Ndlovu Jacqueline N, Lind Jonna, Patlán Andrés Barrera, Upadhaya Nawaraj, Leku Marx R, Akellot Josephine, Skovdal Morten, Augustinavicius Jura L, Tol Wietse A
Global Health Section, University of Copenhagen, Øster Farimagsgade 5, Building 9, Copenhagen, 1353, Denmark.
ARQ Library, ARQ National Psychotrauma Centre, Diemen, The Netherlands.
BMC Health Serv Res. 2024 Dec 2;24(1):1528. doi: 10.1186/s12913-024-11704-7.
Every year, millions of people are affected by humanitarian crises. With a growing population of people affected, the need for coordination and integration of services aiming to improve the effectiveness of mental health and psychosocial support also grows. In this study, we examine how psychological interventions in humanitarian settings globally have been implemented through integration into programming outside of formal healthcare delivery through multisectoral integration.
A comprehensive search of six databases and reference checking was undertaken in 2022. We included studies focusing on implementation strategies and implementation outcomes of multi-sectoral, integrated psychological interventions, with no year limits. We extracted data using the software Covidence, and used the software to manage screening and reviewing processes. All studies were critically appraised for quality and rigor using the mixed-methods appraisal tool.
Eight studies were included in total. We found that interventions targeted conflict affected, displaced and disaster recovering populations. The interventions demonstrated moderate success in reducing psychological distress and enhancing disaster preparedness. We found that key implementation outcomes investigated and prioritised include acceptability, feasibility, and relevance. The studies reported on integration processes that involved task shifting primarily, with an emphasis on different formats of adaptation, partnership creation and capacity development to maximise effectiveness of integrated interventions.
Overall, there is little research being done to rigorously document the processes and experiences of integrating psychological interventions with non-health interventions. This could be an indication that, while multisectoral integration may be more common in practice, little research is being done or reported in this area formally. There is an urgent need for further research into integrated multi-sectoral interventions. This research should aim to understand how social, cultural, and environmental contexts in different ways, and to different degrees, affect what is acceptable and feasible to deliver and how these ultimately influence the impact of integrated interventions.
每年，数百万人受到人道主义危机的影响。随着受影响人群数量的不断增加，旨在提高心理健康和社会心理支持有效性的服务协调与整合需求也在增长。在本研究中，我们探讨了全球人道主义背景下的心理干预如何通过多部门整合纳入正规医疗服务之外的项目实施中。
2022年对六个数据库进行了全面检索并核对参考文献。我们纳入了关注多部门综合心理干预的实施策略和实施结果的研究，无年份限制。我们使用Covidence软件提取数据，并使用该软件管理筛选和评审过程。使用混合方法评估工具对所有研究的质量和严谨性进行严格评估。
共纳入八项研究。我们发现干预措施针对受冲突影响、流离失所和灾后恢复的人群。这些干预措施在减轻心理困扰和增强备灾能力方面取得了一定成效。我们发现所调查和优先考虑的关键实施结果包括可接受性、可行性和相关性。研究报告的整合过程主要涉及任务转移，重点是不同形式的调整、建立伙伴关系和能力发展，以最大限度地提高综合干预措施的有效性。
总体而言，很少有研究严格记录将心理干预与非健康干预整合的过程和经验。这可能表明，虽然多部门整合在实践中可能更为常见，但该领域正式开展或报告的研究很少。迫切需要对综合多部门干预措施进行进一步研究。这项研究应旨在了解社会、文化和环境背景如何以不同方式、在不同程度上影响提供何种可接受和可行的服务，以及这些最终如何影响综合干预措施的效果。
