防治非自愿移民心理健康问题干预措施的系统评价  

Interventions on Preventing and Treating Mental Health Problems of Involuntary Migrants:A Systematic Review

作　　者：刘琴[1] 王宏[1] 王伟[2] 张帆[1] 李鹃[1] 宋文丰[1] 雷迅[1] 李蕾[1] 汪洋[1] 

机构地区：[1]重庆医科大学公共卫生学院,重庆400016 [2]山东潍坊医学院卫生事业管理系,山东261042

出　　处：《中国循证医学杂志》2009年第9期929-937,共9页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金(项目号30671792)

摘　　要：目的全面系统地回顾不同国家和地区为防治非自愿移民心理健康问题所采取的干预措施,并评价不同干预措施的效果。方法检索ISI Web of Science等10个电子数据库和3个灰色文献数据库,检索时间截止至2008年11月。同时检索相关机构网站和Google搜索引擎,以弥补数据库的遗漏。纳入描述和评价已实施的防治非自愿移民心理健康问题的干预研究。由两名研究者独立进行文献筛选、质量评价及资料提取,而后交叉核对,讨论达成一致意见。鉴于各纳入研究的干预类型、干预措施、研究设计及结局指标存在异质性,不能进行Meta分析,采用定性方法系统归纳纳入文献的信息和结果。结果最终纳入35篇文献,其中16篇描述干预措施,19篇评价干预效果。研究对象主要是战争、暴力及其它酷刑引起的难民和寻求庇护者,水库移民仅1篇。所有心理干预分为预防干预和治疗干预两类,其主要干预措施有:心理综合干预、团体疗法、认知行为疗法、证言疗法、叙事暴露疗法、支持性咨询服务、家庭支持及疗法等,其中综合干预是最常用的干预方法。评价心理干预效果的研究大部分为观察性研究,仅6个研究为对照试验,且存在较多方法学局限。绝大多数研究结果显示,已开展的心理干预对非自愿移民心理健康有积极的促进作用。结论目前针对非自愿移民开展的心理健康干预研究有限,尚缺乏设计严谨的评价性研究。应对非自愿移民心理健康干预,尤其是预防性干预开展更多研究,并开展大样本、设计严格的高质量试验,以评价适用于不同非自愿移民群体的最有效的心理干预方式。Objective To systematic review the international interventions on mental health of involuntary migrants,and evaluate the effects of different interventions.Methods We searched 10 international electronic databases and 3 grey literature databases to November 2008.Websites of relevant organizations and Google were searched for any missing information.Research papers that reported describing or evaluating any interventions on preventing and treating mental health problems of involuntary migrants were included.Two reviewers independently screened, appraised and extracted the data, disagreements were resolved by discussion. Implemented interventions were summarized and analyzed by qualitative synthesis method. As there was heterogeneity in the type of interventions, study design, and outcomes, the study results were not pooled statistically in meta analysis. Results Of the 35 studies included in the analysis, 16 studies aimed to describe intervention strategies, while 19 studies were to evaluate effectiveness of interventions. The targeted population were mainly refugees and asylum seekers caused by the war, violence and other tortures, while only one study targeted at reservoir migrants. All the psychological interventions were divided into prevention intervention and treatment intervention. The main interventions include： integrated psychological intervention, group treatment, cognitive behavior therapy, testimony, narrative exposure therapy, supportive counseling service, family support and therapy, etc. Of which, integrated psychological interventions are the most common intervention. Most of the studies evaluating effectiveness are observational studies, while only six are controlled trials. The results of most evaluation studies show that the implemented psychological interventions have positive impact on mental health of involuntary migrants. Conclusions There are limited intervention studies on mental health of involuntary migrants, and evaluation studies are lack of rigorous design. More research especially

关 键 词：非自愿移民 心理健康 干预措施 

分 类 号：B849[哲学宗教—应用心理学] D632.4[哲学宗教—心理学]