社会组织主导的MSM心理干预及效果评估

Psychological intervention on MSM based on social organization and its effect evaluation

目的设计针对男男性行为者(MSM)抑郁、焦虑情绪的心理干预方法,并对干预方法的有效性和可行性进行评估。方法以理性情绪行为疗法+支持性心理疗法为依据,在MSM社会组织的全程参与下,由心理学专业团队设计了由社会组织主导的6单元心理干预团体小组课程。通过100例MSM研究对象的干预对照研究,对干预方法的有效性和可行性进行评估。结果干预后,干预组抑郁评分(44.08±9.30)分和焦虑评分(40.03±9.39)分,与对照组(49.28±10.12)分、(44.88±10.57)分相比,明显下降(P<0.05);干预组的社会支持度评分(34.32±6.70)分与对照组(30.52±8.00)分相比明显上升(P<0.05);干预组的自我认同分值(29.42±6.56)分与对照组(30.56±5.84)分相比无明显变化(P>0.05);干预组最近1次肛交性行为时使用安全套的比例(100.0%)与对照组(77.1%)相比有所上升(P<0.05),干预组最近1个月发生过商业性行为的比例(4.0%)与对照组(16.0%)相比有所下降(P<0.05)。MSM对干预人员和干预活动非常满意和满意占比在80%以上。结论理性情绪行为疗法+支持性心理疗法团体活动可在一定程度上减少抑郁焦虑情绪,提高其社会支持度,有利于减少艾滋病相关高危行为,以社会组织为主导实施心理干预具有较好的可行性。

Objective To produce psychological intervention methods for depression and anxiety of men who had sex with men(MSM),and evaluate the effectiveness and feasibility of the intervention method.Methods Psychological intervention methods were based on rational emotional behavior therapy plus supportive psychotherapy.With the full participation of the MSM social organization,the psychology professional team designed a 6-unit psychological intervention group course led by social organizations.The effectiveness and feasibility of the intervention were evaluated by an interventional controlled study of 100 MSMs.Results After intervention,the depression score(44.08±9.30)and anxiety score(40.03±9.39)of intervention group were significantly lower than that of the control group(49.28±10.12)and(44.88±10.57)(P<0.05).The social support score of the intervention group(34.32±6.70)was significantly higher than that of the control group(30.52±8.00)(P<0.05).There was no significant change in the self-identification score of the intervention group(29.42±6.56)compared with the control group(30.56±5.84)(P>0.05).The proportion of condom use(100.0%)in the intervention group during the most recent anal sex behavior increased compared with the control group(77.1%)(P<0.05).The proportion of commercial sexual behavior in the intervention group in the last month(4.0%)was lower than that in the control group(16.0%)(P<0.05).MSM were satisfied with intervention personnel and interventions at more than 80%.Conclusion Rational emotional behavior therapy plus supportive psychotherapy group activities could reduce depression and anxiety to a certain extent,improve their social support,and help reduce high-risk behaviors related to AIDS.It is feasible to implement psychological interventions led by social organizations.