Rezvanifar Farahnaz, Shariat Seyed Vahid, Shalbafan Mohammadreza, Salehian Razieh, Rasoulian Maryam
Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Front Psychiatry. 2022 Mar 14;13:860117. doi: 10.3389/fpsyt.2022.860117. eCollection 2022.
The importance of stigma toward patients with mental illness in medical students as future physicians cannot be overemphasized. There is currently no formal training to reduce stigma toward mental illness in medical students in their educational curriculums in Iran like most other low and middle income countries. Therefore, aiming to provide a practical and effective training package focused on reducing stigma toward patients with mental illness in medical students, the current study conducted, as an expert panel with Delphi method, based on a scoping review, to develop an education package to improve attitude of medical students toward patients with mental illness.
We surveyed the available international databases including PubMed, Google Scholar, Scopus, PsycINFO, Tripdatabase, Web of Science, Cochrane Database of Systematic Reviews as well as Persian databases including Iranmedex, SID, Irandoc and Magiran in February and March 2020. After an extensive review of related resources, 13 articles met our inclusion criteria. Then, we extracted the related data including type and duration of the interventions, sample size, mean and standard deviation of stigma scores before and after interventions. To develop the package among the included interventions, we asked 16 experts in psychology, psychiatry, and social medicine to rate the interventions based on a number of variables such as effectiveness, feasibility and applicability in a Delphi process.
The selected intervention in Delphi method with consensus of experts included a set of four sequential interactive interventions: showing a movie and discussing it, psychiatric training including contact with people who affected psychiatric disorders, social communication with people who affected psychiatric disorders, and group discussion on defining stigma and personal experiences.
In the present study, we recommend a set of interventions to reduce stigma toward patients with mental illness among medical students in the form of a package of combined, interactive and sequential interventions that have been previously been shown to be effective in reducing stigma related to mental illness. We expect that implementation of these interventions would reduce mental illness stigma in medical students; which needs further verification.
医学生作为未来的医生，对患有精神疾病患者的污名化问题的重要性再怎么强调都不为过。与大多数其他低收入和中等收入国家一样，伊朗目前在医学生的教育课程中没有正式的培训来减少对精神疾病的污名化。因此，为了提供一个实用且有效的培训方案，重点是减少医学生对患有精神疾病患者的污名化，本研究作为一个专家小组采用德尔菲法，基于范围综述，制定了一个教育方案，以改善医学生对患有精神疾病患者的态度。
我们在2020年2月和3月调查了可用的国际数据库，包括PubMed、谷歌学术、Scopus、PsycINFO、Tripdatabase、科学引文索引、Cochrane系统评价数据库以及波斯语数据库，包括Iranmedex、SID、Irandoc和Magiran。在广泛审查相关资源后，13篇文章符合我们的纳入标准。然后，我们提取了相关数据，包括干预措施的类型和持续时间、样本量、干预前后污名得分的均值和标准差。为了在纳入的干预措施中制定该方案，我们邀请了16位心理学、精神病学和社会医学领域的专家，在德尔菲过程中根据有效性、可行性和适用性等多个变量对干预措施进行评分。
在专家达成共识的德尔菲法中选择的干预措施包括一组四个连续的互动干预措施：播放一部电影并进行讨论、精神病学培训，包括与患有精神疾病的人接触、与患有精神疾病的人进行社交沟通，以及关于定义污名和个人经历的小组讨论。
在本研究中，我们推荐一组以组合、互动和连续干预措施包的形式减少医学生对患有精神疾病患者污名化的干预措施，这些措施先前已被证明在减少与精神疾病相关的污名化方面是有效的。我们期望实施这些干预措施将减少医学生对精神疾病的污名化；这需要进一步验证。
