Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Action contre la Faim, Paris, France.
J Glob Health. 2023 Jul 14;13:06010. doi: 10.7189/jogh.13.06010.
In response to the psychological distress experienced by people affected by the onset of the COVID-19 pandemic, Action Against Hunger (Action contre la Faim, ACF) developed and implemented the Emotional and Stress Management Intervention (ESMI) in Liberia, Sierra Leone, and Ivory Coast. ESMI is a person-to-person two-session, non-specialized, mental health and psychosocial support intervention for adults and adolescents in the general population based in problem solving therapy and principles of emotional regulation.
Using de-identified programmatic data for each country, we conducted paired t-tests to assess whether adults and adolescents who received ESMI experienced changes in reported psychological distress and perceived social support following the intervention. We also performed pairwise correlations to test whether there were associations between changes in distress and social support over the course of participation in ESMI. Descriptive analyses were performed for presenting problems and coping strategies reported during the sessions.
Mean scores for psychological distress at baseline and follow-up were significantly different in all countries: Sierra Leone (mean (m) = -6.11; 95% confidence interval (CI) = -6.25 to -5.96); Ivory Coast (m = -3.21; 95% CI = -3.33 to -3.10); and Liberia (m = -2.86; 95% CI = -3.15 to -2.56). Changes in perceived social support were also statistically significant for Sierra Leone (m = 6.87; 95% CI = 6.72-7.02); Ivory Coast (m = 3.12; 95% CI = 2.97-3.27); and Liberia (m = 1.13; 95% CI = 1.00-1.27). Correlations (r) between changes in distress and changes in social support varied by country, and ranged from negative in Liberia, (r = -0.88, P = 0.001), to positive in Ivory Coast (r = 55, P = 0.001), and null in Sierra Leone (r = -0.07, P = 0.11).
Our findings show changes in psychological distress and perceived social support for participants who completed two sessions of ESMI, suggesting a potential benefit of ESMI as a person-to-person mental health and psychosocial support for individuals in distress affected by a pandemic. A future randomized controlled trial with a focus on key implementation factors (i.e., pre-testing visual analogue scales, treatment fidelity, and comparison of in-person vs remote) is recommended as next steps in research.
为了应对 COVID-19 大流行爆发给人们带来的心理困扰，反饥饿行动组织（Action contre la Faim，ACF）在利比里亚、塞拉利昂和科特迪瓦开发并实施了情绪和压力管理干预措施（ESMI）。ESMI 是一种针对普通人群中的成年人和青少年的面对面、非专业的心理健康和心理社会支持干预措施，基于问题解决疗法和情绪调节原则。
使用每个国家的方案数据进行配对 t 检验，以评估接受 ESMI 的成年人和青少年在干预后报告的心理困扰和感知社会支持是否发生变化。我们还进行了两两相关分析，以检验在参与 ESMI 的过程中，困扰和社会支持的变化之间是否存在关联。在会议期间报告的问题和应对策略进行了描述性分析。
所有国家的基线和随访时的心理困扰平均得分均有显著差异：塞拉利昂（m=-6.11；95%置信区间[CI]=-6.25 至-5.96）；科特迪瓦（m=-3.21；95%CI=-3.33 至-3.10）；利比里亚（m=-2.86；95%CI=-3.15 至-2.56）。塞拉利昂（m=6.87；95%CI=6.72-7.02）、科特迪瓦（m=3.12；95%CI=2.97-3.27）和利比里亚（m=1.13；95%CI=1.00-1.27）感知社会支持的变化也具有统计学意义。利比里亚（r=-0.88，P=0.001）的困扰和社会支持变化之间的相关性为负，科特迪瓦（r=55，P=0.001）的相关性为正，塞拉利昂（r=-0.07，P=0.11）的相关性为零。
我们的研究结果表明，完成 ESMI 两个疗程的参与者的心理困扰和感知社会支持均发生变化，这表明 ESMI 作为一种针对大流行中受困扰个人的面对面心理健康和心理社会支持具有潜在益处。建议作为下一步研究，开展一项针对关键实施因素（即预测试视觉模拟量表、治疗一致性和面对面与远程干预的比较）的随机对照试验。
