The Effectiveness of a Multi-Pronged Psycho-Social Intervention Among People With Mental Health and Epilepsy Problems - A Pre-Post Prospective Cohort Study Set in North India
- سال انتشار: 1400
- محل انتشار: مجله بین المللی سیاست و مدیریت بهداشت، دوره: 10، شماره: 9
- کد COI اختصاصی: JR_HPM-10-9_003
- زبان مقاله: انگلیسی
- تعداد مشاهده: 41
نویسندگان
Herbertpur Christian Hospital, Emmanuel Hospital Association, Uttarakhand, India
Northland District Health Board, Whangarei, New Zealand
Herbertpur Christian Hospital, Emmanuel Hospital Association, Uttarakhand, India
Dr. RML Hospital and Post Graduate Institute of Medical Education & Research (PGIMER), New Delhi, India
Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
چکیده
BackgroundIn low- and middle-income settings, many people with mental health problems cannot or do not access psychiatric services. Few studies of people with epilepsy and mental problems have evaluated the effectiveness of a predominantly psycho-social intervention, delivered by lay community workers. The aim of this study was to assess the effectiveness of a community-based complex mental health intervention within informal urban communities while simultaneously addressing social determinants of mental health among disadvantaged people with severe and common mental disorders (CMDs), and epilepsy. MethodsIn this observational, prospective cohort study set in Uttarakhand, India, the lay-worker led intervention included psychoeducation, behavioural activation, facilitation of access to care, and facilitated psycho-social support groups. Participants were categorised as having a severe or CMD or epilepsy and assessed ۵ times over ۲۴ months using primary outcome measures, including the Patient Health Questionnaire (PHQ۹) (severity of depression), the World Health Organization Disability Assessment Schedule (WHODAS ۲.۰), the Recovery Star, and scoring of a bespoke Engagement Index. Analysis included descriptive statistics as well as hierarchical linear regression models to report fixed effects as regression coefficients. ResultsAmong the ۲۹۷ (baseline) participants only ۹۶ people (۳۱%) regularly used psychotropic medication (at least ۴ weeks) and over ۶۰% could not or did not consult a psychiatrist at all in the study period. Nonetheless, people with CMDs showed a significant reduction in their depression severity (PHQ۹: B = -۶.۹۴, ۹۵% CI -۷.۳۷ to -۶.۵۱), while people with severe mental disorders (SMDs) showed a significant reduction in their disability score (WHODAS ۲.۰: B = -۴.۸۶, ۹۵% CI - ۷.۱۴ to- ۲.۵۷). People with epilepsy also reduced their disability score (WHODAS ۲.۰: B = -۵.۲۲, ۹۵% CI -۷.۲۹ to -۳.۱۵). ConclusionThis study shows significant improvements in mental health, depression, recovery, disability and social engagement for people with common and SMDs, and epilepsy, through a community-based intervention that was nonpharmaceutical. It provides preliminary evidence of the value of predominantly psycho-social interventions implemented by lay health workers among people with limited or no access to psychiatric services.کلیدواژه ها
Psychosocial, India, Mental Health, Intervention, Epilepsyاطلاعات بیشتر در مورد COI
COI مخفف عبارت CIVILICA Object Identifier به معنی شناسه سیویلیکا برای اسناد است. COI کدی است که مطابق محل انتشار، به مقالات کنفرانسها و ژورنالهای داخل کشور به هنگام نمایه سازی بر روی پایگاه استنادی سیویلیکا اختصاص می یابد.
کد COI به مفهوم کد ملی اسناد نمایه شده در سیویلیکا است و کدی یکتا و ثابت است و به همین دلیل همواره قابلیت استناد و پیگیری دارد.