Santé Sud, Bamako, Mali.
Global Health, Sanofi, Gentilly, France.
Pan Afr Med J. 2021 Apr 21;38:389. doi: 10.11604/pamj.2021.38.389.26838. eCollection 2021.
despite the high prevalence and significant burden of mental disorders, they remain grossly under-diagnosed and undertreated. In low-income countries, such as Mali, integrating mental health services into primary care is the most viable way of closing the treatment gap. This program aimed to provide a mental health training intervention to rural general practitioners (GPs), to organize community awareness activities, and to evaluate the impact on mental health knowledge and through the number of new patients diagnosed with mental disorders and managed by these general practitioners.
a pre-test/post-test design and the monthly monitoring of the number of new patients diagnosed with mental disorders by the trained GPs were used to evaluate the effect of the training interventions (two face-to-face group training workshops followed by individual follow-up supervisions) and of the community awareness activities.
the mean knowledge score of the 19 GPs who completed the initial 12-day group training raised from 24.6/100 at baseline, to 61.5/100 after training (p<0.001), a 150% increase. Among them, sixteen completed the second 6-day group training with a mean score increasing from 50.2/100 to 70.1/100 (p<0.001), a 39.6% improvement. Between July 2018 and June 2020, 2,396 new patients were diagnosed with a mental disorder by the 19 GPs who took part in the program.
despite limited data regarding the effect of the community awareness component at this stage, the findings from this study suggest that the training intervention improved GPs' knowledge and skills, resulting in a significant number of new patients being identified and managed.
尽管精神障碍的患病率很高,给患者带来的负担也很沉重,但这些疾病的诊断率和治疗率仍然严重偏低。在马里等低收入国家,将精神卫生服务纳入初级保健是缩小治疗缺口的最可行方法。本项目旨在为农村全科医生(GP)提供精神卫生培训干预,组织社区宣传活动,并评估其对精神卫生知识的影响,以及通过这些全科医生诊断和管理的新精神障碍患者数量。
采用预测试/后测试设计,并每月监测经过培训的全科医生诊断的新精神障碍患者数量,以评估培训干预(两次面对面小组培训讲习班,随后进行个人后续监督)和社区宣传活动的效果。
19 名完成最初为期 12 天的小组培训的全科医生的平均知识得分从基线时的 24.6/100 提高到培训后的 61.5/100(p<0.001),增加了 150%。其中,16 人完成了第二次为期 6 天的小组培训,平均得分从 50.2/100 提高到 70.1/100(p<0.001),提高了 39.6%。在 2018 年 7 月至 2020 年 6 月期间,19 名参与该项目的全科医生共诊断出 2396 名新的精神障碍患者。
尽管在现阶段,关于社区宣传部分效果的数据有限,但本研究的结果表明,培训干预提高了全科医生的知识和技能,导致大量新患者被识别和管理。