Department of Psychology, University of Miami, Coral Gables, Florida, USA.
Department of Psychology, University of Nevada, Las Vegas, 4505 South Maryland Parkway, MS 5030, Las Vegas, Nevada, 89154-5030, USA.
BMC Psychiatry. 2023 Jan 13;23(1):32. doi: 10.1186/s12888-023-04528-y.
Task sharing is an implementation strategy which increases access to services by training and supporting treatment delivery by nonspecialists. Such an approach has demonstrated effectiveness for depression and other mental health outcomes; however, few studies in high-income countries have examined nonspecialist providers' (NSPs) perspectives of the acceptability, feasibility, and appropriateness of delivering mental health interventions. We examine qualitative reports of NSPs experiences delivering a brief structured behavioral intervention for depression (called "Do More, Feel Better" [DMFB]) to adults aged 55 and older.
All NSPs (N = 4, 100%) who delivered DMFB participated in a focus group to probe their perceptions of the acceptability, feasibility, and appropriateness of both the intervention and their delivery experience as NSPs. Two coders analyzed the qualitative data from focus groups using codebook thematic analysis.
NSPs perceived the intervention and delivery experience to be acceptable, feasible, and appropriate. Qualitative results provided insight into specific barriers and facilitators which may be important to consider when planning to implement task sharing. Themes that emerged from qualitative data included supervision being highly acceptable and feasible, appropriateness of the intervention for NSPs, and the feasibility of tailoring the intervention to patient participants. NSPs also expressed difficulty managing emotional investment in patients' success and providing therapy during a pandemic and racial violence in the US.
Our results can inform future implementation and sustainment of task sharing interventions to expand access to care.
任务分担是一种实施策略，通过培训和支持非专业人员提供治疗服务来增加服务的可及性。这种方法已经证明对抑郁症和其他心理健康结果有效；然而，在高收入国家，很少有研究考察非专业提供者（NSPs）对提供心理健康干预措施的可接受性、可行性和适当性的看法。我们研究了 NSPs 提供针对 55 岁及以上成年人的简短结构化行为干预（称为“做更多，感觉更好”[DMFB]）的经验的定性报告。
所有提供 DMFB 的 NSP（N=4，100%）都参加了焦点小组，以探究他们对干预措施以及作为 NSP 提供干预措施的可接受性、可行性和适当性的看法。两位编码员使用代码本主题分析对焦点小组的定性数据进行了分析。
NSPs 认为干预措施和交付体验是可接受、可行和适当的。定性结果深入了解了在计划实施任务分担时可能需要考虑的具体障碍和促进因素。从定性数据中出现的主题包括监督是高度可接受和可行的、干预措施对 NSPs 的适宜性以及根据患者参与者的情况调整干预措施的可行性。NSPs 还表示，在大流行和美国种族暴力期间，他们在管理对患者成功的情感投入以及提供治疗方面存在困难。
我们的研究结果可以为未来实施和维持任务分担干预措施以扩大获得护理的机会提供信息。
