Psychological intervention

心理干预
  • 文章类型: Journal Article
    背景:患有各种罕见或孤儿疾病(ROD)的患者会遇到常见的心理社会困难。这些需求来自多种因素的结合,例如患者种类繁多,资源稀少,以及对身体健康需求的集中努力,提高了患者的预期寿命和质量。因此,在考虑患者的心理社会需求方面的差距正在扩大,例如应对身体限制的影响,减少社会孤立和痛苦。为了弥补这一差距,我们开发了,试点测试和评估的可接受性,可行性,实施,以及Connect-ROD的短期影响,在线团体干预,以支持成年患者的ROD(AP-ROD),旨在改善应对机制,加强控制感,并支持AP-ROD的个人目标。一项由深入预测试组成的定性研究,测试后访谈和标准化问卷,对两个连续干预组的14名参与者进行了研究。
    结果:Connect-ROD干预在接受和承诺疗法以及社区心理学方法中有着强烈的锚定。试点测试使我们能够改进初始结构,并制作在线交付的手动10周计划,由2小时的会议组成,包括正式活动,交流和作业。评估显示令人满意的可接受性和可及性,主持人的合规交付,以及对个人目标的短期影响,控制感,应对机制,症状管理,接受与疾病相关的情绪,苦恼,自我效能感,社会支持和联系。该计划未显示对整体生活质量的短期影响。
    结论:建议对Connect-ROD进行更大规模的评估。似乎有希望支持各种AP-ROD,他们生活在疾病的复杂心理社会后果中。
    BACKGROUND: Patients living with various rare or orphan diseases (ROD) experience common psychosocial difficulties. Those need emerge from a combination of factors, such as the large variety of patients and the rarity of resources, as well as concentrated efforts on physical health needs that yielded increases in life expectancy and quality in patients. A gap is therefore rising in the consideration of psychosocial needs of patients, such as coping with the impacts of physical limitations, reducing social isolation and distress. To contribute to address this gap, we developed, pilot-tested and evaluated the acceptability, feasibility, implementation, and short-term effects of Connect-ROD, an online group intervention to support adult patients with a ROD (AP-ROD), which aims to improve coping mechanisms, reinforce sense of control, and support personal goals of AP-ROD. A qualitative study comprising of in-depth pretests, post-test interviews and standardized questionnaires, was conducted with 14 participants in two consecutive intervention groups.
    RESULTS: The Connect-ROD intervention is strongly anchored in acceptance and commitment therapy as well as community psychology approaches. A pilot test allowed us to improve on the initial structure and to produce a manualized 10-week program delivered online, made up of 2-h sessions comprising formal activities, exchanges and homework. The evaluation showed satisfactory acceptability and accessibility, compliant delivery by facilitators, and promising short-term effects on personal objectives, sense of control, coping mechanisms, symptom management, acceptance of the emotions associated with the disease, distress, self-efficacy, social support and connectedness. The program did not show short-term effects on overall quality of life.
    CONCLUSIONS: It is recommended that Connect-ROD is evaluated on a larger scale. It seems promising to support various AP-ROD who live with the complex psychosocial consequences of their disease.
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  • 文章类型: Journal Article
    综合有关执行心肺复苏(CPR)的外行反应者经验的定性证据。
    使用Thomas和Harden方法进行定性证据合成。PubMed,科克伦图书馆,WebofScience,OVIDMedline,Embase,CINAHL,CNKI,和万方数据库进行了系统搜索。研究的质量由关键评估技能计划工具(CASP)进行评估。
    总共确定了5,610项研究,9项研究纳入分析.产生了四个分析主题:心肺复苏术前的情绪矛盾,心肺复苏期间的心理耐受性,心肺复苏后的感知体验,增强心理韧性。
    在心肺复苏术期间,产妇反应者面临复杂的心理体验,这可能容易受到心理影响,如“损失厌恶”,\"\"旁观者效应\"和\"知识诅咒。“除了及时的心肺复苏再培训,应指导外行响应者管理心理困扰并提高心理韧性。更重要的是,心理后遗症可能是持久的,需要在评估跨学科性的基础上进行持续的心理干预和随访。
    UNASSIGNED: To synthesize qualitative evidence on the experience of lay responders performing cardiopulmonary resuscitation (CPR).
