Barts and London School of Medicine & Dentistry, Wolfson Institute of Preventive Medicine, Room Number: OAB 108, Centre for Psychiatry, Old Anatomy Building, Charterhouse Square, 6BQ, London EC1M, UK.
Syst Rev. 2013 Feb 25;2:15. doi: 10.1186/2046-4053-2-15.
Black and Minority Ethnic (BME) groups in receipt of specialist mental health care have reported higher rates of detention under the mental health act, less use of psychological therapies, and more dissatisfaction. Although many explanations have been put forward to explain this, a failure of therapeutic communications may explain poorer satisfaction, disengagement from services and ethnic variations in access to less coercive care. Interventions that improve therapeutic communications may offer new approaches to tackle ethnic inequalities in experiences and outcomes.
The THERACOM project is an HTA-funded evidence synthesis review of interventions to improve therapeutic communications between black and minority ethnic patients in contact with specialist mental health services and staff providing those services. This article sets out the protocol methods for a necessarily broad review topic, including appropriate search strategies, dilemmas for classifying different types of therapeutic communications and expectations of the types of interventions to improve them. The review methods will accommodate unexpected types of study and interventions. The findings will be reported in 2013, including a synthesis of the quantitative and grey literature.
A particular methodological challenge is to identify and rate the quality of many different study types, for example, randomised controlled trials, observational quantitative studies, qualitative studies and case studies, which comprise the full range of hierarchies of evidence. We discuss the preliminary methodological challenges and some solutions. (PROSPERO registration number: CRD42011001661).
在接受专业精神健康护理的黑人和少数族裔群体中，报告称在精神卫生法下被拘留的比率更高，接受心理治疗的比例更低，而且满意度更低。尽管已经提出了许多解释来解释这种情况，但治疗性沟通的失败可能可以解释较差的满意度、与服务脱节以及获得较少强制性护理的种族差异。改善治疗性沟通的干预措施可能为解决在经历和结果方面的种族不平等问题提供新的方法。
THERACOM 项目是一项由 HTA 资助的证据综合审查，旨在评估改善与专业精神健康服务接触的黑人和少数族裔患者与提供这些服务的工作人员之间治疗性沟通的干预措施。本文为一个必要的广泛审查主题制定了方案方法，包括适当的搜索策略、对不同类型的治疗性沟通进行分类的难题以及对改善治疗性沟通的干预措施的期望。审查方法将适应意外类型的研究和干预措施。研究结果将于 2013 年报告，包括定量和灰色文献的综合。
一个特别的方法学挑战是识别和评估许多不同研究类型的质量，例如随机对照试验、观察性定量研究、定性研究和案例研究，这些研究构成了证据层次的全部范围。我们讨论了初步的方法学挑战和一些解决方案。（PROSPERO 注册编号：CRD42011001661）。
