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Mental health Apps to address inequitable access to care in specific regions of the global North and South: A scoping review 精神卫生应用程序解决全球北方和南方特定地区不公平获得医疗服务的问题:范围审查
Pub Date : 2021-07-07 DOI: 10.32920/ihtp.v1i2.1425
Raneeshan Rasendran, F. Ahmad
Introduction: There is a recent growth in the development of mental health applications (MHAPPs) to reduce stigma, improve knowledge and facilitate access to care especially in the area of common mood disorders. Yet, it remains unclear whether such interventions can address the access to care gap equitably in the global North and South. Such understanding could provide insights for mental health innovations during the COVID-19 pandemic as well. Methods: Using Arksey and O’Malley’s methodical framework, a scoping review was conducted on academic and grey literature published during 2015 and 2019. The countries of India and China were selected as exemplar for the global South and Canada and US for the global North. The reviewed literature was synthesized through thematic analysis and employed the social determinants of health lens.  Results: 20 articles were selected for full-text review. The results reveal that MHAPPs for depression and anxiety are efficacious in improving symptoms across the examined regions. Outcome scores (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, flourishing scale, social interaction anxiety scale) improved in 13 studies. Yet, public awareness in the global North and logistical barriers (mental health stigma/discrimination, financial and social challenges, usability of apps, and cultural barriers to self-care) in the global South inhibit uptake. Conclusion: Awareness of MHAPPs and logistical barriers must be addressed to make MHAPPs more accessible. Policy makers should be cautious in implementing MHAPPs in disadvantaged communities given several challenges. A broader policy level emphasis is needed to address the logistical capabilities and cultural sensitivity of MHAPPs. The findings are also discussed in relation to the digital innovations for mental health in the pandemic. Given the focus of the presented review on specific regions, the transferability of findings warrant caution.
导读:最近在精神卫生应用(MHAPPs)方面的发展有所增长,以减少耻辱感,提高知识和促进获得护理,特别是在常见情绪障碍领域。然而,目前尚不清楚这些干预措施是否能够公平地解决全球北方和南方在获得医疗服务方面的差距。这种理解也可以为COVID-19大流行期间的心理健康创新提供见解。方法:采用Arksey和O 'Malley的方法框架,对2015年至2019年发表的学术文献和灰色文献进行范围评估。印度和中国被选为全球南方的典范,加拿大和美国被选为全球北方的典范。回顾文献是通过专题分析和采用健康镜头的社会决定因素综合。结果:20篇文章入选全文综述。研究结果表明,针对抑郁和焦虑的MHAPPs在改善被检查区域的症状方面是有效的。结果评分(患者健康问卷-9,广泛性焦虑障碍-7,繁荣量表,社会互动焦虑量表)在13项研究中得到改善。然而,全球北方的公众意识和全球南方的后勤障碍(精神健康耻辱/歧视、金融和社会挑战、应用程序的可用性以及自我保健的文化障碍)阻碍了人们的接受。结论:必须解决对MHAPPs的认识和后勤障碍,使MHAPPs更容易获得。考虑到一些挑战,决策者在弱势社区实施MHAPPs时应谨慎。需要在更广泛的政策层面强调解决MHAPPs的后勤能力和文化敏感性问题。还讨论了调查结果与大流行期间精神卫生的数字创新的关系。鉴于本次审查的重点是特定区域,调查结果的可转移性值得谨慎对待。
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引用次数: 0
Mental health seeking behaviour of women university students: An intersectional analysis 女大学生心理健康寻求行为的交叉分析
Pub Date : 2021-07-07 DOI: 10.32920/ihtp.v1i2.1436
Rodrick Lal, G. Reaume, Christo El Morr, N. Khanlou
This research study explored the mental health seeking behaviour of racialized and non-racialized female students at a large size public university located in Ontario, Canada. A sample consisting of 570 students participated in the cross-sectional survey.  The majority (n = 413, 84.1%) were identified as Canadian racialized female students. The remainder (n = 78, 15.9%) were Canadian non-racialized female students, identifying with dominant Canadian culture. We contended that intersectionality, an emergent theoretical and methodological public health framework, provides a powerful tool for understanding these complex interlocking experiences in the context of mental health. High levels of depression and anxiety symptoms were reported by both the racialized non-racialized female students. The proportion of students with CES-D scores > 16 (indicating that may suffer from depression) was higher among the female racialized students (n = 265, 64.2%) than the non-racialized female students (n = 39, 50.0%). Approximately, half of the racialized students (n = 202, 48.9%) had BAS scores > 10 indicating that they may suffer from anxiety. About half (n = 38, 48.7%) of the non-racialized students also had BAS scores > 10 indicating that they may suffer from anxiety. The findings of this research study advocate university governance, healthcare professionals, and counsellors need to improve their services to address the specific needs and concerns of racialized students. Future research should focus on how findings can be translated into practice by designing culturally adaptive treatment modalities, that focus on resolving mental health problems in racialized and non-racialized female students especially in times of crisis similar to the Corvid-19 pandemic.
