防治非自愿移民心理健康問題干預措施的系統評價_《中國循證醫學雜志》

作者：

劉琴 ¹ , 王宏 ¹ , 王偉 ² , 張帆 ¹ , 李鵑 ¹ , 宋文豐 ¹ , 雷迅 ¹ , 李蕾 ¹ ,  汪洋 ¹

1. 重慶醫科大學公共衛生學院(重慶 400016);2. 山東濰坊醫學院衛生事業管理系(山東 261042);

關鍵詞：

非自愿移民心理健康干預措施

DOI：

10.7507/1672-2531.20090164

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　全面系統地回顧不同國家和地區為防治非自愿移民心理健康問題所采取的干預措施,并評價不同干預措施的效果。
方法　檢索 ISI Web of Science 等 10 個電子數據庫和 3 個灰色文獻數據庫,檢索時間截止至 2008 年 11 月。同時檢索相關機構網站和 Google 搜索引擎,以彌補數據庫的遺漏。納入描述和評價已實施的防治非自愿移民心理健康問題的干預研究。由兩名研究者獨立進行文獻篩選、質量評價及資料提取,而后交叉核對,討論達成一致意見。鑒于各納入研究的干預類型、干預措施、研究設計及結局指標存在異質性,不能進行 Meta 分析, 采用定性方法系統歸納納入文獻的信息和結果。
結果　最終納入35篇文獻,其中16篇描述干預措施,19篇評價干預效果。研究對象主要是戰爭、暴力及其它酷刑引起的難民和尋求庇護者,水庫移民僅 1 篇。所有心理干預分為預防干預和治療干預兩類,其主要干預措施有:心理綜合干預、團體療法、認知行為療法、證言療法、敘事暴露療法、支持性咨詢服務、家庭支持及療法等,其中綜合干預是最常用的干預方法。評價心理干預效果的研究大部分為觀察性研究,僅 6 個研究為對照試驗,且存在較多方法學局限。絕大多數研究結果顯示,已開展的心理干預對非自愿移民心理健康有積極的促進作用。
結論　目前針對非自愿移民開展的心理健康干預研究有限,尚缺乏設計嚴謹的評價性研究。應對非自愿移民心理健康干預,尤其是預防性干預開展更多研究,并開展大樣本、設計嚴格的高質量試驗,以評價適用于不同非自愿移民群體的最有效的心理干預方式。

引用本文： 劉琴,王宏,王偉,張帆,李鵑,宋文豐,雷迅,李蕾,汪洋. 防治非自愿移民心理健康問題干預措施的系統評價. 中國循證醫學雜志, 2009, 09(9): 929-937. doi: 10.7507/1672-2531.20090164 復制

