健康照護專業人員及學生的心理健康素養：介入成效與長期態度或行為變化的統合分析

Background Stigma existing among healthcare providers (HCPs) may lead to a poor quality of healthcare services for people with mental illness. Given a plenty of research on changing the stigma of mental illness, little is known regarding evidence on interventions for reducing mental illness stigma in HCPs. This study aimed to conduct a network meta-analysis to estimate the relative efficacy among different types of anti-stigma interventions among HCPs. Materials and Methods This study has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42018112865). A systematic review was carried out in PubMed, MEDLINE, ERIC, PsycARTICLES, PsycINFO, CINAHL and Cochrane Library till 2018. Search terms fell into four categories: stigma, mental illness, anti-stigma intervention, and HCPs (professionals and students). Studies were limited to randomized and non-randomized controlled trials. Data was analyzed using a random-effect model with the effect size based on standardized mean difference (SMD). Results A total of 18 studies (20 trails) from nine countries were included in the analysis. In the network meta-analysis, rank probabilities showed that intervention of indirect contact plus lecture (SUCRA=81.5%), direct contact plus problem-based learning workshop (SUCRA=77.4%), and indirect contact (SUCRA=72.2%) had the highest probability of being ranked first, second, and third. Intervention with contact alone and with education combining social contact had a better ranking than those with education alone on reducing stigma. This might extend previous research that social contact is the most effective type of short-term intervention to improve stigma-related attitudes not only among the public but also among HCPs. Conclusion This study indicates that HCPs’ negative attitude toward mental illness can be changed in a positive way throughout an appropriate intervention. Our findings suggest that education combining social contact is the most effective type of anti-stigma interventions, which can be implemented in clinical practices to help reduce the negative effects of stigma among HCPs and improve the healthcare services for people living with mental illness. Further research is required to investigate the active ingredients of interventions in order to maximize the efficacy.