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Feasibility trial of a scalable transdiagnostic group psychological intervention for Syrians residing in a refugee camp
European Journal of Psychotraumatology ( IF 5.783 ) Pub Date : 2021-06-30 , DOI: 10.1080/20008198.2021.1932295
Aemal Akhtar 1, 2 , Luana Giardinelli 3 , Ahmad Bawaneh 3 , Manar Awwad 3 , Hadeel Al-Hayek 3 , Claire Whitney 4 , Mark J D Jordans 5, 6 , Marit Sijbrandij 2 , Pim Cuijpers 2 , Katie Dawson 1 , Richard Bryant 1
Affiliation  

ABSTRACT

Background: Approximately 10% of Syrian refugees currently reside in camp settings, which can impose additional post-migration stressors. With elevated rates of psychological distress and few available resources, task-shifting psychosocial programmes are necessary to provide adequate care. One such programme developed by the World Health Organization (WHO) is Group Problem Management Plus (GroupPM+).

Objective: This study aimed to test the safety and acceptability of GroupPM+ in a refugee camp and to identify areas for adaptation in preparation for a definitive RCT.

Method: A feasibility randomized controlled trial (RCT) was conducted in Azraq refugee camp in Jordan. Inclusion criteria were: (1) Syrian adults aged ≥18 years, (2) parent of a child aged 10–16 years, (3) experiencing psychological distress as defined by a score of ≥16 on the Kessler Distress Scale, and (4) ≥17 on the WHO Disability Assessment Schedule 2.0. Following baseline assessments, participants were randomized to receive GroupPM+ or enhanced treatment-as-usual. Post-assessments were conducted one week following the last GroupPM+ session. Primary outcomes were feasibility and acceptance of GroupPM+; symptoms of anxiety, depression, PTSD, prodromal psychosis, grief, and child’s self-reported psychological distress were also assessed.

Results: Of the 207 persons screened, 64 (31%) screened positive for psychological distress. Of the 35 randomized into the GroupPM+ intervention, 24 (69%) completed the intervention. No adverse events were reported throughout the trial. Children whose parents received GroupPM+ had greater reductions in internalizing and externalizing symptoms at posttreatment. 55 (86%) participants completed the post-assessment follow-up. These results demonstrate both the feasibility of conducting the trial in a camp and acceptance of the GroupPM+ intervention by Syrian refugees.

Conclusions: Following the feasibility trial, both the implementation procedures and intervention were safe and culturally acceptable. The results support the readiness for a definitive RCT to determine the effectiveness and cost-effectiveness of the intervention in camp settings.



中文翻译:

对居住在难民营的叙利亚人进行可扩展的跨诊断群体心理干预的可行性试验

摘要

背景:大约 10% 的叙利亚难民目前居住在难民营环境中,这可能会带来额外的移民后压力源。随着心理压力的增加和可用资源的减少,任务转移心理社会计划对于提供足够的护理是必要的。世界卫生组织 (WHO) 开发的一项此类计划是 Group Problem Management Plus (GroupPM+)。

目的:本研究旨在测试 GroupPM+ 在难民营中的安全性和可接受性,并确定适应区域,为最终的 RCT 做准备。

方法:在约旦的 Azraq 难民营进行了一项可行性随机对照试验 (RCT)。纳入标准为:(1) ≥ 18 岁的叙利亚成年人,(2) 10-16 岁儿童的父母,(3) 经历了凯斯勒痛苦量表评分≥16 分所定义的心理痛苦,以及 (4 ) ≥ WHO 残疾评估表 2.0 中的 17。在基线评估之后,参与者被随机分配接受 GroupPM+ 或常规强化治疗。后评估是在最后一次 GroupPM+ 会议后一周进行的。主要成果是 GroupPM+ 的可行性和接受度;还评估了焦虑、抑郁、创伤后应激障碍、前驱精神病、悲伤和儿童自我报告的心理困扰的症状。

结果:在接受筛查的 207 人中,64 人 (31%) 的心理困扰筛查呈阳性。在随机分配到 GroupPM+ 干预的 35 人中,24 人 (69%) 完成了干预。在整个试验过程中没有报告不良事件。父母接受 GroupPM+ 治疗的儿童在治疗后的内化和外化症状有更大程度的减轻。55 名 (86%) 参与者完成了评估后跟进。这些结果证明了在营地进行试验的可行性以及叙利亚难民对 GroupPM+ 干预的接受程度。

结论:在可行性试验之后,实施程序和干预都是安全的并且在文化上可以接受。结果支持确定 RCT 的确定性 RCT 的准备情况,以确定营地环境中干预措施的有效性和成本效益。

更新日期:2021-06-30
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