1.	聯合國世界移民趨勢報告: 中國成新興目的國. 中國經濟網, 2006, 6: http://news.xinhuanet.com/newscenter/2006-06/08/ content_4663370.htm.
2.	Harpham T. Urbanization and mental health in developing countries: a research role for social scientists, public health professionals and social psychiatrists. Social Science & Medicine, 1994, 39(2): 233-245.
3.	Pernice R, Trlin A, Henderson A, et al. Employment and mental health of three groups of immigrants to New Zealand. New Zealand Journal of Psychology, 2000, 29(1): 24-29.
4.	Bhugra D. Migration and schizophrenia. Acta Psychiatrica Scandinavica. Supplementum, 2000, 102: 68-73.
5.	Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. Journal of American Medical Association, 2005, 294: 602-612.
6.	Scudder T, Colson E. Involuntary migration and resettlement: the pattern and responses of dislocated people. Westview Press, 1982: 269.
7.	Bhugra D, Jones P. Migration and mental health. Advances in Psychiatric Treatment, 2001, 7: 216-222.
8.	Hodes M. Psychologically distressed refugee children in the United Kingdom. Child Psychology and Psychiatry Review, 2000, 5: 57-68. 9 Weine SM, Dzubur Kulnovic A, Pavkovic I, et al. Testimony psychotherapy in Bosnian refugees: A pilot study. Am J Psychiatry, 1998, 155: 1720-1726. 10 宋英. 心理輔導解決移民心理問題對照研究. 中國公共衛生, 2006, 22(2): 140-141. 11 Nicholl C, Thompson A. The psychological treatment of post traumatic stress disorder (PTSD) in adult refugees: A review of the current state of psychological therapies. Journal of Mental Health, 2004, 13(4): 351-362.
9.	Ehntholt KA, Yule W. Practitioner Review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology and Psychiatry, 2006, 47(12): 1197-1210.
10.	Williams CL, Berry JW. Primary prevention of acculturative stress among refugees: application of psychological theory and practice. American Psychologist, 1991, 46(6): 632-641.
11.	Hoffpauir SA, Woodruff LA. Effective Mental Health Response to Catastrophic Events: Lessons Learned From Hurricane Katrina. Family & Community Health, 2008, 31(1): 17-22.
12.	Birman D, Beehler S, Harris EM, et al. International family, adult, and child enhancement services (FACES): A community-based comprehensive services model for refugee children in resettlement. American Journal of Orthopsychiatry, 2008, 78(1): 121-132.
13.	Kinzie JD, Leung P, Bui A, et al. Group Therapy with Southeast Asian Refugees. Community Mental Health Journal, 1988, 24(2): 157-166.
14.	Nicholson BL, Kay DM. Group treatment of traumatized Cambodian women: A culture-specific approach. Social Work, 1999, 44(5): 470-479.
15.	Stevan MW, Alma DK, Ivan P, et al. Testimony Psychotherapy in Bosnian Refugees: A Pilot Study. Am J Psychiatry, 1998, 155: 1720-1726.
16.	Gafner G, Benson S. Indirect Ego-Strengthening in Treating PTSD in Immigrants from Central America. Contemporary Hypnosis, 2001, 18 (3): 135-144.
17.	Jaranson JM, Bamford P. Program Models for Mental Health Treatment of Refugees. Report 1987.
18.	Schulz PM, Resick PA, Huber LC, et al. The Effectiveness of Cognitive Processing Therapy for PTSD with Refugees in a Community Setting. Cognitive and Behavioral Practice, 2006, 13(4): 322-331.
19.	Khamphakdy-Brown S, Jones LN, Nilsson JE, et al. The Empowerment Program: An Application of an Outreach Program for Refugee and Immigrant Women. Journal of Mental Health Counseling, 2006, 28(1): 38-47.
20.	Boehnlein JK, Kinzie JD, Sekiya U, et al. A Ten-Year Treatment Outcome Study of Traumatized Cambodian Refugees. The Journal of Nervous and Mental Disease, 2004, 192(10): 658-663.
21.	Fischman Y, Ross J. Group Treatment of Exiled Survivors of Torture. American Journal of Orthopsychiatry, 1990, 60(1): 135-142.
22.	Hinton DE, Chhean D, Pich V, et al. A Randomized Controlled Trial of Cognitive-Behavior Therapy for Cambodian Refugees With Treatment-Resistant PTSD and Panic Attacks: A Cross-Over Design. Journal of Traumatic Stress, 2005, 18(6): 617-629.
23.	Moore LJ, Boehnlein JK. Treating psychiatric disorders among Mien refugees from highland Laos. Soc Sci Med, 1991, 32(9): 1029-1036.
24.	Weine SM, Raina DJ, Zhubi M, et al. The Tafes Multi-family Group Intervention for Kosovar Refugee: A Feasibility Study. The Journal of Nervous and Mental Disease, 2003, 191(2): 100-107.
25.	Nieves-Grafals S. Brief therapy of civil war-related trauma: a case study. Cultur Divers Ethnic Minor Psychol, 2001, 7(4): 387-398.