本研究探讨了加拿大安大略省一所大型公立大学中种族化和非种族化女学生的心理健康寻求行为。样本包括570名学生参加了横断面调查。大多数(n = 413, 84.1%)被确定为加拿大种族化的女学生。其余(n = 78, 15.9%)为加拿大非种族化女学生,认同加拿大主流文化。我们认为,交叉性是一个新兴的理论和方法论公共卫生框架,为理解心理健康背景下这些复杂的连锁体验提供了有力的工具。种族化的女学生和非种族化的女学生都报告了高水平的抑郁和焦虑症状。种族化女生的CES-D分数> 16(可能患有抑郁症)的比例(n = 265, 64.2%)高于非种族化女生(n = 39, 50.0%)。大约有一半的种族化学生(n = 202, 48.9%)的BAS分数> 10,表明他们可能患有焦虑。大约一半(n = 38, 48.7%)的非种族化学生的BAS分数也> 10,这表明他们可能患有焦虑症。这项研究的结果提倡大学治理、医疗保健专业人员和辅导员需要改善他们的服务,以解决种族化学生的具体需求和关注。未来的研究应侧重于如何通过设计文化适应性治疗方式将研究结果转化为实践,这些治疗方式侧重于解决种族化和非种族化女学生的心理健康问题,特别是在类似于covid -19大流行的危机时期。
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引用次数: 4
Migrants’ wellbeing and use of information and communication technologies. 移徙者的福祉和信息和通信技术的使用。
Pub Date : 2021-07-07 DOI: 10.32920/ihtp.v1i2.1421
J. Salma, L. Kaewwilai, S. A. Ali
The number of migrants is increasing worldwide coupled with an ever-expanding entrenchment of information and communication technologies (ICTs) in the fabric of daily life. There has been little attention in the health disciplines to the unique ways migrants adopt and are influenced by ICTs across multiple local and transnational social spaces. This scoping review explores the current evidence on migrants’ ICT-mediated transnational social activities and related influences on wellbeing. The review was conducted using Arksey and O'Malley’s (2005) methodological framework and a total of 37 articles were included for the final study. Key findings highlight barriers and facilitators of ICT use in transnational contexts, types of ICT-mediated transnational social activities; and reported influences on migrants’ wellbeing. Migrants’ ICT use facilitates reciprocal channels of social support and continuation of valued social roles. Social role disruption, unequal exchange of social support, and mismatch between migrants’ expectations around ICT use and that of left-behind communities are some of the negative processes with psychological, social, and emotional consequences identified in the review.  Main review conclusions emphasize the need to further explore the quality and intensity of ICT-mediated social influences on migrants’ wellbeing and to incorporate a transnational lens in the design of digital learning interventions targeting vulnerable migrant populations.