    UNASSIGNED: Qualitative evidence synthesis was performed using the Thomas and Harden method. The PubMed, Cochrane Library, Web of Science, OVID Medline, Embase, CINAHL, CNKI, and WanFang databases were systematically searched. The quality of the research was assessed by the Critical Assessment Skills Program Tool (CASP).
    UNASSIGNED: A total of 5,610 studies were identified, and 9 studies were included in the analysis. Four analytical themes were generated: emotional ambivalence before CPR, psychological tolerance during CPR, perceived experience after CPR, and enhancing psychological resilience.
    UNASSIGNED: Lay responders face complicated psychological experience during CPR, which may be susceptible to psychological effects such as \"loss aversion,\" \"bystander effects\" and \"knowledge curse.\" In addition to the timely retraining of CPR, lay responders should be instructed to manage psychological distress and improve psychological resilience. More importantly, the psychological sequelae may be long-lasting, requiring ongoing psychological intervention and follow-up based on valuing transdisciplinarity across endeavours.
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  • 文章类型: Journal Article
    从家庭住宅到疗养院的过渡对老年人来说可能是一种情绪紧张的经历。本研究旨在研究叙事疗法结合解决焦点(NTCSF)计划对心理调节的可行性和效果,抑郁症,疗养院居民的自我效能感。在福建省开展非随机并行对照试验,中国涉及来自四个独立疗养院的81名参与者(干预=41,比较=40)。对照组接受常规机构护理,而干预组除了接受常规护理外,还接受了为期3周的NTCSF计划。在方差分析中,在“心理调节”(T=4.007,P<0.001)和“自我效能感”(T=3.204,P=0.002)方面存在显着差异,与对照组相比。在基线时,两组之间的“抑郁”没有显着差异(t=-1.550,P=0.125),但实验组干预后抑郁显著降低(t=-2.204,P=0.033)。发现NTCSF计划可有效改善养老院居民的心理调节。试验注册本研究在中国临床试验注册中心注册(注册号:ChiCTR-2100042767)。
    The transition from the family home to a nursing home can be an emotionally stressful experience for older adults. This study aimed to examine the feasibility and effects of a narrative therapy combined with a solution focus (NTCSF) program on the psychological adjustment, depression, and self-efficacy of nursing home residents. A non-random concurrent controlled trial was conducted in Fujian, China that involved 81 participants (intervention = 41, comparison = 40) from four separate nursing homes. The control group received routine institutional care, while the intervention group underwent a three-week NTCSF program in addition to receiving routine care. In the variance analyses, significant differences were found in \"psychological adjustment\" (T = 4.007, P < 0.001) and \"self-efficacy\" (T = 3.204, P = 0.002), compared to the control group. There was no significant difference in \"depression\" (t = -1.550, P = 0.125) between the groups at the baseline, but the experimental group showed a significant decrease in depression (t = -2.204, P = 0.033) after the intervention. The NTCSF program was found to be effective in improving the psychological adjustment of nursing home residents. Trial registration This study was registered on the Chinese Clinical Trial Registry (Registration No: ChiCTR-2100042767).
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  • 文章类型: Journal Article
    背景:在怀孕和分娩期间,除了积极的感觉,女性经历诸如对分娩的恐惧(FoC)并担心其后果,这可能会在怀孕期间对母亲和她的孩子产生负面影响,delivery,和产后。进行这项研究是为了确定产前非药物干预措施对减少FoC的有效性。
    方法:本研究方案注册于PROSPERO(ID:CRD42023468547)。PubMed,WebofScience,科克伦,Scopus,SID(科学信息数据库)和GoogleScholar搜索引擎数据库进行了系统搜索,直到2023年7月27日,没有时间限制,仅限于波斯语和英语研究,以执行此概述。使用等级评估证据的确定性,使用AMSTAR2的方法学质量和使用PRISMA评分的报告质量。对从原始试验中提取的数据进行Meta分析,以评估不同干预措施对降低FoC的效果。使用亚组分析和荟萃回归模型来检查高度异质性,敏感性分析用于消除高偏倚风险研究对研究结果的影响.
