Ngo Victoria K, Weiss Bahr, Lam Trung, Dang Thanh, Nguyen Tam, Nguyen Mai Hien
The RAND Corporation, Santa Monica, California.
Vanderbilt University, Nashville, Tennessee.
J Cogn Psychother. 2014;28(3):156-167. doi: 10.1891/0889-8391.28.3.156.
In this article, we discuss the Vietnam Multicomponent Collaborative Care for Depression Program, which was designed to provide evidence-based depression care services in low-resource, non-Western settings such as Vietnam. The article provides the program development background; the social, economic, and political context in which the program was developed; and the structure and content of the program and their underlying rationale in the context of rural Vietnam. Although the program was found to be acceptable, feasible, and effective in reducing depression outcomes, we did face challenges in implementation, which are outlined in this article. Key challenges included cultural factors (e.g., a lack of recognition of depression as a health-related entity amenable to professional treatment, relatively low levels of psychological mindedness useful for understanding of psychological interventions) and health system (e.g., lack of mental health specialists, overburdened health providers unfamiliar with behavioral interventions) factors. We discuss the strategies we employed to resolve these challenges and our successes and failures therein. We conclude with recommendations for others interested in implementing similar programs in low- and middle-income countries settings.
在本文中，我们讨论越南抑郁症多成分协作护理项目，该项目旨在越南等资源匮乏的非西方环境中提供循证抑郁症护理服务。本文介绍了项目开发背景、项目开发所处的社会、经济和政治背景，以及项目的结构和内容及其在越南农村背景下的基本原理。尽管该项目在降低抑郁症结局方面被认为是可接受、可行且有效的，但我们在实施过程中确实面临挑战，本文对此进行了概述。主要挑战包括文化因素（例如，缺乏将抑郁症视为适合专业治疗的与健康相关实体的认识、有助于理解心理干预的心理意识水平相对较低）和卫生系统因素（例如，缺乏心理健康专家、负担过重且不熟悉行为干预的医疗服务提供者）。我们讨论了为解决这些挑战所采用的策略以及我们在其中的成败。最后，我们为有兴趣在低收入和中等收入国家实施类似项目的其他人提供了建议。
