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医疗保健提供者反耻辱计划的关键要素:评估研究的数据综合分析

Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies.

作者信息

Knaak Stephanie, Modgill Geeta, Patten Scott B

机构信息

Research Associate, Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, Calgary, Alberta.

Principal Investigator, Health Professionals, Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, Calgary, Alberta; Professor, Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta; Member, Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta.

出版信息

Can J Psychiatry. 2014 Oct;59(10 Suppl 1):S19-26. doi: 10.1177/070674371405901s06.

Abstract

OBJECTIVE

As part of its ongoing effort to combat stigma against mental illness among health care providers, the Mental Health Commission of Canada partnered with organizations conducting anti-stigma interventions. Our objective was to evaluate program effectiveness and to better understand what makes some programs more effective than others. Our paper reports the elements of these programs found to be most strongly associated with favourable outcomes.

METHODS

Our study employed a multi-phased, mixed-methods design. First, a grounded theory qualitative study was undertaken to identify key program elements. Next, each program (n = 22) was coded according to the presence or absence of the identified key program ingredients. Then, random-effects, meta-regression modelling was used to examine the association between program outcomes and the key ingredients.

RESULTS

The qualitative analysis led to a 6-ingredient model of key program elements. Results of the quantitative analysis showed that programs that included all 6 of these ingredients performed significantly better than those that did not. Individual analyses of each of the 6 ingredients showed that including multiple forms of social contact and emphasizing recovery were characteristics of the most effective programs.

CONCLUSIONS

The results provide a validation of a 6-ingredient model of key program elements for anti-stigma programming for health care providers. Emphasizing recovery and including multiple types of social contact are of particular importance for maximizing the effectiveness of anti-stigma programs for health care providers.

摘要

目的

作为其持续努力消除医疗保健提供者对精神疾病污名化的一部分,加拿大心理健康委员会与开展反污名化干预措施的组织合作。我们的目标是评估项目效果,并更好地理解为何有些项目比其他项目更有效。我们的论文报告了这些项目中发现与良好结果最密切相关的要素。

方法

我们的研究采用了多阶段、混合方法设计。首先,开展了一项扎根理论定性研究以确定关键项目要素。接下来,根据已确定的关键项目要素的存在与否对每个项目(n = 22)进行编码。然后,使用随机效应元回归模型来检验项目结果与关键要素之间的关联。

结果

定性分析得出了一个包含6个要素的关键项目要素模型。定量分析结果表明,包含所有这6个要素的项目比未包含的项目表现显著更好。对这6个要素分别进行的分析表明,包含多种形式的社会接触并强调康复是最有效项目的特征。

结论

研究结果验证了针对医疗保健提供者的反污名化项目关键项目要素的6要素模型。强调康复并包含多种类型的社会接触对于最大化针对医疗保健提供者的反污名化项目的有效性尤为重要。

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