de Haan Anna M, Boon Albert E, de Jong Joop T V M, Vermeiren Robert R J M
Pharos, Dutch Centre of Expertise on Health Disparities.
Stichting De Jutters, Youth Mental Health Care Center, the Netherlands.
Transcult Psychiatry. 2018 Feb;55(1):3-30. doi: 10.1177/1363461517731702. Epub 2017 Oct 16.
A large proportion of treatments in youth mental health care are prematurely terminated by the patient. Treatment dropout can have severe consequences. Since ethnic minority youth are treated less often for mental disorders than other youth, it is important to analyse their risk for dropout and to determine if there are ethnicity-specific determinants. This review aimed to provide an overview of the findings from empirical studies on child and adolescent therapy dropout by ethnic minority and to determine if there were ethnicity-specific dropout determinants. An extensive literature search was performed to locate relevant journal articles. Identified articles were inspected for relevant references and these articles were then included in the meta-analysis. A total of 27 studies were accepted for analysis. The results showed that ethnic minority patients have a higher risk of treatment dropout than ethnic majority patients and that dropout rates are ethnically specific. Several differences in dropout predictors among the ethnic groups were found. In spite of diverse results, review limitations, and the lack of several key variables in the available research, some clinical recommendations are made. The review indicates that to prevent dropout, therapists should pay attention to variables such as ethnic background, therapist-patient ethnic match, and the quality of the therapeutic relationship.
在青少年心理健康护理中,很大一部分治疗会被患者过早终止。治疗中断可能会产生严重后果。由于少数民族青少年因精神障碍接受治疗的频率低于其他青少年,因此分析他们的治疗中断风险并确定是否存在特定种族的决定因素非常重要。本综述旨在概述关于少数民族儿童和青少年治疗中断的实证研究结果,并确定是否存在特定种族的治疗中断决定因素。我们进行了广泛的文献检索以查找相关期刊文章。对识别出的文章检查其相关参考文献,然后将这些文章纳入荟萃分析。共有27项研究被纳入分析。结果表明,少数民族患者比多数民族患者有更高的治疗中断风险,且中断率具有种族特异性。研究发现不同种族在治疗中断预测因素方面存在若干差异。尽管结果多样、存在综述局限性以及现有研究缺乏若干关键变量,但仍提出了一些临床建议。该综述表明,为防止治疗中断,治疗师应关注种族背景、治疗师与患者的种族匹配度以及治疗关系质量等变量。