Santos Osvaldo, Lopes Elisa, Virgolino Ana, Stefanovska-Petkovska Miodraga, Dinis Alexandra, Ambrósio Sara, Heitor Maria João
Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Front Psychiatry. 2018 Feb 7;9:13. doi: 10.3389/fpsyt.2018.00013. eCollection 2018.
Epidemiologic evidence highlights the harmful consequences of unemployment on health and well-being. This emphasizes the need to design low-cost interventions to prevent the adverse mental health effects of unemployment. The main aim of this study was to create expert-consensus regarding development and implementation of a brief, sustainable, and effective intervention program for promoting mental health among unemployed.
The Delphi technique entailed a selected panel of 75 experts from various relevant professional backgrounds. Panel members were asked to state their level of agreement (5-point Likert scale) regarding (a) required characteristics for an effective mental health intervention for unemployed people and (b) key variables for assessing the effectiveness of that intervention. Consensus was obtained throughout two rounds of data collection through e-mail contact, with structured questionnaires. Items of the questionnaire were based on literature reviews about community-based interventions for unemployed individuals.
Overall, 46 experts collaborated with the Delphi process (final participation rate: 61.3%). Based on a review of the literature, 185 items were identified and grouped into two broad categories (set of characteristics of the intervention and set of variables for effectiveness assessment), aggregating a total of 11 dimensions. The two Delphi rounds resulted in the selection of 35 characteristic items for the intervention program and 54 variables for its effectiveness assessment. Brief group interventions were considered to be effective and sustainable for mental health promotion in unemployment conditions if targeting mental health literacy, training interpersonal skills, and job-search skills.
As agreed by the panel of experts, a brief, sustainable and effective intervention can be developed and implemented by accounting for unemployed capacity-building for mental health self-care and adequate job-searching attitudes and skills. These results should be further implemented in community and multisector-based standardized interventions, targeting mental health among unemployed people, ensuring adequate conditions for its effectiveness assessment.
流行病学证据凸显了失业对健康和幸福的有害影响。这强调了设计低成本干预措施以预防失业对心理健康产生不利影响的必要性。本研究的主要目的是就制定和实施一项简短、可持续且有效的干预计划以促进失业者的心理健康达成专家共识。
德尔菲法涉及一个由75名来自不同相关专业背景的专家组成的选定小组。要求小组成员就以下方面表明他们的同意程度(5点李克特量表):(a)针对失业者的有效心理健康干预所需的特征;(b)评估该干预效果的关键变量。通过两轮电子邮件联系,使用结构化问卷进行数据收集,从而达成共识。问卷项目基于对针对失业个体的社区干预的文献综述。
总体而言,46名专家参与了德尔菲过程(最终参与率:61.3%)。基于文献综述,确定了185个项目并将其分为两大类(干预特征集和效果评估变量集),共汇总为11个维度。两轮德尔菲法导致为干预计划选择了35个特征项目以及为其效果评估选择了54个变量。如果以心理健康素养、人际技能培训和求职技能为目标,简短的小组干预被认为对在失业情况下促进心理健康是有效且可持续的。
正如专家小组所认同的,通过考虑失业者心理健康自我护理的能力建设以及适当的求职态度和技能,可以制定并实施一项简短、可持续且有效的干预措施。这些结果应在针对失业者心理健康的社区和多部门标准化干预中进一步实施,并确保有足够的条件对其效果进行评估。