在世界范围内,移民人数不断增加,而信息和通信技术(ict)在日常生活中的地位也日益巩固。卫生学科很少注意到移民在多个地方和跨国社会空间采用和受到信通技术影响的独特方式。本综述探讨了目前关于移民信息通信技术介导的跨国社会活动及其对幸福感的相关影响的证据。本综述采用Arksey和O'Malley(2005)的方法框架进行,最终研究共纳入37篇文章。主要发现强调了在跨国背景下使用信息通信技术的障碍和促进因素,信息通信技术介导的跨国社会活动的类型;以及对移民福利的影响。移民对信息通信技术的使用促进了社会支持的互惠渠道和有价值的社会角色的延续。社会角色中断、社会支持的不平等交换以及移民对信息通信技术使用的期望与留守社区的期望之间的不匹配是审查中确定的一些具有心理、社会和情感后果的负面过程。主要审查结论强调,需要进一步探讨信息通信技术介导的对移民福祉的社会影响的质量和强度,并在设计针对弱势移民群体的数字学习干预措施时纳入跨国视角。
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引用次数: 3
Perspectives of service agencies on factors influencing immigrants’ mental health in Alberta, Canada 加拿大艾伯塔省移民心理健康影响因素的服务机构视角
Pub Date : 2021-07-07 DOI: 10.32920/ihtp.v1i2.1437
Dominic A. Alaazi, S. Meherali, E. Diaz, K. Hegadoren, Neelam Saleem Punjani, B. Salami
Newcomers to Canada experience resettlement challenges that affect their mental well-being. Guided by an intersectionality theoretical framework, we sought the perspectives of immigrant service agencies on factors influencing immigrants’ mental health in Alberta, Canada.  Data were collected by means of qualitative interviews and focus groups with immigrant service providers. Our data analysis identified seven themes – precarious immigration status, employment discrimination, social isolation, socioeconomic pressures, sociocultural stress, gender and age-related vulnerabilities, and lack of appropriate mental health supports – reflecting the major intersecting determinants of immigrants’ mental health. We propose policy interventions for addressing the mental health vulnerabilities of immigrants.  
加拿大的新移民经历了重新安置的挑战,影响了他们的心理健康。在交叉性理论框架的指导下,我们寻求移民服务机构对影响加拿大阿尔伯塔省移民心理健康因素的观点。数据收集的方式定性访谈和焦点小组与移民服务提供者。我们的数据分析确定了七个主题——不稳定的移民身份、就业歧视、社会孤立、社会经济压力、社会文化压力、性别和年龄相关的脆弱性,以及缺乏适当的心理健康支持——反映了移民心理健康的主要交叉决定因素。我们提出了解决移民心理健康脆弱性的政策干预措施。
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引用次数: 2
Engaging in a newspaper cartoon thematic analysis to understand the socioeconomic, health, political, and environmental impact of COVID-19 in Sri Lanka 参与报纸漫画专题分析,了解2019冠状病毒病对斯里兰卡的社会经济、健康、政治和环境影响
Pub Date : 2021-07-07 DOI: 10.32920/ihtp.v1i2.1420
D. Dassanayake, S. Rathnayake, Sujeewa Dilhani Maithreepala, Nimanthika Sanjeewani
Introduction: Newspaper cartoons are viewed as an effective means of communicating important social concerns.   Method:An exploratory content analysis of newspaper cartoons was done during the COVID-19 outbreak in Sri Lanka . Cartoons from eight daily online newspapers published from 15th of March to 15th of April 2020 were included. “corona”, “COVID-19”, or “Sri Lanka” were used as keywords. Thematic analysis was used to identify the different perspectives of cartoons. Results: Background of COVID-19 pandemic, health, social, economic, political, and environmental aspects emerged within a sample of 87 cartoons. Thirteen common themes were identified as COVID-19 as a pandemic, COVID-19 has become a crisis for Sri Lanka, prevention is the priority, knowledge deficit leads to breaking health advice, efforts to control virus outbreak, shifting socio-cultural practices, effects of lockdown, rich man’s virus – poor suffer the most bringing the global economy to its knee, coronavirus is driving the black market for essential stuff, seeking strategies to hold the election, applying health precautions in election activities and other political involvements. Conclusion: Cartoons were effectively used to give broad health and other messages to the public during the COVID-19 outbreak in Sri Lanka. Newspaper cartoons can be used as an effective mode of disseminating information during a crisis.
