ABSTRACT

Objective

There is an urgent need to equip community-based careworkers with the skills to address the mental health needs of orphans and vulnerable children (OVC) as an essential response to shortages in human resources for mental health in Sub-Saharan Africa. We conducted a quasi-experimental feasibility trial in South Africa to adapt and evaluate an established year-long semi-structured, manualized video-feedback caregiver intervention (the Mediational Intervention for Sensitizing Caregivers; MISC) for community-based organizations (CBOs).

Methods

Following a year-long iterative cross-cultural adaptation of MISC, we recruited 88 OVC (ages 7–11; 45.5% girls) and their CBO careworkers (N = 18; 94.4% female). Two CBOs (45 children; 9 CBO careworkers) received 12 months of MISC, and two CBOs (43 children; 9 CBO careworkers) received treatment as usual. Child mental health and quality of caregiving were assessed at 6 months into the intervention and at completion through multi-informant questionnaires and video-recordings of careworker-child interactions. Qualitative interviews were conducted to evaluate feasibility and acceptability.

Results

MISC-CBO was acceptable and feasible in terms of attendance and post-intervention interviews. MISC improved child mental health, as well as the quality of careworker caregiving in terms of interactive effects for affective and cognitive (Expanding) components of MISC, and main effects for the cognitive components of Rewarding and Provision of meaning. MISC components did not mediate the effects of the intervention.

Conclusions

The current study shows that laypersons with no tertiary education and virtually no prior training who undergo MISC training can improve caregiving quality and the mental health of OVCs.

中文翻译：

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提高护理人员敏感性的调解干预措施，以改善孤儿和弱势儿童的心理健康结果

摘要

客观的

迫切需要为社区护理人员提供满足孤儿和弱势儿童 (OVC) 心理健康需求的技能，作为应对撒哈拉以南非洲心理健康人力资源短缺的重要对策。我们在南非进行了一项准实验性可行性试验，以适应和评估针对社区组织 (CBO) 已建立的为期一年的半结构化、手动视频反馈护理人员干预措施（护理人员敏化调解干预措施；MISC）。

方法

经过一年的 MISC 迭代跨文化适应，我们招募了 88 名 OVC（7-11 岁；45.5% 女孩）及其 CBO 护理人员（N = 18；94.4% 女性）。两名 CBO（45 名儿童；9 名 CBO 护理人员）接受了 12 个月的 MISC，两名 CBO（43 名儿童；9 名 CBO 护理人员）照常接受治疗。在干预后 6 个月以及完成后，通过多方调查问卷和护理人员与儿童互动的视频记录对儿童心理健康和护理质量进行评估。进行定性访谈以评估可行性和可接受性。

结果

MISC-CBO 在出勤率和干预后访谈​​方面是可以接受和可行的。MISC 改善了儿童心理健康，以及护理人员的护理质量，包括 MISC 情感和认知（扩展）成分的交互作用，以及奖励和意义提供的认知成分的主要影响。MISC 成分不介导干预措施的效果。

结论

目前的研究表明，没有接受过高等教育且几乎没有接受过培训的非专业人士接受 MISC 培训可以提高孤儿弱势群体的护理质量和心理健康。