Vancampfort Davy, Mugisha James, Rosenbaum Simon, Van Damme Tine
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.
University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium.
Pan Afr Med J. 2024 Aug 7;48:160. doi: 10.11604/pamj.2024.48.160.39919. eCollection 2024.
primary care settings are ideal to implement suicide risk reduction initiatives in low-and middle-income countries. Health staff working in primary care settings are often over-burdened and under-resourced. Task-shifting through lifestyle counseling by lay health workers might be a relevant intervention. The aim of this secondary analysis from a pilot study exploring the efficacy of lay health worker (LHW)-led physical activity (PA) counselling for primary care patients with mental health problems (PCMH) was to investigate the efficacy of PA on reducing suicidal ideation.
from 130 Ugandan PCMH screened in two centers, 8.5% (n=11) reported suicidal ideation. These 11 PCMH (9♀, median age= 52 years, interquartile range= 37 years) participated once weekly for 8 weeks in group PA counselling based on the mental contrasting and implementation of intentions framework. All participants completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Simple Physical Activity Questionnaire (SIMPAQ) pre- and immediately post-intervention.
in PCMH with suicidal ideation (PHQ-9 item 9≥1) the prevalence of suicidal ideation dropped to 9% post-intervention, i.e. only one patient reported suicidal ideation post-intervention. Following the intervention, significant (P<0.05) increases in walking, exercising and incidental PA (SIMPAQ) levels, and reductions in depressive and anxiety symptoms were observed.
our data demonstrate that LHW-led PA counselling might be promising intervention in reducing suicidal ideation in primary care patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.
在低收入和中等收入国家，初级保健机构是实施降低自杀风险举措的理想场所。在初级保健机构工作的卫生人员往往负担过重且资源不足。通过非专业卫生工作者进行生活方式咨询来实现任务转移可能是一种相关干预措施。这项二次分析源自一项探索非专业卫生工作者（LHW）主导的体育活动（PA）咨询对患有心理健康问题的初级保健患者（PCMH）疗效的试点研究，其目的是调查体育活动对减少自杀意念的疗效。
在两个中心筛查的130名乌干达PCMH中，8.5%（n = 11）报告有自杀意念。这11名PCMH（9名女性，年龄中位数 = 52岁，四分位间距 = 37岁）基于心理对比和实施意图框架，每周参加一次为期8周的团体体育活动咨询。所有参与者在干预前和干预后立即完成了患者健康问卷 - 9（PHQ - 9）、广泛性焦虑障碍 - 7（GAD - 7）和简单体育活动问卷（SIMPAQ）。
在有自杀意念的PCMH（PHQ - 9第9项≥1）中，干预后自杀意念的患病率降至9%，即干预后只有一名患者报告有自杀意念。干预后，观察到步行、锻炼和偶然体育活动（SIMPAQ）水平显著（P < 0.05）提高，抑郁和焦虑症状减轻。
我们的数据表明，由非专业卫生工作者主导的体育活动咨询可能是在资源匮乏环境中减少初级保健患者自杀意念的一种有前景的干预措施。有必要进行随机对照试验来证实这些有益的发现。