导读:报纸漫画被视为传达重要社会问题的有效手段。方法:对斯里兰卡2019冠状病毒病疫情期间的报纸漫画进行探索性内容分析。包括2020年3月15日至4月15日期间出版的八份每日在线报纸的漫画。关键词是“冠状病毒”、“COVID-19”或“斯里兰卡”。主题分析用于识别卡通的不同视角。结果:在87幅漫画样本中出现了COVID-19大流行、健康、社会、经济、政治和环境方面的背景。新冠肺炎已成为斯里兰卡的一场危机、预防是首要任务、知识不足导致违反健康建议、努力控制病毒爆发、社会文化习俗的转变、封锁的影响、富人的病毒——穷人受影响最大、全球经济陷入瘫痪、冠状病毒推动必需品黑市、寻求举行选举的战略、在选举活动和其他政治活动中采取卫生预防措施。结论:在斯里兰卡2019冠状病毒病爆发期间,漫画被有效地用于向公众提供广泛的健康和其他信息。在危机期间,报纸漫画可以作为一种有效的信息传播方式。
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引用次数: 0
“The little lights in this dark tunnel”: Emotional support of nurses working in COVID-19 acute care hospital environments “黑暗隧道中的小灯”:COVID-19急症护理医院环境中护士的情感支持
Pub Date : 2021-04-05 DOI: 10.32920/IHTP.V1I1.1417
J. Lapum, M. Nguyen, Sannie Lai, J. McShane, S. Fredericks
Background: Working on the frontlines of hospitals during the COVID-19 pandemic has been challenging and distressing for nurses. The troublesome nature of these emotions have surfaced because of uncharted territory related to this virus, compromised work conditions, unfavourable patient outcomes, and the witnessing of suffering and loss. Although there has been renewed emphasis on how to emotionally support nurses, the nature of support needed is somewhat unknown considering that healthcare professionals have not experienced a pandemic of this magnitude in their lifetime. Aim: We explored how nurses were emotionally supported and how they can be better supported while working in COVID-19 acute care hospital environments. Methods: In this narrative study, semi-structured interviews were conducted with 20 registered nurses working in hospitals in the Greater Toronto Area and working on units caring for COVID-19+ patients. Results and Conclusions: Our findings reflected the organic emergence of support, intentional forms of support, and the social justice nature of support. It is important for hospital and government leaders to employ a multifold approach to emotionally support nurses. These supports include information transparency, visible presence of leadership, and recognition of nurses’ contributions. While emotionally supporting nurses, these types of resources can act as “little lights in this dark tunnel” of COVID-19 and illuminate a path forward. Implications: Some strategies relevant to clinical practice include regular rounding of units by leaders, and transparent communication about information and resources. Other strategies are on-site psychological support and legitimate support of mental health sick days as well as lobbying governments for financial compensation for the risky work involved in being a frontline provider and appropriate provision of personal protective equipment.
背景:在2019冠状病毒病大流行期间,护士在医院一线的工作充满挑战和痛苦。由于与该病毒有关的未知领域、恶劣的工作条件、不利的患者预后以及目睹痛苦和损失,这些情绪的麻烦性质已经浮出水面。虽然重新强调了如何在情感上支持护士,但考虑到卫生保健专业人员一生中从未经历过如此大规模的流行病,所需支持的性质有些未知。目的:我们探讨了护士在COVID-19急性护理医院环境中如何获得情感支持,以及如何更好地支持他们。方法:采用半结构化访谈方法,对20名在大多伦多地区医院和COVID-19+患者护理单位工作的注册护士进行访谈。结果和结论:我们的研究结果反映了支持的有机出现、支持的有意形式和支持的社会正义性质。对医院和政府领导来说,重要的是采用多种方式在情感上支持护士。这些支持包括信息透明、领导的明显存在以及对护士贡献的认可。在为护士提供情感支持的同时,这些类型的资源可以作为COVID-19“黑暗隧道中的小灯”,照亮前进的道路。启示:一些与临床实践相关的策略包括领导定期对单位进行四舍五入,以及信息和资源的透明沟通。其他战略包括现场心理支持和对精神健康病假的合法支持,以及游说政府为作为一线提供者所涉及的危险工作提供经济补偿和适当提供个人防护装备。
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引用次数: 6
Invisible diaspora: A scoping review of migrant caregivers’ social integration trajectory 看不见的散居:移民看护者社会融合轨迹的范围审查
Pub Date : 2021-04-04 DOI: 10.32920/IHTP.V1I1.1419
Oona St-Amant, M. Vahabi, J. Wong, B. Salami, K. Fung, J. Miholjcic, V. Tan
Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequate public policy and programs on child and elder care in Canada. Consequently, migrant caregivers have become an invisible diaspora filling a domestic labour gap with few protections. Aim and Methods: This scoping review aims to identify the systemic barriers that undermine social integration of migrant caregivers. We searched ten publication index databases from 2001-2020. We retrieved 1,624 articles, after accounting for exclusion criteria, 22 peer-reviewed articles were selected for this review representing migrant women across Canada who are and/or were part of the program. Results: Four key barriers were identified: economic exploitation, deskilling and downward occupational mobility, asymmetrical accountability, and social isolation. Conclusion: Discriminatory policies and hidden exploitative employment practices of the Canadian Caregiver program perpetuate a cycle of marginalization. This review also found that community support groups and alliances function to promote resilience among migrant caregivers through community advocacy.