    结果:总体而言,概述中包括15项系统综述(SRs),其中9项研究进行了荟萃分析.考虑到方法学质量,这些SR处于低到极低的状态,并且有关于报告质量的相对完整的报告.Meta分析结果表明,心理干预(SMD-2.02,95%CI-2.69至-1.36,16项试验,1057名与会者,I2=95%)和产前教育(SMD-0.88,95%CI-1.16至-0.61,4项试验,432名参与者,I2=72.8%)相对于产前常规护理而言,FoC显着降低,证据的确定性较低。相对于产前常规护理,分心技术导致FoC显着降低,证据具有很高的确定性(SMD-0.75,95%CI-1.18至-0.33,4项试验,329名与会者,I2=69%),但是,相对于证据的确定性非常低的产前常规护理,加强护理不会导致FoC显着下降(SMD-1.14,95%CI-2.85至0.58,3项试验,232名参与者,I2=97%)。
    结论:分心技术可有效降低FoC。关于心理干预和产前教育对减少FoC的影响,研究结果表明,干预措施可能导致FoC的减少。非常不确定的证据表明,加强护理不能有效降低FoC。
    BACKGROUND: During pregnancy and childbirth, alongside positive feelings, women undergo feelings such as fear of childbirth (FoC) and worry about its consequences, which could leave negative effects on the mother and her child during pregnancy, delivery, and postpartum. The study was carried out to determine the effectiveness of prenatal non-pharmacological interventions on reducing the FoC.
    METHODS: The protocol of the study was registered in PROSPERO (ID: CRD42023468547). PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database) and Google Scholar search engine databases were systematically searched until July 27, 2023 with no limitation of time and limited to Persian and English studies in order to perform this overview. Certainty of evidence was assessed using GRADE, methodological quality using AMSTAR 2 and reporting quality using PRISMA score. Meta-analysis was performed on the data extracted from the original trials to evaluate the effect of different interventions on reducing the FoC. Sub-group analysis and meta-regression models were used to examine high heterogeneity, and sensitivity analysis was used to eliminate the effect of high risk of bias studies on the study findings.
    RESULTS: Overall, 15 systematic reviews (SRs) were included in the overview, among which meta-analysis was performed in 9 studies. Considering methodological quality, these SRs were in low to critically low status and had relatively complete reports regarding reporting quality. Meta-analysis findings indicated that psychological interventions (SMD -2.02, 95% CI -2.69 to -1.36, 16 trials, 1057 participants, I2 = 95%) and prenatal educations (SMD -0.88, 95% CI -1.16 to -0.61, 4 trials, 432 participants, I2 = 72.8%) cause a significant reduction in FoC relative to prenatal usual cares with low certainty of evidence. Distraction techniques lead to a significant reduction in FoC relative to prenatal usual care with high certainty of evidence (SMD -0.75, 95% CI -1.18 to -0.33, 4 trials, 329 participants, I2 = 69%), but enhanced cares do not result in a significant decrease FoC relative to prenatal usual care with very low certainty of evidence (SMD -1.14, 95% CI -2.85 to 0.58, 3 trials, 232 participants, I2 = 97%).
    CONCLUSIONS: Distraction techniques are effective in reducing FoC. Regarding the effect of psychological interventions and prenatal educations on the reduction of FoC, the findings indicated that the interventions may result in the reduction of FoC. Very uncertain evidence showed that enhanced cares are not effective in reducing the FoC.
