印度大吉岭地区教师向学生提供任务转移型心理健康护理的教师、护理人员及学生接受度：一项混合方法试点研究
Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study.
作者信息
Cruz Christina M, Dukpa Choden, Vanderburg Juliana L, Rauniyar Abhishek K, Giri Priscilla, Bhattarai Surekha, Thapa Arpana, Hampanda Karen, Gaynes Bradley N, Lamb Molly M, Matergia Michael
机构信息
Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599 USA.
School Psychology Program, University of North Carolina at Chapel Hill School of Education, Chapel Hill, NC USA.
出版信息
Discov Ment Health. 2022;2(1):21. doi: 10.1007/s44192-022-00024-z. Epub 2022 Oct 31.
BACKGROUND
The acceptability of teachers delivering task-shifted mental health care to their school-aged students is understudied. Here, we evaluate teachers', students', and caregivers' acceptability of (Teachers Leading the Frontlines), an alternative system of care in which teachers are trained and supervised to deliver transdiagnostic, non-manualized task-shifted care to their students.
METHODS
In a 2019 single-arm, mixed methods, pragmatic acceptability pilot study in Darjeeling, India, 13 teachers delivered task-shifted child mental health care to 26 students in need. Teachers delivered care through using a transdiagnostic, non-manualized therapy modality, "education as mental health therapy" (Ed-MH). Measured with validated scales, teachers' and students' acceptability were compared after teacher training (PRE) and at the end of intervention (POST) using paired tests. Teachers (n = 7), students (n = 7), and caregivers (n = 7) completed semi-structured interviews POST.
RESULTS
Teachers' quantitative measures indicated moderate acceptability PRE and POST and did not change PRE to POST. Children's measures showed acceptability PRE and POST but decreased PRE to POST. Teachers and caregivers universally expressed acceptability in interviews. Facilitators of acceptability included impact, trust of teachers, and teachers' ability to make adaptations. Conditions required for acceptability included supervision and teachers emphasizing academics benefits over mental health benefits to caregivers. Barriers to acceptability included a lack of teacher time and stigma. Interviewed students universally were unaware of receiving care; teachers intentionally avoided singling them out.
CONCLUSION
Teachers, caregivers, and children found teacher delivering task-shifted care acceptable, a key factor in care adoption and sustainability, though interviewed children were unaware of receiving care. The trial was registered on January 01, 2018 with Clinical Trials Registry-India (CTRI), Reg. No. CTRI/2018/01/011471, Ref. No. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s44192-022-00024-z.
背景
教师为学龄学生提供任务转移式心理健康护理的可接受性研究不足。在此，我们评估教师、学生和照料者对“教师引领前线”（Teachers Leading the Frontlines）这一替代护理系统的可接受性，该系统中教师接受培训和监督，以便为学生提供跨诊断、非手册化的任务转移式护理。
方法
在2019年于印度大吉岭开展的一项单臂、混合方法、务实可接受性试点研究中，13名教师为26名有需要的学生提供了任务转移式儿童心理健康护理。教师通过使用一种跨诊断、非手册化的治疗方式“将教育作为心理健康治疗”（Ed-MH）来提供护理。使用经过验证的量表进行测量，在教师培训后（干预前）和干预结束时（干预后），通过配对检验比较教师和学生的可接受性。13名教师、7名学生和7名照料者在干预后完成了半结构化访谈。
结果
教师的定量测量结果表明，干预前和干预后的可接受性为中等，且从干预前到干预后没有变化。儿童的测量结果显示干预前和干预后具有可接受性，但从干预前到干预后有所下降。教师和照料者在访谈中普遍表示接受。可接受性的促进因素包括影响、对教师的信任以及教师进行调整的能力。可接受性所需的条件包括监督以及教师向照料者强调学业益处而非心理健康益处。可接受性的障碍包括教师时间不足和污名化。接受访谈的学生普遍不知道自己接受了护理；教师有意避免将他们单独挑出。
结论
教师、照料者和儿童认为教师提供任务转移式护理是可接受的，这是护理采用和可持续性的一个关键因素，尽管接受访谈的儿童不知道自己接受了护理。该试验于2018年1月1日在印度临床试验注册中心（CTRI）注册，注册号为CTRI/2018/01/011471，参考文献编号为REF/2017/11/015895。http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27。
补充信息
在线版本包含可在10.1007/s44192-022-00024-z获取的补充材料。
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