背景:加拿大照顾者计划于1992年启动,其功能是掩盖加拿大在儿童和老年人护理方面的公共政策和计划的不足。因此,移民看护者已经成为一种无形的散居者,填补了国内劳动力缺口,几乎没有什么保护。目的和方法:本综述旨在确定影响流动护理人员社会融合的系统性障碍。我们检索了2001-2020年间的10个出版物索引数据库。我们检索了1,624篇文章,在考虑了排除标准后,我们选择了22篇同行评议的文章,这些文章代表了加拿大各地的移民妇女,她们是和/或曾经是该计划的一部分。结果:确定了四个主要障碍:经济剥削、技能下降和向下的职业流动、不对称的问责制和社会孤立。结论:加拿大护工项目的歧视性政策和隐性剥削性就业实践使边缘化的循环永久化。本综述还发现,社区支持团体和联盟通过社区倡导来促进移民看护者的复原力。
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引用次数: 0
Influence of preferences in intervention research: A scoping review 干预研究中偏好的影响:范围综述
Pub Date : 2021-04-04 DOI: 10.32920/IHTP.V1I1.1424
S. Sidani
Introduction: Accounting for treatment preferences is beneficial in practice, it increases adherence to treatment and improves health outcomes. The randomized controlled trial (RCT) is considered the most robust in generating valid evidence on effectiveness, yet it ignores participants’ preferences for treatment. This scoping review addressed three questions: 1) How are treatment preferences conceptualized in intervention research? 2) To what extent do treatment preferences affect participants’ enrollment in trials, withdrawal from the study, adherence to treatment, and outcomes? And 3) What designs are used to account for treatment preferences in intervention evaluation research? Methods: The first five steps of the scoping review methodology framework were applied: 1) identifying the research questions; 2) searching the literature; 3) selecting articles; 4) charting data; and 5) summarizing findings. Results: Treatment preferences refer to choice treatment; they are shaped by participants’ beliefs and appraisal of the interventions. Evidence from reviews and primary studies indicated that offering participants the opportunity to choose and receive the preferred treatment enhances enrollment and reduces withdrawal in trials; however, the evidence regarding the influence of treatment preferences on adherence to treatment and improvement in outcomes is inconclusive. Designs that account for treatment preferences include: RCT, RCT with a comprehensive cohort, partially randomized preference trial, and two-stage partially randomized trial. Conclusion: The pattern of results may be attributed to the methods for assessing treatment preferences. A systematic method for assessing preferences is recommended.
