Adeboye Adeniyi, Aghalu Ugochukwu, Onuorah Whitney, Samuel-Nwokeji Chizor, Nwanguma Chimaobi, Akerele Adekunle, Wasige Judy
Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom.
Department of Epidemiology, Medical Statistics and Environmental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
PLOS Glob Public Health. 2025 Jul 22;5(7):e0004272. doi: 10.1371/journal.pgph.0004272. eCollection 2025.
Photovoice is a transformative tool for improving health outcomes among people living with mental ill-health (PLWMI), fostering empowerment and social change. Only one meta-analysis has evaluated the effectiveness of photovoice for mental health outcomes. However, the study focused on various health conditions and only addressed two mental health outcomes. With an exclusive focus on mental health and stigma, this meta-analysis aimed to provide a comprehensive understanding of photovoice's impact on eight mental health and stigma-related outcomes in PLWMI and healthcare providers (HCPs). The study included seven randomised control trials (Sample size (n)=754), retrieved from electronic databases including Cochrane Trials, CINAHL Plus, ProQuest, Medline, PsychInfo, and Google Scholar, published between 2013 and 2023. Random-effects meta-analyses were conducted to calculate effect sizes (Cohen's d (d)). The study protocol was pre-registered on PROSPERO (CRD42023476867). Results showed significant improvements in mental health outcomes for PLWMI. Photovoice led to reductions in social withdrawal (n = 318; d, 95% CI = -0.20, -0.41 to 0.00) and depression (n = 267; d, 95% CI = -0.23, -0.45 to -0.02). Additionally, it increased self-efficacy (n = 267; d, 95% CI = 0.22, 0.00 to 0.44) and recovery (n = 285; d, 95% CI = 0.19, -0.02 to 0.41). However, there was a decrease in stigma resistance (n = 318; d, 95% CI = -0.13, -0.36 to 0.10). Among HCPs, there were significant improvements in both stigma and mental health-related outcomes, with reductions in anger (n = 330; d, 95% CI = -1.05, -2.79 to 0.69), social distance (n = 418; d, 95% CI = -1.41, -3.02 to 1.03), and the perception of danger (n = 115; d, 95% CI = -1.80, -5.04 to 1.44). The findings highlight the potential of photovoice as an effective intervention for improving mental health outcomes and reducing stigma in both PLWMI and HCPs. Consequently, photovoice can play a crucial role in enhancing the well-being of PLWMI and in transforming HCP attitudes within healthcare settings.
照片发声法是一种变革性工具，可改善患有精神疾病的人群（PLWMI）的健康状况，促进赋权和社会变革。只有一项荟萃分析评估了照片发声法对心理健康结果的有效性。然而，该研究关注的是各种健康状况，仅涉及两项心理健康结果。本荟萃分析专门聚焦于心理健康和耻辱感，旨在全面了解照片发声法对PLWMI和医疗保健提供者（HCP）的八项心理健康及与耻辱感相关结果的影响。该研究纳入了七项随机对照试验（样本量（n）=754），这些试验从包括Cochrane试验、CINAHL Plus、ProQuest、Medline、PsychInfo和谷歌学术在内的电子数据库中检索，发表时间为2013年至2023年。进行随机效应荟萃分析以计算效应大小（科恩d值（d））。该研究方案已在PROSPERO上预先注册（CRD42023476867）。结果显示，PLWMI的心理健康结果有显著改善。照片发声法使社交退缩减少（n = 318；d，95%置信区间= -0.20，-0.41至0.00），抑郁减轻（n = 267；d，95%置信区间= -0.23，-0.45至-0.02）。此外，它还提高了自我效能感（n = 267；d，95%置信区间= 0.22，0.00至0.44）和康复水平（n = 285；d，95%置信区间= 0.19，-0.02至0.41）。然而，耻辱感抵抗力有所下降（n = 318；d，95%置信区间= -0.13，-0.36至0.10）。在HCP中，耻辱感和心理健康相关结果都有显著改善，愤怒情绪减少（n = 330；d，95%置信区间= -1.05，-2.79至0.69），社交距离缩短（n = 418；d，95%置信区间= -1.41，-3.02至1.03），对危险的认知降低（n = 115；d，95%置信区间= -1.80，-5.04至1.44）。研究结果凸显了照片发声法作为一种有效干预措施在改善PLWMI和HCP的心理健康结果及减少耻辱感方面的潜力。因此，照片发声法在提升PLWMI的幸福感以及改变医疗保健环境中HCP的态度方面可发挥关键作用。
