scholarly journals Efficacy and cultural adaptations of narrative exposure therapy for trauma-related outcomes in refugees/asylum-seekers: A systematic review and meta-analysis

2020 ◽  
Vol 30 (4) ◽  
pp. 301-314
Author(s):  
Ashley Wright ◽  
Alexandra Reisig ◽  
Breda Cullen



2019 ◽  
Vol 10 (1) ◽  
pp. 1550344 ◽  
Author(s):  
Jeannette C.G. Lely ◽  
Geert E. Smid ◽  
Ruud A. Jongedijk ◽  
Jeroen W. Knipscheer ◽  
Rolf J. Kleber


Mindfulness ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 317-332 ◽  
Author(s):  
Rebeca Castellanos ◽  
Melek Yildiz Spinel ◽  
Van Phan ◽  
Rosaura Orengo-Aguayo ◽  
Kathryn L. Humphreys ◽  
...  


2019 ◽  
Author(s):  
Raquel Proenca ◽  
Fernanda Mattos Souza ◽  
Mayara Lisboa Bastos ◽  
Rosangela Caetano ◽  
Jose Ueleres Braga ◽  
...  

Abstract Background: In 2017, there were 68.5 million refugees, asylum seekers and persons displaced by wars and conflicts worldwide. Tuberculosis prevalence in the country of origin and adverse conditions endured during their journey may increase their risk for tuberculosis. Objective: We summarized the prevalence of active and latent tuberculosis infection among refugees and asylum seekers through a literature systematic review and meta-analysis by country of origin. Methods: Articles published in Medline, EMBASE, Web of Science and LILACS from 2000 to August 2017 were searched for, without language restriction. Two independent authors performed the study selection, data extraction and quality assessment. Random effect models were used to estimate pooled measures of active and latent tuberculosis prevalence. Sub-group analysis was performed according to country of origin and host continent. Results: Sixty-seven out of 767 identified papers were included, of which 16 entered the meta-analysis. Pooled prevalence of active and latent tuberculosis was 1% [95% confidence interval (CI)=1-2%] and 37% (95% CI=23-52%), respectively, both with high level of heterogeneity (I 2 =98.2% and 99.8%). Prevalence varied more according to countries of origin than host continent. Ninety-one per cent of studies reported routine screening of recently arrived immigrants in the host country; two-thirds confirmed tuberculosis bacteriologically. Many studies failed to provide relevant information. Conclusion: Tuberculosis is a major health problem among refugees and asylum seekers and should be given special attention in any host continent. To protect this vulnerable population, ensuring access to healthcare for early detection for prevention and treatment of the disease is essential. Key words: Forced migration. Mycobacterium Tuberculosis. Latent tuberculosis infection. Prevalence. Global health.



2017 ◽  
Vol 48 (5) ◽  
pp. 714-727 ◽  
Author(s):  
A. Degnan ◽  
S. Baker ◽  
D. Edge ◽  
W. Nottidge ◽  
M. Noke ◽  
...  

BackgroundEvidence-based psychosocial treatments for schizophrenia founded on Western belief systems and values may not be efficacious in different cultures without adaptation. This systematic review analyses the nature and outcomes of culturally-adapted psychosocial interventions in schizophrenia, examining how interventions have been adapted, their efficacy and what features drive heterogeneity in outcome.MethodArticles identified by searching electronic databases from inception to 3 March 2016, reference lists and previous reviews were independently screened by two authors for eligible controlled trials. Data on the nature of adaptations was analysed inductively using thematic analyses. Meta-analyses were conducted using random effects models to calculate effect sizes (Hedges’ g) for symptoms.ResultsForty-six studies with 7828 participants were included, seven adapted for minority populations. Cultural adaptations were grouped into nine themes: language, concepts and illness models, family, communication, content, cultural norms and practices, context and delivery, therapeutic alliance, and treatment goals. Meta-analyses showed significant post-treatment effects in favour of adapted interventions for total symptom severity (n = 2345, g: −0.23, 95% confidence interval (CI) −0.36 to −0.09), positive (n = 1152, g: −0.56, 95% CI −0.86 to −0.26), negative (n = 855, g: −0.39, 95% CI −0.63 to −0.15), and general (n = 525, g: −0.75, CI −1.21 to −0.29) symptoms.ConclusionsThe adaptation process can be described within a framework that serves as a benchmark for development or assessment of future adaptations. Culturally adapted interventions were more efficacious than usual treatment in proportion to the degree of adaptation. There is insufficient evidence to show that adapted interventions are better than non-adapted interventions. Features of context, intervention and design influenced efficacy. Investigating whether adaptation improves efficacy, most importantly amongst ethnic minorities, requires better designed trials with comparisons against unadapted interventions.



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