导言:考虑治疗偏好在实践中是有益的,它增加了对治疗的依从性并改善了健康结果。随机对照试验(RCT)被认为在产生有效性的有效证据方面是最可靠的,但它忽略了参与者对治疗的偏好。本综述涉及三个问题:1)干预研究中治疗偏好是如何概念化的?2)治疗偏好在多大程度上影响受试者入组试验、退出研究、坚持治疗和结局?3)在干预评估研究中使用什么设计来解释治疗偏好?方法:应用范围审查方法学框架的前五个步骤:1)确定研究问题;2)文献检索;3)选择文章;4)制图数据;5)总结研究结果。结果:治疗偏好指选择治疗;它们是由参与者的信念和对干预措施的评价形成的。来自综述和初步研究的证据表明,为参与者提供选择和接受首选治疗的机会可以提高入组率,减少试验中的退出;然而,关于治疗偏好对治疗依从性和结果改善的影响的证据尚无定论。考虑治疗偏好的设计包括:随机对照试验、综合队列随机对照试验、部分随机偏好试验和两阶段部分随机试验。结论:结果的模式可能归因于评估治疗偏好的方法。推荐一种评估偏好的系统方法。
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引用次数: 0
The impact of a transitional intervention for youth living with early psychosis: A mixed methods study 过渡性干预对青少年早期精神病患者的影响:一项混合方法研究
Pub Date : 2021-04-04 DOI: 10.32920/IHTP.V1I1.1423
E. McCay, P. Tibbo, Gretchen Conrad, Andria Aiello, C. Crocker, H. Beanlands, Jasna K. Schwind, Nicole Kirwan, J. Langley, Clare Sheasgreen, A. Danaher
Our research team implemented and evaluated a 12-week manual-based intervention focused on sustaining recovery for youth with psychosis, as they transitioned from Early Psychosis Intervention (EPI) to community-based care teams. The study employed a mixed methods prospective cohort design. Statistically significant improvement in functioning was observed for the intervention group participants only; as well as observed improvements in self-esteem and quality of life (SQLS), compared to the comparison group who demonstrated a significant decline in functioning. The qualitative findings revealed a sense of optimism about the future and the value of realistic goal-setting in the intervention group. Keywords: Early Psychosis, Transitional Intervention, Recovery, Functioning, Goal-Setting    
我们的研究团队实施并评估了一项为期12周的以手册为基础的干预,重点是在青少年精神病患者从早期精神病干预(EPI)过渡到以社区为基础的护理团队时,持续恢复。本研究采用混合方法、前瞻性队列设计。只有干预组的参与者在功能上有统计学上的显著改善;以及观察到的自尊和生活质量(SQLS)的改善,与表现出功能显著下降的对照组相比。定性调查结果显示,干预组对未来的乐观态度和现实目标设定的价值。关键词:早期精神病,过渡性干预,康复,功能,目标设定
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引用次数: 0
A scoping review of insomnia treatments for people living with HIV 艾滋病毒感染者失眠治疗的范围审查
Pub Date : 2021-04-04 DOI: 10.32920/IHTP.V1I1.1422
Joyal Miranda, S. Sidani, J. Côté, S. Fredericks
Abstract To date, little is known in terms of viable treatments for insomnia in people living with HIV. The primary aim of this scoping review is to identify non-pharmacological treatments for insomnia in people living with HIV (PLWH). A framework by Arksey and O’Malley was used to guide the conduct of this scoping review. Seven studies were identified. Three of the studies used cognitive-behavioral type of treatments versus physical or alternative types of treatment. The most effective treatments with the largest effect sizes were found to be cognitive-behavioral treatments for the sleep outcomes of sleep quantity (1.11-1.91) and sleep quality (1.11-1.91). This review found that cognitive behavioral interventions were found to be the most effective treatments for insomnia for PLWH. Further research would benefit from larger sample size studies in addition to focusing on the determinants of insomnia in PLWH in order to further provide a treatment that is focused on the needs of PLWH.    
迄今为止,对于HIV感染者失眠的可行治疗方法知之甚少。本综述的主要目的是确定HIV感染者(PLWH)失眠的非药物治疗方法。Arksey和O 'Malley的框架被用来指导这种范围审查的进行。共确定了7项研究。其中三项研究使用了认知行为疗法,而不是物理疗法或替代疗法。认知行为治疗对睡眠量(1.11-1.91)和睡眠质量(1.11-1.91)的影响最大,效果最有效。本综述发现认知行为干预是治疗PLWH患者失眠最有效的方法。除了关注PLWH患者失眠的决定因素外,进一步的研究将受益于更大样本量的研究,以便进一步提供一种专注于PLWH患者需求的治疗方法。
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引用次数: 0
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International Health Trends and Perspectives
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