在医疗保健系统环境中开发与心理健康相关的结构性耻辱测量框架:修改后的德尔菲研究
Dristy Gurung1,2, Bhawana Subedi1, Brandon A Kohrt3
1Transcultural Psychosocial Organization Nepal (TPO Nepal), Kathmandu, Nepal.
PloS one
|January 31, 2025
概括
这项研究开发了一个框架来衡量精神卫生保健中的结构性耻辱,解决全球文献差距. 该框架由专家和有实践经验的人提供信息,有助于定义和监测医疗保健系统中的不平等现象.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 卫生公平研究 卫生公平研究
- 污名的测量 污名测量
背景情况:
- 全球关于精神卫生保健中的结构性耻辱的文献有限.
- 结构性耻辱导致负面经历,并减少了有生活经验的人 (PWLEs) 获得优质护理的机会.
- 这项研究探讨了医疗保健系统中测量结构性耻辱的必要性.
研究的目的:
- 探讨在医疗保健机构中测量结构性耻辱的关键组成部分.
- 开发一个基于共识的框架来识别和衡量结构性耻辱.
- 为旨在减少精神卫生保健不平等的干预提供信息.
主要方法:
- 一种经过修改的Delphi方法,涉及三轮与全球专家 (耻辱研究人员,PWLEs,决策者) 的讨论.
- 文献审查以确定初始指标,随后是专家咨询研讨会和在线调查以排名.
- 使用史密斯突出指数和肯德尔一致系数分析共识.
主要成果:
- 在五个核心测量领域内确定结构性耻辱的指标.
- 第三轮每个领域产生了4-5个非常突出的指标,在专家之间建立了共识.
- 专家们对定义,测量障碍和具体指标提供了有价值的反.
结论:
- 开发的框架有助于定义和衡量与心理健康相关的结构性耻辱.
- 它强调了医疗保健结构中的不平等现象,这些不平等现象会对PWLEs产生负面影响.
- 这种概念化,由PWLE和低收入和中等收入国家 (LMICs) 的利益相关者提供信息,有助于全球监测结构性耻辱.
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