评估针对山地部落的抑郁关怀模式：基于家庭和社区的参与式研究。
Evaluation of a depression care model for the hill tribes: a family and community-based participatory research.
机构信息
School of Nursing, Mae Fah Luang University, Chiang Rai Province, Mueang Chiang Rai, Thailand.
Center of Excellence for the Hill Tribe Health Research and Training, Mae Fah Luang University, Mueang Chiang Rai, Thailand.
出版信息
BMC Psychiatry. 2023 Aug 4;23(1):563. doi: 10.1186/s12888-023-05058-3.
BACKGROUND
Even though, there is a particularly high prevalence of depression among individuals from the hill tribes in northern Thailand, they are unable to receive appropriate intervention due to cultural, transportation, communication, and legal barriers. Using community-based participatory research (CBPR), a depression care model was developed for the hill tribe population. The effectiveness of this model was examined using questionnaires, observations, focus groups, and in-depth interviews.
METHODS
Participants include people with depression (n = 17) who were chosen based on their mild to moderately severe depression scores on the Patient Health Questionnaire 9-item (PHQ-9 scores of 5-19) and their caregivers (n = 5). The in-depth interview was conducted to distinguish the selected participants into two groups. The first group, the self-help group program, consisted of 12 participants endorsing negative thoughts about themselves and inappropriate problems solving. The second group, the family camp program, had ten participants, including five patients with family-related issues and their family members. Subjects separately participated in either the self-help or the family groups over three weeks. They completed the PHQ-9 at the beginning and end of the intervention. Questionnaires, observations, focus groups, and in-depth interviews were used to evaluate the effectiveness of the model. Content analysis was used to examine the qualitative data. Wilcoxon signed-rank test was used to analyze the changes in the severity of depression before and after participation in the intervention.
RESULTS
The depression scores on the PHQ-9 of 12 participants improved significantly (11.92 ± 1.08 vs. 3.08 ± 0.51; p = 0.002) following participation in the self-help group. Increased self-esteem and improved interpersonal relationships were reported by participants in the self-help group program during interviews. There was no significant difference in the depression scores of 10 participating in the family camp program (6.00 ± 3.83 to 5.30 ± 3.56; p = 0.161).
CONCLUSION
A model for depression care was tested in a hill tribe community, and its effectiveness was clearly observed. The developed model can be applied to other hill tribe communities in northern Thailand to improve depression care.
背景
尽管泰国北部山区部落的人抑郁发病率特别高，但由于文化、交通、沟通和法律障碍，他们无法得到适当的干预。本研究采用社区参与式研究（CBPR），为山区部落人群开发了一种抑郁护理模式。使用问卷、观察、焦点小组和深入访谈来评估该模式的有效性。
方法
参与者包括 17 名患有抑郁症的患者（根据患者健康问卷 9 项（PHQ-9）得分 5-19 分选择轻度至中度抑郁的患者）及其照顾者（n=5）。通过深入访谈将选定的参与者分为两组。第一组，自助组，由 12 名对自己持消极想法和不恰当解决问题的参与者组成。第二组，家庭营组，由 10 名患者及其家庭成员组成，其中 5 名患者有家庭问题。参与者在三周内分别参加自助组或家庭组。他们在干预开始和结束时完成 PHQ-9。使用问卷、观察、焦点小组和深入访谈评估模型的有效性。采用内容分析法对定性资料进行分析。采用 Wilcoxon 符号秩检验分析参与干预前后抑郁严重程度的变化。
结果
参加自助组的 12 名参与者的 PHQ-9 抑郁评分显著改善（11.92±1.08 与 3.08±0.51；p=0.002）。自助组的参与者在访谈中报告说自尊心提高，人际关系得到改善。参加家庭营的 10 名参与者的抑郁评分没有显著差异（6.00±3.83 至 5.30±3.56；p=0.161）。
结论
在一个山区部落社区中测试了一种抑郁护理模式，并观察到其有效性。所开发的模式可以应用于泰国北部其他山区部落社区，以改善抑郁护理。
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