26.	Oras R, Ezpeleta SC, Ahmad A. Treatment of traumatized refugee children with Eye Movement Desensitization and Reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 2004, 58(3): 199-203.
27.	Basoglu M, Ekblad S, Ba ?a ?rnhielm S, et al. Cognitive-behavioral treatment of tortured asylum seekers: a case study. Journal of Anxiety Disorders, 2004, 18(3): 357-369. 31Rousseau C, Drapeau A, Lacroix L, et al. Evaluation of a classroom program of creative expression workshops for refugee and immigrant children. Journal of Child Psychology and Psychiatry, 2005, 46: 2, 180-185.
28.	Rousseau C, Benoit M, Gauthier MF, et al. Classroom Drama Therapy Program for Immigrant and Refugee Adolescents: A Pilot Study. Clinical Child Psychology and Psychiatry, 2007, 12(3): 451-465.
29.	Luebben S. Testimony work with Bosnian refugees: living in legal limbo. British Journal of Guidance & Counselling, 2003, 31(4): 393-402.
30.	Mohlen H, Parzer P, Resch F, et al. Psychosocial support for war- traumatized child and adolescent refugees: evaluation of a short term treatment program. Australian & New Zealand Journal of Psychiatry, 2005, 39(1-2): 81-87.
31.	O’Shea B, Hodes M, Down G, et al. A School-based Mental Health Service for Refugee Children. Clinical Child Psychology & Psychiatry, 2000, 5(2): 189-201.
32.	Barrett PM, Moore AF, Sonderegger R. The FRIENDS program for young former-Yugoslavian refugees in Australia: A pilot study. Behaviour Change, 2000, 17(3): 124-133.
33.	Carlsson JM, Mortensen EL, Kastrup M. A Follow-Up Study of Mental Health and Health-Related Quality of Life in Tortured Refugees in Multidisciplinary Treatment. The Journal of Nervous and Mental Disease, 2005, 193(10): 651-657.
34.	VanDijk JA, Schoutrop MJA, Spinhoven P. Testimony therapy: Treatment method for traumatized victims of organized violence. American Journal of Psychotherapy, 2003. 57(3): 361-373.
35.	Betancourt TS. Stressors, supports and the social ecology of displacement: Psychosocial dimensions of an emergency education program for Chechen adolescents displaced in Ingushetia, Russia. Culture Medicine and Psychiatry, 2005, 29(3): 309-340.
36.	Miller KE, Billings DL. Playing to Grow: A Primary Mental Health Intervention With Guatemalan Refugee Children. American Journal of Orthopsychiatry, 1994, 64(3): 346-356.
37.	Ley K. Bread and roses: supporting refugee women in a multicultural group. Intervention, 2006, 4(1): 47-52.
38.	Tribe R, Silva PD. Psychological intervention with displaced widows in Sri Lanka. International Review of Psychiatry, 1999, 11(2/3): 184-190.
39.	Onyut LP, Neuner F, Schauer E, et al. The Nakivale Camp Mental Health Project: Building local competency for psychological assistance to traumatised refugees. Intervention: International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 2004, 2(2): 90-107.
40.	Onyut LP, Neuner F, Schauer E, et al. Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement. Bmc Psychiatry, 2005, 5: 7.
41.	Neuner F, Schauer M, Klaschik C, et al. A Comparison of Narrative Exposure Therapy, Supportive Counseling, and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement. Journal of Consulting and Clinical Psychology, 2004, 72(4): 579-587.
42.	Gupta L, Zimmer C. Psychosocial intervention for war-affected children in Sierra Leone. The British Journal of Psychiatry, 2008, 192(3): 212-216.
43.	Stepakoff S, Hubbard J, Katoh M, et al. Trauma healing in refugee camps in Guinea: A psychosocial program for Liberian and Sierra Leonean survivors of torture and war. American Psychologist, 2006, 61(8): 921-932.
44.	Prilleltensky JS. Cultural diversity and mental health. Towards integrative practice. Clinical Psychology Review, 2002, 22(8): 1133-1154.
45.	Brune M, Haasen C, Krausz M, et al. Belief systems as coping factors for traumatised refugees: A pilot study. European Psychiatry, 2002, 17: 451-458.
46.	Veer Van der G. Counseling and therapy with refugees and victims of trauma. 1998, 2nd edn. London: Wiley & Sons.
47.	Watters C. Emerging paradigms in the mental health care of refugees. Social Science and Medicine, 2001, 52: 1709-1718.
48.	Summerfield D. Asylum seekers, refugees and mental health services in the UK. Psychiatric Bulletin, 2001, 25: 161-163.

