具体障碍或促进因素.
结论:
- 尽管存在重大结构和组织挑战,但通过IPC将抑郁症治疗纳入结核病计划中的初级保健中被认为是可以接受的,可行的和可取的.
- 这些发现支持将心理健康干预措施纳入常规结核病护理途径.
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