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绘制和识别战争影响儿童心理健康和心理社会支持干预措施的障碍和促进因素。

MAPPING AND IDENTIFYING BARRIERS AND FACILITATORS TO MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT INTERVENTIONS FOR WAR-AFFECTED CHILDREN.

机构信息

INTERNATIONAL PLATFORM ON MENTAL HEALTH, KYIV, UKRAINE.

ATHENA INSTITUTE, VRIJE UNIVERSITEIT, AMSTERDAM, THE NETHERLANDS.

出版信息

Pol Merkur Lekarski. 2023;51(1):64-73. doi: 10.36740/Merkur202301110.

Abstract

OBJECTIVE

Aim: to map MHPSS interventions for war-affected children, and to identify the barriers and facilitators for interventions target¬ing different layers of the MHPSS pyramid; to assess differences in methodology and study design to give a general outlook for potential future evaluation of interventions.

PATIENTS AND METHODS

Materials and methods: A scoping review was conducted by utilising PubMed, Scopus, PsychINFO scientific databases (765 articles were found). In addition to IASC MHPSS intervention pyramid as our framework, we used a combination of inductive and de¬ductive coding to find common themes in facilitators and barriers to the effectiveness of interventions within each layer. To geographically illustrate the locations of war-affected areas and their correlating intervention types, we developed a visual map.

CONCLUSION

Conclusions: The phenomenon of unequal distribution of interventions (concentrated in West Asia, North and sub-Saharan Africa, with no interventions (found in literature) in South American or South-East Asia). III-rd level of IASC MHPSS Pyramid "focused, non-specialized supports", received great deal of efforts in MHPSS interventions conducted for children in war-affected areas. Main barriers: increasing trauma-related symptoms; lack of parental or caregiver support impaired successful intervention out¬comes for war-affected children; lack of political will and financial resources, difficulties in priority-setting, or an insufficient health workforce ongoing conflicts. Main facilitators: culturally appropriate design and collaboration with local stakeholders; caregiver involvement in interventions for war-affected children.

摘要

目的

旨在绘制受战争影响儿童的心理健康、社会心理支持和精神卫生服务干预措施图,并确定针对心理健康、社会心理支持和精神卫生服务金字塔不同层面的干预措施的障碍和促进因素;评估方法和研究设计的差异,为未来干预措施的潜在评估提供总体展望。

患者和方法

材料和方法:利用 PubMed、Scopus、PsychINFO 科学数据库进行了范围综述(发现了 765 篇文章)。除了将 IASC 心理健康、社会心理支持和精神卫生服务干预金字塔作为我们的框架外,我们还使用了归纳和演绎编码相结合的方法,在每个层面的干预措施的有效性中找到促进因素和障碍的共同主题。为了直观地说明受战争影响地区的地理位置及其相关干预类型,我们开发了一张可视化地图。

结论

干预措施分布不均的现象(集中在西亚、北非和撒哈拉以南非洲,而在南美洲或东南亚没有文献报道的干预措施)。IASC 心理健康、社会心理支持和精神卫生服务金字塔的第三层“有针对性的、非专业化的支持”,在针对受战争影响地区儿童的心理健康、社会心理支持和精神卫生服务干预措施中得到了大量关注。主要障碍包括创伤相关症状增加;父母或照顾者支持缺失,影响受战争影响儿童的干预措施效果;政治意愿和财政资源缺乏、优先事项设定困难或卫生人力不足;持续冲突。主要促进因素包括文化上适当的设计和与当地利益相关者的合作;照顾者参与受战争影响儿童的干预措施。

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