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  • 文章类型: Journal Article
    背景:针对需要心理支持的临床和非临床人群,已经开发了可扩展的心理干预措施,例如WHO的自助加(SH)。SH+已成功实施,以防止寻求庇护者和难民中常见的精神障碍,这些寻求庇护者和难民由于强迫移民水平的增加而数量不断增加。这些人群经常接触多种,严重的创伤来源,这些事件对治疗的影响证据不足,特别是对于非临床人群。目的:我们旨在研究潜在创伤经历(PTE)的影响以及创伤后应激障碍(PTSD)症状对SH后改善的中介作用。方法:分配给SH+的参与者接受了至少三个疗程(N=345),从两个大的,随机化,涉及寻求庇护者和难民的欧洲预防审判。痛苦的措施,抑郁症,功能损害,创伤后应激症状在基线和干预后6个月给予,以及福祉和生活质量的衡量标准。构建调整后的模型来检查PTE对干预后改善的影响。然后测试了PTSD症状在这种关系中的可能介导作用。结果:PTE数量的增加降低了SH对所有措施的有益作用。在分析幸福感和生活质量的指标时,这种关系是由PTSD的症状介导的。然而,这不适用于心理健康问题的措施。结论:暴露于PTE可能会在很大程度上降低SH+的获益。PTSD症状学起着特殊的作用,对经历PTE的参与者的心理健康和生活质量的中介作用。医疗保健专业人员和研究人员应考虑PTE和PTSD症状在移民和难民治疗中的作用,并为暴露于多种PTE的病例探索可行的附加解决方案。
    越来越多的潜在创伤经历可以降低在多个国家的移民和难民中进行手动团体心理治疗干预的有益效果。在没有创伤后应激障碍的完整阈值诊断的情况下,创伤后应激症状仍然介导潜在创伤经历与随访中某些结局改善之间的关系。虽然潜在创伤经历数量的调节作用适用于所有结果(抑郁症状,心理困扰,功能损害,幸福,和生活质量),创伤后应激症状在这种关系中的中介作用仅适用于幸福感和生活质量。
    Background: Scalable psychological interventions such as the WHO\'s Self-Help Plus (SH+) have been developed for clinical and non-clinical populations in need of psychological support. SH+ has been successfully implemented to prevent common mental disorders among asylum seekers and refugees who are growing in number due to increasing levels of forced migration. These populations are often exposed to multiple, severe sources of traumatisation, and evidence of the effect of such events on treatment is insufficient, especially for non-clinical populations.Objective: We aim to study the effect of potentially traumatic experiences (PTEs) and the mediating role of symptoms of posttraumatic stress disorder (PTSD) on the improvement following SH+.Method: Participants allocated to SH+ who received at least three sessions (N = 345) were extracted from two large, randomised, European prevention trials involving asylum seekers and refugees. Measures of distress, depression, functional impairment, and post-traumatic stress symptoms were administered at baseline and 6 months post-intervention, together with measures of well-being and quality of life. Adjusted models were constructed to examine the effect of PTEs on post-intervention improvement. The possible mediating role of PTSD symptoms in this relationship was then tested.Results: Increasing numbers of PTEs decreased the beneficial effect of SH+ for all measures. This relationship was mediated by symptoms of PTSD when analysing measures of well-being and quality of life. However, this did not apply for measures of mental health problems.Conclusions: Exposure to PTEs may largely reduce benefits from SH+. PTSD symptomatology plays a specific, mediating role on psychological well-being and quality of life of participants who experienced PTE. Healthcare professionals and researchers should consider the role of PTEs and PTSD symptoms in the treatment of migrants and refugees and explore possible feasible add-on solutions for cases exposed to multiple PTEs.
    Increasing numbers of potentially traumatic experiences can decrease the beneficial effect of a manualized group psychotherapeutic intervention in migrants and refugees across multiple countries.In absence of a full threshold diagnosis of post-traumatic stress disorder, post-traumatic stress symptoms still mediate the relation between potentially traumatic experiences and some outcome improvements at follow-up.While the moderating role of number of potentially traumatic experiences applies to all outcomes (depression symptoms, psychological distress, functional impairment, well-being, and quality of life), the mediating role of post-traumatic stress symptoms in this relation only applies to well-being and quality of life.
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  • 文章类型: Journal Article
    背景:心理干预是功能性/分离性癫痫发作(FDS)最推荐的治疗方法;然而,它们对癫痫发作结果的有效性存在持续的不确定性.
    方法:本系统综述和荟萃分析综合了现有数据。2023年2月,我们完成了对四个电子数据库的系统搜索。我们描述了捕获的癫痫发作相关结果的范围,使用荟萃分析方法分析治疗和随访期间收集的数据;并探索结局之间异质性的来源。
    结果:总体而言,确定了44项相关研究,涉及1,300名患者。大多数被归类为高(39.5%)或中等(41.9%)的偏见风险。除一项研究外,所有研究都检查了癫痫发作频率;癫痫发作强度,严重程度或麻烦程度为10;以及癫痫发作持续时间和一项研究中的集群。可以对癫痫发作自由和癫痫发作减少进行Meta分析。治疗结束时癫痫发作自由度的汇总估计为40%,而随访则为36%。癫痫发作频率改善≥50%的合并率为66%和75%。所包括的癫痫发作自由调节变量均无显着。在集团层面,治疗阶段癫痫发作频率改善,合并效应大小适中(d=0.53).FDS频率每月减少6.5次癫痫发作的中位数。还有证据表明,其他(非频率)癫痫发作相关的心理治疗措施有所改善,但数据不足以进行荟萃分析.
