背景:精神分裂症在卫生专业人员中受到严重污名化。鉴于健康专业学生是未来的劳动力成员,将为精神分裂症患者提供护理,实施旨在减少该群体污名化的干预措施至关重要.
目的:本范围综述旨在识别和综合现有的有关干预措施的文献,以减少健康专业学生的精神分裂症污名,并确定文献中可能存在的差距。
方法:检索了9个电子数据库和灰色文献,包括PubMed,Embase,护理和相关健康文献的累积指数,PsycINFO,MEDLINE,WebofScience,Scopus,中国国家知识基础设施,万方,和谷歌在2023年5月5日。两名研究人员独立进行数据筛选,数据提取,并评估研究风险。最新的搜索也在2024年5月22日进行。随机试验的Cochrane偏倚风险工具版本2和非随机研究的偏倚风险用于评估研究偏倚风险。数据综合和分析由两名审阅者使用叙述方法进行。报告遵循系统审查的首选报告项目和范围审查的荟萃分析扩展。
结果:本综述包括21项研究,涉及2520名健康专业学生。大多数纳入的研究是非随机对照试验(38%)和事后研究(52%)。大多数纳入的研究在美国进行(24%)。10项研究(48%)的参与者是医学生。干预会议的数量从1到13不等,平均为3次。7项(33%)研究的干预持续时间少于4周,16项(76%)研究没有随访。使用各种量表来评估精神分裂症污名的结果。只有两项研究(10%)表明干预无效,大多数干预措施由精神病学系教师和精神分裂症患者领导。
结论:大多数研究(90%)使用了各种方法,包括面对面或在线教育,与精神分裂症患者直接接触,或其组合,减少健康专业学生的耻辱。然而,没有人在他们的干预设计中解决文化和移情因素,纳入的研究缺乏理论指导。这篇综述只包括具有显著异质性的英语定量研究,有17项研究(81%)显示出严重或高偏倚风险,限制全面讨论。这些发现为未来的系统评价提供了有价值的见解。减少健康专业学生精神分裂症污名的研究需要解决文化和移情因素。
BACKGROUND: Schizophrenia is heavily stigmatized among health professionals. Given that health professional students are future members of the workforce and will provide care for people with schizophrenia, it is essential to implement interventions aimed at reducing stigma among this group.
OBJECTIVE: This scoping
review aimed to identify and synthesize existing literature on interventions to decrease schizophrenia stigma among health professional students, and to determine the possible gaps in the literature.
METHODS: Nine electronic databases and gray literature were searched, including PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, MEDLINE, Web of Science, Scopus, China National Knowledge Infrastructure, WanFang, and Google on 5 May 2023. Two researchers independently conducted data screening, data extraction, and assessed study risks. A most updated search was also done on 22 May 2024. The Cochrane risk of bias tool version 2 for randomized trials and Risk of Bias in Non-randomized Studies were used to assess the studies\' risk of bias. Data synthesis and analysis were conducted by two reviewers using a narrative approach. Reporting adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
RESULTS: This
review included twenty-one studies with 2520 health professional students. The majority of included studies were non-randomized controlled trials (38 %) and pre-post studies (52 %). Most of the included studies were conducted in the United States (24 %). The participants in ten (48 %) studies were medical students. The number of intervention sessions ranged from one to 13, with an average of three. Seven (33 %) studies had an intervention duration of less than four weeks and 16 (76 %) studies had no follow-up. Various scales were used to assess the outcomes of schizophrenia stigma. Only two studies (10 %) indicated the intervention\'s ineffectiveness, with the majority of interventions led by psychiatry department faculty and individuals with schizophrenia.
CONCLUSIONS: Most studies (90 %) utilized various approaches, including face-to-face or online education, direct contact with individuals with schizophrenia, or a combination thereof, to diminish stigma among health professional students. However, none addressed cultural and empathy factors in their intervention designs, and the included studies lacked theoretical guidance. The
review only comprised English quantitative studies with significant heterogeneity, with 17 studies (81 %) displaying serious or high risk of bias, limiting comprehensive discussions. These findings offer valuable insights for future systematic
review. Tweetable abstract Studies on reducing health professional students\' schizophrenia stigma need to address cultural and empathy factors.