制定原住民和托雷斯海峡岛民物质使用问题心理健康急救指南：德尔菲研究。
Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study.
机构信息
Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia.
出版信息
BMC Psychiatry. 2010 Oct 8;10:78. doi: 10.1186/1471-244X-10-78.
BACKGROUND
Problems with substance use are common in some Aboriginal communities. Although problems with substance use are associated with significant mortality and morbidity, many people who experience them do not seek help. Training in mental health first aid has been shown to be effective in increasing knowledge of symptoms and behaviours associated with seeking help. The current study aimed to develop culturally appropriate guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person who is experiencing problem drinking or problem drug use (e.g. abuse or dependence).
METHODS
Twenty-eight Aboriginal health experts participated in two independent Delphi studies (n = 22 problem drinking study, n = 21 problem drug use; 15 participated in both). Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the content. Statements were accepted for inclusion in the guidelines if they were endorsed by ≥ 90% of panellists as either 'Essential' or 'Important'. At the end of the two Delphi studies, participants were asked to give feedback on the value of the project and their participation experience.
RESULTS
From a total of 735 statements presented over two studies, 429 were endorsed (223 problem drinking, 206 problem drug use). Statements were grouped into sections based on common themes (n = 7 problem drinking, n = 8 problem drug use), then written into guideline documents. Participants evaluated the Delphi method employed, and the guidelines developed, as useful and appropriate for Aboriginal and Torres Strait Islander people.
CONCLUSIONS
Aboriginal health experts were able to reach consensus about culturally appropriate first aid for problems with substance use. Many first aid actions endorsed in the current studies were not endorsed in previous international Delphi studies, conducted on problem drinking and problem drug use in non-Indigenous people, highlighting the need for culturally specific first aid strategies to be employed when assisting Aboriginal or Torres Strait Islander people.
背景
在一些原住民社区，物质使用问题很常见。尽管物质使用问题与高死亡率和高发病率相关，但许多经历这些问题的人并未寻求帮助。心理健康急救培训已被证明可有效提高与寻求帮助相关的症状和行为知识。本研究旨在制定为经历饮酒或药物使用问题（例如滥用或依赖）的原住民或托雷斯海峡岛民提供心理健康急救的文化适宜性指南。
方法
28 名原住民健康专家参加了两项独立的德尔菲研究（n = 22 项饮酒问题研究，n = 21 项药物使用问题；15 名参与者同时参加了两项研究）。通过在线问卷向小组委员会成员展示有关可能的急救行动的陈述，并鼓励他们提出未涵盖在内容中的其他行动。如果陈述得到≥90%的小组成员认可为“必要”或“重要”，则将其接受纳入指南。在两项德尔菲研究结束时，参与者被要求对项目的价值及其参与经验提供反馈。
结果
在两项研究共提出的 735 项陈述中，有 429 项被认可（223 项饮酒问题，206 项药物使用问题）。陈述按常见主题分组（n = 7 项饮酒问题，n = 8 项药物使用问题），然后写入指南文件。参与者评估了所采用的德尔菲法以及为原住民和托雷斯海峡岛民制定的指南，认为这些方法有用且适宜。
结论
原住民健康专家能够就物质使用问题的文化适宜急救达成共识。当前研究中认可的许多急救行动在之前针对非原住民的饮酒和药物使用问题进行的国际德尔菲研究中未得到认可，这突出了在帮助原住民或托雷斯海峡岛民时需要采用具有文化特异性的急救策略。
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