    结论:这项研究的结果补充了先前的荟萃分析,该分析描述了心理治疗相关的非癫痫相关结局的改善。需要进一步研究最合适的FDS严重性度量。
    BACKGROUND: Psychological interventions are the most recommended treatment for functional/dissociative seizures (FDS); however, there is ongoing uncertainty about their effectiveness on seizure outcomes.
    METHODS: This systematic review and meta-analysis synthesises the available data. In February 2023, we completed a systematic search of four electronic databases. We described the range of seizure-related outcomes captured, used meta-analytic methods to analyse data collected during treatment and follow-up; and explored sources of heterogeneity between outcomes.
    RESULTS: Overall, 44 relevant studies were identified involving 1,300 patients. Most were categorised as being at high (39.5 %) or medium (41.9 %) risk of bias. Seizure frequency was examined in all but one study; seizure intensity, severity or bothersomeness in ten; and seizure duration and cluster in one study each. Meta-analyses could be performed on seizure freedom and seizure reduction. A pooled estimate for seizure freedom at the end of treatment was 40 %, while for follow-up it was 36 %. Pooled rates for ≥50 % improvement in seizure frequency were 66 % and 75 %. None of the included moderator variables for seizure freedom were significant. At the group level, seizure frequency improved during the treatment phase with a moderate pooled effect size (d = 0.53). FDS frequency reduced by a median of 6.5 seizures per month. There was also evidence of improvement of the other (non-frequency) seizure-related measures with psychological therapy, but data were insufficient for meta-analysis.
    CONCLUSIONS: The findings of this study complement a previous meta-analysis describing psychological treatment-associated improvements in non-seizure-related outcomes. Further research on the most appropriate FDS-severity measure is needed.
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  • 文章类型: Journal Article
    患有中风或短暂性脑缺血发作(TIA)的人可能会遇到心理和/或认知困难。中风后心理和神经心理干预的研究越来越多,然而,发表的系统综述在范围和方法上有所不同,包括不同类型和严重程度的中风,有时,关于评估的干预措施的有效性得出了不同的结论。在这个伞式审查中,我们旨在系统总结现有的评估心理干预对卒中/TIA后情绪和认知的系统评价。
    我们将根据JBI证据综合手册进行这项总括审查。从一开始将搜索以下数据库:Cochrane系统评论数据库,效果评论数据库(DARE),MEDLINE,Embase,CINAHL,PsycINFO,和认识论。将包括在搜索日期之前发布或不发布荟萃分析的系统评价。包括针对任何中风类型或严重程度的情绪和/或认知结果的心理干预在内的评论将被筛选是否合格。叙事综合,包括内容分析,将被使用。审查的每个阶段都将由两名独立审查者处理,第三名审查者将被考虑解决分歧。将使用AMSTAR2评估纳入的审查的方法质量。
    现有的系统评价为卒中后/TIA心理干预的有效性提供了各种证据。这篇综述旨在总结针对情绪和认知的不同类型的心理和神经心理学干预措施的知识和证据。研究结果将突出重要的知识差距,并有助于优先考虑未来的研究问题。
    该协议于2022年11月15日在国际系统审查前瞻性注册(PROSPERO)中进行了前瞻性注册;PROSPEROCRD42022375947。
    UNASSIGNED: People who have had a stroke or a Transient Ischaemic Attack (TIA) can experience psychological and/or cognitive difficulties. The body of research for psychological and neuropsychological interventions after stroke is growing, however, published systematic reviews vary in scope and methodology, with different types and severity of strokes included, and at times, diverse conclusions drawn about the effectiveness of the interventions evaluated. In this umbrella review, we aim to systematically summarise the existing systematic reviews evaluating psychological interventions for mood and cognition post-stroke/TIA.
