印度北部德拉敦一个城市贫民窟针对年轻女性的简短心理健康与恢复力试点干预的效果：一项准实验研究。
Outcomes of a brief mental health and resilience pilot intervention for young women in an urban slum in Dehradun, North India: a quasi-experimental study.
作者信息
Mathias K, Pandey A, Armstrong G, Diksha P, Kermode M
机构信息
1Emmanuel Hospital Association, New Delhi, India.
Present Address: Landour Community Hospital, Mussoorie, Uttarakhand 248179 India.
出版信息
Int J Ment Health Syst. 2018 Aug 18;12:47. doi: 10.1186/s13033-018-0226-y. eCollection 2018.
BACKGROUND
Mental illness is a leading cause of the disease burden among young people. Poor mental health is linked to childhood adversity such as gender inequality, poverty and low educational attainment. Psycho-social assets in adolescents can moderate these impacts and be strengthened. The aim of this study was to assess the effectiveness of a brief mental health and resilience intervention among disadvantaged young women in urban North India.
METHODS
We used an uncontrolled repeated measures design to evaluate the effectiveness of the 15-module mental health and resilience curriculum among young women residing in a slum in Dehradun, Uttarakhand. Standardised psychometric assessments were done to assess outcomes of the intervention at three time-points: pre-intervention (T1), post-intervention (T2), and 8-months post-intervention (T3), covering domains of self-efficacy, resilience, anxiety, depression and gender attitudes.
RESULTS
Young women completing the intervention (n = 106) had all left school before 10th class. A statistically significant improvement in all psychometric measures was found at T2. These improvements were sustained at T3 in the areas of anxiety, depression and gender equality attitudes, while the measures of resilience and self-efficacy had declined to baseline.
CONCLUSIONS
This intervention delivered by community-based peers among highly disadvantaged young women can lead to sustained improvements in anxiety and depression and attitudes to gender equality. While other studies in LMIC have shown increased adolescent resilience through peer-led curriculums, this study demonstrates improvements in mental health and gender attitudes can endure 8-months post-intervention. This low-cost, brief intervention can improve mental health resiliency and self-efficacy among disadvantaged young people. Further research should explore how to bring sustained improvements in resilience.
背景
精神疾病是年轻人疾病负担的主要原因。心理健康不佳与童年时期的逆境相关，如性别不平等、贫困和低教育水平。青少年的心理社会资产可以缓和这些影响并得到增强。本研究的目的是评估在印度北部城市处境不利的年轻女性中进行的简短心理健康与复原力干预的效果。
方法
我们采用无对照重复测量设计，以评估在北阿坎德邦德拉敦一个贫民窟居住的年轻女性中实施的15单元心理健康与复原力课程的效果。在三个时间点进行标准化心理测量评估以评估干预结果：干预前（T1）、干预后（T2）和干预后8个月（T3），涵盖自我效能感、复原力、焦虑、抑郁和性别态度等领域。
结果
完成干预的年轻女性（n = 106）均在十年级之前辍学。在T2时，所有心理测量指标均有统计学上的显著改善。在焦虑、抑郁和性别平等态度方面，这些改善在T3时得以维持，而复原力和自我效能感指标已降至基线水平。
结论
由社区同龄人对高度不利的年轻女性实施的这种干预可使焦虑、抑郁及性别平等态度得到持续改善。虽然其他中低收入国家的研究表明通过同伴主导的课程可提高青少年的复原力，但本研究表明心理健康和性别态度的改善在干预后8个月仍能持续。这种低成本的简短干预可改善处境不利年轻人的心理健康复原力和自我效能感。进一步的研究应探索如何使复原力得到持续改善。
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