1. 聯合國世界移民趨勢報告: 中國成新興目的國. 中國經濟網, 2006, 6: http://news.xinhuanet.com/newscenter/2006-06/08/ content_4663370.htm.
2. Harpham T. Urbanization and mental health in developing countries: a research role for social scientists, public health professionals and social psychiatrists. Social Science & Medicine, 1994, 39(2): 233-245.
3. Pernice R, Trlin A, Henderson A, et al. Employment and mental health of three groups of immigrants to New Zealand. New Zealand Journal of Psychology, 2000, 29(1): 24-29.
4. Bhugra D. Migration and schizophrenia. Acta Psychiatrica Scandinavica. Supplementum, 2000, 102: 68-73.
5. Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. Journal of American Medical Association, 2005, 294: 602-612.
6. Scudder T, Colson E. Involuntary migration and resettlement: the pattern and responses of dislocated people. Westview Press, 1982: 269.
7. Bhugra D, Jones P. Migration and mental health. Advances in Psychiatric Treatment, 2001, 7: 216-222.
8. Hodes M. Psychologically distressed refugee children in the United Kingdom. Child Psychology and Psychiatry Review, 2000, 5: 57-68. 9 Weine SM, Dzubur Kulnovic A, Pavkovic I, et al. Testimony psychotherapy in Bosnian refugees: A pilot study. Am J Psychiatry, 1998, 155: 1720-1726. 10 宋英. 心理輔導解決移民心理問題對照研究. 中國公共衛生, 2006, 22(2): 140-141. 11 Nicholl C, Thompson A. The psychological treatment of post traumatic stress disorder (PTSD) in adult refugees: A review of the current state of psychological therapies. Journal of Mental Health, 2004, 13(4): 351-362.
9. Ehntholt KA, Yule W. Practitioner Review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology and Psychiatry, 2006, 47(12): 1197-1210.
10. Williams CL, Berry JW. Primary prevention of acculturative stress among refugees: application of psychological theory and practice. American Psychologist, 1991, 46(6): 632-641.
11. Hoffpauir SA, Woodruff LA. Effective Mental Health Response to Catastrophic Events: Lessons Learned From Hurricane Katrina. Family & Community Health, 2008, 31(1): 17-22.
12. Birman D, Beehler S, Harris EM, et al. International family, adult, and child enhancement services (FACES): A community-based comprehensive services model for refugee children in resettlement. American Journal of Orthopsychiatry, 2008, 78(1): 121-132.
13. Kinzie JD, Leung P, Bui A, et al. Group Therapy with Southeast Asian Refugees. Community Mental Health Journal, 1988, 24(2): 157-166.
14. Nicholson BL, Kay DM. Group treatment of traumatized Cambodian women: A culture-specific approach. Social Work, 1999, 44(5): 470-479.
15. Stevan MW, Alma DK, Ivan P, et al. Testimony Psychotherapy in Bosnian Refugees: A Pilot Study. Am J Psychiatry, 1998, 155: 1720-1726.
16. Gafner G, Benson S. Indirect Ego-Strengthening in Treating PTSD in Immigrants from Central America. Contemporary Hypnosis, 2001, 18 (3): 135-144.
17. Jaranson JM, Bamford P. Program Models for Mental Health Treatment of Refugees. Report 1987.
18. Schulz PM, Resick PA, Huber LC, et al. The Effectiveness of Cognitive Processing Therapy for PTSD with Refugees in a Community Setting. Cognitive and Behavioral Practice, 2006, 13(4): 322-331.
19. Khamphakdy-Brown S, Jones LN, Nilsson JE, et al. The Empowerment Program: An Application of an Outreach Program for Refugee and Immigrant Women. Journal of Mental Health Counseling, 2006, 28(1): 38-47.
20. Boehnlein JK, Kinzie JD, Sekiya U, et al. A Ten-Year Treatment Outcome Study of Traumatized Cambodian Refugees. The Journal of Nervous and Mental Disease, 2004, 192(10): 658-663.
21. Fischman Y, Ross J. Group Treatment of Exiled Survivors of Torture. American Journal of Orthopsychiatry, 1990, 60(1): 135-142.
22. Hinton DE, Chhean D, Pich V, et al. A Randomized Controlled Trial of Cognitive-Behavior Therapy for Cambodian Refugees With Treatment-Resistant PTSD and Panic Attacks: A Cross-Over Design. Journal of Traumatic Stress, 2005, 18(6): 617-629.
23. Moore LJ, Boehnlein JK. Treating psychiatric disorders among Mien refugees from highland Laos. Soc Sci Med, 1991, 32(9): 1029-1036.
24. Weine SM, Raina DJ, Zhubi M, et al. The Tafes Multi-family Group Intervention for Kosovar Refugee: A Feasibility Study. The Journal of Nervous and Mental Disease, 2003, 191(2): 100-107.
25. Nieves-Grafals S. Brief therapy of civil war-related trauma: a case study. Cultur Divers Ethnic Minor Psychol, 2001, 7(4): 387-398.
