PDF(Pubmed)
Abstract：
BACKGROUND: We piloted the Friendship Bench-an evidence-based, urban-area task sharing intervention for common mental disorders-in rural Zimbabwe. The intervention combines problem solving therapy with income generating activities. This study sought to understand the intervention\'s implementation in terms of acceptability, feasibility, and sustainability as well as local attitudes towards mental wellbeing in rural Zimbabwe.
METHODS: Using four separate semi-structured interview guides, we conducted in-depth interviews (N = 32) with patients (n = 9), village health workers (n = 12), nurses (n = 6), and community leaders (n = 5). We analyzed our data using thematic analysis with a diverse coding team using an integrative deductive-inductive approach.
RESULTS: Five themes emerged: 1) explanatory models for mental illness, 2) clinical workflow and emphasis on documentation, 3) positive feedback about the Friendship Bench, 4) accessibility, and 5) feasibility.
CONCLUSIONS: In its current format, our intervention was acceptable but neither feasible nor sustainable. Sociocultural context is critical in the development of rural task sharing interventions for mental health. We thus recommend a robust pilot and adaptation phase when scaling task sharing interventions in rural sub-Saharan Africa to elevate community voices, leverage existing social structures, and embed interventions as deeply into communities as possible.
METHODS: Using four separate semi-structured interview guides, we conducted in-depth interviews (N = 32) with patients (n = 9), village health workers (n = 12), nurses (n = 6), and community leaders (n = 5). We analyzed our data using thematic analysis with a diverse coding team using an integrative deductive-inductive approach.
RESULTS: Five themes emerged: 1) explanatory models for mental illness, 2) clinical workflow and emphasis on documentation, 3) positive feedback about the Friendship Bench, 4) accessibility, and 5) feasibility.
CONCLUSIONS: In its current format, our intervention was acceptable but neither feasible nor sustainable. Sociocultural context is critical in the development of rural task sharing interventions for mental health. We thus recommend a robust pilot and adaptation phase when scaling task sharing interventions in rural sub-Saharan Africa to elevate community voices, leverage existing social structures, and embed interventions as deeply into communities as possible.
摘要：
背景：我们试行了友谊长凳-一个基于证据的，津巴布韦农村地区常见精神障碍的城市地区任务共享干预。干预措施将解决问题的疗法与创收活动相结合。这项研究试图从可接受性的角度理解干预措施的实施，可行性,和可持续性以及当地对津巴布韦农村心理健康的态度。
方法：使用四个独立的半结构化面试指南，我们对患者（n=9）进行了深入访谈（n=32），村卫生工作者(n=12)，护士（n=6），和社区领袖（n=5）。我们使用综合演绎归纳方法，与不同的编码团队一起使用主题分析来分析我们的数据。
结果：出现了五个主题：1）精神疾病的解释模型，2)临床工作流程和强调文档，3）关于友谊长凳的积极反馈，4）可达性，5）可行性。
结论：在其当前格式中，我们的干预是可以接受的，但既不可行也不可持续。社会文化背景对于制定农村任务分担干预措施以促进心理健康至关重要。因此，我们建议在撒哈拉以南非洲农村地区扩大任务共享干预措施以提高社区声音时，建立一个强有力的试点和适应阶段。利用现有的社会结构，并将干预措施尽可能深入地嵌入社区。
方法：使用四个独立的半结构化面试指南，我们对患者（n=9）进行了深入访谈（n=32），村卫生工作者(n=12)，护士（n=6），和社区领袖（n=5）。我们使用综合演绎归纳方法，与不同的编码团队一起使用主题分析来分析我们的数据。
结果：出现了五个主题：1）精神疾病的解释模型，2)临床工作流程和强调文档，3）关于友谊长凳的积极反馈，4）可达性，5）可行性。
结论：在其当前格式中，我们的干预是可以接受的，但既不可行也不可持续。社会文化背景对于制定农村任务分担干预措施以促进心理健康至关重要。因此，我们建议在撒哈拉以南非洲农村地区扩大任务共享干预措施以提高社区声音时，建立一个强有力的试点和适应阶段。利用现有的社会结构，并将干预措施尽可能深入地嵌入社区。
