撒哈拉以南非洲地区精神分裂症患者的治疗方法：适应性现实主义综述。

Treatments for people living with schizophrenia in Sub-Saharan Africa: an adapted realist review.

机构信息

School of Health Sciences, University of Tasmania, Launceston, TAS, Australia.

Centre for Rural Health, University of Tasmania, Launceston, TAS, Australia.

出版信息

Int Nurs Rev. 2018 Mar;65(1):78-92. doi: 10.1111/inr.12391. Epub 2017 May 25.

DOI:10.1111/inr.12391

PMID:28543089

Abstract

AIM: To identify the treatments and interventions available and their impact on people living with schizophrenia in Sub-Saharan Africa. BACKGROUND: Help-seeking behaviour and the choice of treatment are largely influenced by socio-cultural factors and beliefs about the causes of mental illness. This review addresses the gap in knowledge regarding the treatment options available to people living with schizophrenia in Sub-Saharan Africa. DESIGN: Adapted realist literature review. DATA SOURCES: Electronic databases searched in June 2016 included PubMed, EMBASE, PsycINFO, ProQuest and CINAHL. REVIEW METHODS: The adapted realist review approach used to synthesize the published research involved identifying the review aim, searching and selecting relevant studies, extracting, iteratively analysing and synthesizing relevant data and reporting results. RESULTS: Forty studies from eight countries were reviewed. Most people were treated by both faith/traditional healers and modern psychiatry. Common treatments included antipsychotics, electroconvulsive therapy and psychosocial interventions. Few treatment options were available outside major centres, there was poor adherence to medication and families reported a high level of burden associated with caring for a relative. LIMITATIONS: Major limitations of this review were the lack of studies, variable quality and low level of evidence available from most countries from Sub-Saharan Africa and lack of generalizability. CONCLUSION: People living with schizophrenia in Sub-Saharan Africa were treated by faith, traditional healers and modern psychiatry, if at all. Further research is needed to better understand the local situation and the implications for caring for people from this region. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Mental health services in Sub-Saharan Africa are limited by fiscal shortages, lack of mental health services and qualified mental health professionals. This review provides evidence to inform nursing and healthcare policy, including recruiting and training mental health professionals and ensuring access to evidence-based, person-centred and culturally relevant mental health services within the primary care context.

摘要

目的：确定在撒哈拉以南非洲地区，可用于治疗精神分裂症患者的治疗方法和干预措施，及其对患者的影响。

背景：寻求治疗的行为以及治疗方法的选择在很大程度上受到社会文化因素和对精神疾病病因的信念的影响。本综述旨在填补撒哈拉以南非洲地区精神分裂症患者可获得的治疗方法方面的知识空白。

设计：改编后的现实主义文献综述。

资料来源：2016 年 6 月检索的电子数据库包括 PubMed、EMBASE、PsycINFO、ProQuest 和 CINAHL。

综述方法：用于综合已发表研究的改编现实主义综述方法包括确定综述目的、搜索和选择相关研究、提取、迭代分析和综合相关数据以及报告结果。

结果：综述共纳入来自 8 个国家的 40 项研究。大多数患者同时接受了传统信仰/治疗者和现代精神病学的治疗。常见的治疗方法包括抗精神病药物、电惊厥疗法和心理社会干预。除了主要中心之外，很少有治疗选择，药物治疗的依从性较差，并且家属报告说照顾亲属的负担很重。

局限性：本综述的主要局限性是缺乏研究、研究质量参差不齐以及来自撒哈拉以南非洲大多数国家的证据水平较低，缺乏普遍性。

结论：在撒哈拉以南非洲，精神分裂症患者如果接受治疗，通常会同时接受传统信仰/治疗者、传统治疗者和现代精神病学的治疗。需要进一步研究以更好地了解当地情况以及对来自该地区的患者进行护理的影响。

对护理和卫生政策的影响：撒哈拉以南非洲的精神卫生服务受到财政短缺、缺乏精神卫生服务和合格的精神卫生专业人员的限制。本综述提供了证据，为护理和医疗保健政策提供了信息，包括招聘和培训精神卫生专业人员，以及确保在初级保健背景下获得以患者为中心、基于证据且具有文化相关性的精神卫生服务。