    UNASSIGNED: We will conduct this umbrella review according to the JBI Manual for Evidence Synthesis. The following databases will be searched from inception: Cochrane Database of Systematic Reviews, Database of Reviews of Effects (DARE), MEDLINE, Embase, CINAHL, PsycINFO, and Epistemonikos. Systematic reviews with or without meta-analysis published until the search date will be included. Reviews including psychological interventions addressing mood and/or cognition outcomes for any stroke type or severity will be screened for eligibility. A narrative synthesis, including content analysis, will be used. Each stage of the review will be processed by two independent reviewers and a third reviewer will be considered to resolve disagreements. The methodological quality of the included reviews will be assessed using AMSTAR 2.
    UNASSIGNED: Existing systematic reviews provide varied evidence on the effectiveness of psychological interventions post-stroke/TIA. This umbrella review aims to summarise knowledge and evidence on different types of psychological and neuropsychological interventions targeting mood and cognition. Findings will highlight important knowledge gaps and help prioritise future research questions.
    UNASSIGNED: This protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on November 15, 2022; PROSPERO CRD42022375947.
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  • 文章类型: Journal Article
    背景:患有人类免疫缺陷病毒(HIV)的青少年患抑郁症的风险增加,对他们坚持抗逆转录病毒治疗(ART)和治疗结果产生负面影响。将精神保健纳入艾滋病毒护理和治疗环境可改善全面护理。然而,一体化在坦桑尼亚仍然具有挑战性,就像在其他高负担和低资源环境中一样。这项工作的总体目标是为艾滋病毒感染者(ALWHIV)青少年抑郁症的心理干预措施的发展提供信息。我们描述了实施一体化的感知障碍和机会,基于证据的心理干预,从青少年的角度管理艾滋病毒护理和治疗中心(HIV-CTC)的青少年抑郁症,看护者,和达累斯萨拉姆的医疗保健提供者(HCP),坦桑尼亚。
    方法:为干预制定和实施提供信息,本研究通过由实施研究综合框架(CFIR)提供的现象学方法进行了定性设计,以探索ALWHIV中的实施障碍和促进者,HCP,和照顾者。在Kinondoni达累斯萨拉姆的三个HIV-CTC中进行了45次深入访谈。音频记录逐字转录,并通过NVIVO软件进行演绎分析。
    结果:实施综合心理干预以解决ALWHIV患者抑郁症的障碍包括(A)护理人员的心理健康意识差,青少年,HCP,和政策制定者,(B)对精神卫生保健的严重污名,(C)青少年与HCPs之间在精神保健方面的沟通不畅,(D)缺乏对精神卫生保健的经证实的有效性和指导方针的情境干预,(E)精神卫生保健支持性监督和指导不足。实施的促进者包括支持性基础设施,来自艾滋病毒执行伙伴的积极压力,改变的张力,以及参与者对心理干预与普通艾滋病毒护理和治疗咨询相比具有优势的看法。
    结论:尽管在HIVCTC中实施心理干预存在一些可改变的障碍,有令人鼓舞的促进者和实施综合方案的机会,基于证据的心理干预,以解决Kinondoni达累斯萨拉姆的ALWHIV抑郁症,坦桑尼亚。
    BACKGROUND: Adolescents living with Human Immunodeficiency Virus (HIV) have an increased risk of depression, negatively affecting their adherence to antiretroviral therapy (ART) and treatment outcomes. Integrating mental health care in HIV care and treatment settings improves comprehensive care. However, integration remains challenging in Tanzania, like in other high-burden and low-resource settings. The overall objective of this work is to inform the development of a psychological intervention for depression in adolescents living with HIV (ALWHIV). We describe perceived barriers and opportunities for implementing an integrated, evidence-based psychological intervention to manage adolescent depression in HIV care and treatment centers (HIV-CTC) from the perspectives of adolescents, caregivers, and healthcare providers (HCPs) in Dar es Salaam, Tanzania.
    METHODS: To inform intervention development and implementation, this study utilized a qualitative design through a phenomenological approach informed by the Consolidated Framework for Implementation Research (CFIR) to explore implementation barriers and facilitators in ALWHIV, HCPs, and caregivers. Forty-five in-depth interviews were conducted in three HIV-CTCs in Kinondoni Dar es Salaam. Audio records were transcribed verbatim and analyzed deductively through NVIVO software.