26. Oras R, Ezpeleta SC, Ahmad A. Treatment of traumatized refugee children with Eye Movement Desensitization and Reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 2004, 58(3): 199-203.
27. Basoglu M, Ekblad S, Ba ?a ?rnhielm S, et al. Cognitive-behavioral treatment of tortured asylum seekers: a case study. Journal of Anxiety Disorders, 2004, 18(3): 357-369. 31Rousseau C, Drapeau A, Lacroix L, et al. Evaluation of a classroom program of creative expression workshops for refugee and immigrant children. Journal of Child Psychology and Psychiatry, 2005, 46: 2, 180-185.
28. Rousseau C, Benoit M, Gauthier MF, et al. Classroom Drama Therapy Program for Immigrant and Refugee Adolescents: A Pilot Study. Clinical Child Psychology and Psychiatry, 2007, 12(3): 451-465.
29. Luebben S. Testimony work with Bosnian refugees: living in legal limbo. British Journal of Guidance & Counselling, 2003, 31(4): 393-402.
30. Mohlen H, Parzer P, Resch F, et al. Psychosocial support for war- traumatized child and adolescent refugees: evaluation of a short term treatment program. Australian & New Zealand Journal of Psychiatry, 2005, 39(1-2): 81-87.
31. O’Shea B, Hodes M, Down G, et al. A School-based Mental Health Service for Refugee Children. Clinical Child Psychology & Psychiatry, 2000, 5(2): 189-201.
32. Barrett PM, Moore AF, Sonderegger R. The FRIENDS program for young former-Yugoslavian refugees in Australia: A pilot study. Behaviour Change, 2000, 17(3): 124-133.
33. Carlsson JM, Mortensen EL, Kastrup M. A Follow-Up Study of Mental Health and Health-Related Quality of Life in Tortured Refugees in Multidisciplinary Treatment. The Journal of Nervous and Mental Disease, 2005, 193(10): 651-657.
34. VanDijk JA, Schoutrop MJA, Spinhoven P. Testimony therapy: Treatment method for traumatized victims of organized violence. American Journal of Psychotherapy, 2003. 57(3): 361-373.
35. Betancourt TS. Stressors, supports and the social ecology of displacement: Psychosocial dimensions of an emergency education program for Chechen adolescents displaced in Ingushetia, Russia. Culture Medicine and Psychiatry, 2005, 29(3): 309-340.
36. Miller KE, Billings DL. Playing to Grow: A Primary Mental Health Intervention With Guatemalan Refugee Children. American Journal of Orthopsychiatry, 1994, 64(3): 346-356.
37. Ley K. Bread and roses: supporting refugee women in a multicultural group. Intervention, 2006, 4(1): 47-52.
38. Tribe R, Silva PD. Psychological intervention with displaced widows in Sri Lanka. International Review of Psychiatry, 1999, 11(2/3): 184-190.
39. Onyut LP, Neuner F, Schauer E, et al. The Nakivale Camp Mental Health Project: Building local competency for psychological assistance to traumatised refugees. Intervention: International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 2004, 2(2): 90-107.
40. Onyut LP, Neuner F, Schauer E, et al. Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement. Bmc Psychiatry, 2005, 5: 7.
41. Neuner F, Schauer M, Klaschik C, et al. A Comparison of Narrative Exposure Therapy, Supportive Counseling, and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement. Journal of Consulting and Clinical Psychology, 2004, 72(4): 579-587.
42. Gupta L, Zimmer C. Psychosocial intervention for war-affected children in Sierra Leone. The British Journal of Psychiatry, 2008, 192(3): 212-216.
43. Stepakoff S, Hubbard J, Katoh M, et al. Trauma healing in refugee camps in Guinea: A psychosocial program for Liberian and Sierra Leonean survivors of torture and war. American Psychologist, 2006, 61(8): 921-932.
44. Prilleltensky JS. Cultural diversity and mental health. Towards integrative practice. Clinical Psychology Review, 2002, 22(8): 1133-1154.
45. Brune M, Haasen C, Krausz M, et al. Belief systems as coping factors for traumatised refugees: A pilot study. European Psychiatry, 2002, 17: 451-458.
46. Veer Van der G. Counseling and therapy with refugees and victims of trauma. 1998, 2nd edn. London: Wiley & Sons.
47. Watters C. Emerging paradigms in the mental health care of refugees. Social Science and Medicine, 2001, 52: 1709-1718.
48. Summerfield D. Asylum seekers, refugees and mental health services in the UK. Psychiatric Bulletin, 2001, 25: 161-163.

《中國循證醫學雜志》

防治非自愿移民心理健康問題干預措施的系統評價

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《中國循證醫學雜志》

防治非自愿移民心理健康問題干預措施的系統評價

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