    RESULTS: Barriers to implementing an integrated psychological intervention to address depression in ALWHIV included (A) poor mental health awareness among caregivers, adolescents, HCPs, and policy-makers, (B) high level of stigma against mental health care, (C) poor communication between adolescents and HCPs concerning mental health care, (D) lack of contextualized intervention of proven effectiveness and guidelines of mental health care, and (E) inadequate mental health care supportive supervision and mentorship. Facilitators for implementation included supportive infrastructure, positive pressure from HIV implementing partners, tension for change, and participant\'s perception of the advantage of a psychological intervention as compared to just usual HIV care and treatment counseling.
    CONCLUSIONS: Despite several modifiable barriers to implementing a psychological intervention in HIV CTC, there were encouraging facilitators and opportunities for implementing an integrated, evidence-based psychological intervention to address depression in ALWHIV in Kinondoni Dar es Salaam, Tanzania.
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  • 文章类型: Journal Article
    许多心理干预措施可用于癌症患者的自杀和死亡意念(SDI)和自杀行为。确定降低癌症患者SDI和自杀行为的最佳心理干预措施。然而,尚不清楚哪种心理干预最有效。我们通过搜索从开始之日起至2022年4月8日的七个数据库进行了成对和网络荟萃分析。此网络荟萃分析的一个重要重点是比较各种心理干预措施对降低癌症患者SDI和自杀行为的影响。为了确定疗效,我们使用标准化平均差(SMD)和95%置信区间(CI)。此外,成对的荟萃分析,不一致性测试,网络荟萃分析,累积排名曲线(SUCRA)下的表面,比较调整后的漏斗图,亚组分析,并进行了敏感性分析。本研究共检索了8项研究,涉及1,350名患者。结果表明,移情治疗(SUCRA=95.3%)在6种干预措施中效果最好。综合心理干预(SUCRA=77.6%)排名前两位,其次是以意义为中心的治疗(SUCRA=40.7%)。比较调整漏斗图显示无明显的发表偏倚。此外,敏感性分析后,我们的结论没有明显变化.在这个网络荟萃分析中,移情疗法被认为是降低癌症患者SDI和自杀行为的最佳选择.应进行进一步的多中心和高质量的RCT研究,以使我们的结论更加严格。
    Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.
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  • 文章类型: Journal Article
    研究表明,犯罪的个人通常会表现出各种早期适应不良模式(EMS)。EMS是由记忆组成的广泛而普遍的主题或模式,情感,认知,以及关于自己和一个人与他人关系的身体感觉。此外,EMS在不同类型的犯罪行为的发生和维持中起着至关重要的作用,强调对肇事者实施图式疗法(ST)的必要性。因此,本系统审查评估了ST对犯罪个人的有效性。四个数据库(PubMed,Scopus,WebofScience,和Scielo)进行了研究,以检查ST对犯罪个人的有效性。确定了17项研究,但只有15人符合入选标准。结果表明,ST可以在EMS中产生有益的影响,模式,人格症状,和犯罪的风险因素(例如,认知扭曲)。然而,研究,除了稀缺,揭示了一些方法论上的局限性。ST对犯罪的人来说是一种很有希望的治疗方法,尽管研究方法存在缺陷,这阻碍了我们得出更坚定的结论。虽然很有希望,需要更多的研究来提高我们对ST治疗在法医学环境中的影响的认识.
    Research suggests that individuals who commit crimes often exhibit various early maladaptive schemas (EMSs). EMSs are a broad and pervasive theme or pattern consisting of memories, emotions, cognitions, and bodily sensations concerning oneself and one\'s relationships with others. Furthermore, EMSs play a crucial role in the onset and maintenance of different types of offending behaviors, highlighting the need to implement schema therapy (ST) for perpetrators. Therefore, the present systematic review assesses the effectiveness of ST for individuals who committed crimes. Four databases (PubMed, Scopus, Web of Science, and Scielo) were searched for studies examining the effectiveness of ST for individuals who committed crimes. Seventeen studies were identified, but only 15 met the criteria for inclusion. Results showed that ST can lead to beneficial effects in EMSs, schema modes, personality symptoms, and risk factors to commit crimes (e.g., cognitive distortions). However, the studies, besides being scarce, revealed some methodological limitations. ST is a promising therapy for individuals who committed crimes, despite the studies\' methodological shortcomings, which prevent us from drawing more firm conclusions. Although promising, more research is needed to enhance our understanding of the impact of ST therapies in forensic settings.
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