A Systematic Review of the Effectiveness of School-based Interventions for Mental Health Symptoms of Children or Adolescents After War or Natural Disaster

Yıl 2019, Cilt: 3 Sayı: 1, 71 - 102, 01.12.2019

Rüveyda Çal

https://doi.org/10.37344/talim.2020.8

Öz

Worldwide, wars and natural disasters affect a considerable number of children and adolescents and this number is constantly increasing. On the other hand, such extraordinary situations cause children and adolescents to be exposed to traumatic events and pave the way for serious mental health disorders. Although schools are one of the main institutions in transferring mental health services, especially after these crisis situations, studies on the effectiveness of school-based interventions remain insufficient in the literature. This review examined the efficacy of schoolbased interventions for post-traumatic stress disorder PTSD , depression and anxiety symptoms of war or natural disaster exposed children or adolescents. The systematic research was conducted in four databases, PsychInfo, PubMED, Scopus and PTSDPubs, using key subject terms “schoolbased interventions”, “war”, “natural disaster” and “trauma”. Identified papers were assessed using Effective Public Health Practice Project EPHPP quality assessment tool for quantitative studies. A total of 12 studies were selected that met the inclusion and exclusion criteria. While most studies have shown declines in PTSD, depression and anxiety symptoms, the most successful results have been observed in PTSD symptoms following interventions for natural disaster-induced trauma. Interventions in which practitioners were teachers and lasted longer than others yielded the most successful results in all three types of symptoms. The study concluded that prioritizing schoolbased interventions that persist long and delivered by teachers after wars or natural disasters may be more effective in improving PTSD, depression and anxiety symptoms of children or adolescents

Anahtar Kelimeler

School-based interventions • War • Natural Disaster • PTSD • Depression • Anxiety

Savaş veya Doğal Afet Sonrasında Çocuk veya Ergenlere Uygulanan Okul Bazlı Müdahalelerin Ruh Sağlığı Semptomlarına Etkililiği Üzerine Bir Sistematik Derleme

Öz

Dünya üzerinde azımsanamayacak sayıda çocuk ve ergen, savaşlar ve doğal afetlerden etkilenmekte ve bu sayı gün geçtikçe artmaktadır. Öte yandan, olağan düzeni sarsan bu durumlar, çocuk ve ergenlerin travmatik olaylara maruz kalma olasılıklarını ve dolayısıyla ciddi ruh sağlığı problemleri yaşama risklerini artırmaktadır. Okullar, özellikle bu kriz durumlarından sonra ruh sağlığı hizmetlerinin aktarılmasını sağlayan kurumların başında geldikleri halde, literatürde bu hizmetlerin etkililiği konusunda yeterince çalışma bulunmamaktadır. Bu derlemede, okul bazlı müdahalelerin, savaş veya doğal afet kaynaklı travmaya maruz kalmış çocuk veya ergenlerdeki travma sonrası stres bozukluğu TSSB , depresyon ve anksiyete semptomları üzerinde etkililiği araştırılmıştır. Sistematik araştırma PsychInfo, PubMEd, Scopus ve PTSDPubs veri tabanları üzerinden “okul-bazlı müdahaleler”, “savaş”, “doğal afet” ve “travma” anahtar kelimelerini kullanarak gerçekleştirilmiştir. Erişilen çalışmaların kalite değerlendirmesi “Etkili Halk Sağlığı Projesi” nitel çalışmalar için kalite değerlendirme aracı ile yapılmıştır. Yeterli kalitede bulunan çalışmalar içerisinden dahil etme ve hariç tutma kriterlerine uyan 12 çalışma seçilmiştir. Çalışmaların çoğu TSSB, depresyon ve anksiyete semptomlarında düşüşler olduğunu gösterirken, en başarılı sonuçların doğal afet kaynaklı travma için yapılan müdahaleler sonucunda TSSB semptomlarında alındığı gözlemlenmiştir. Uygulayıcıların öğretmenler olduğu ve diğerlerine göre daha uzun süren müdahalelerin üç semptom türünde de en başarılı müdahaleler olduğu görülmüştür. Bu çalışma sonucunda, savaş ve doğal afetlerden sonra uzun süren ve öğretmenler tarafından aktarılan okul bazlı müdahalelere öncelik verilmesinin TSSB, depresyon ve anksiyete semptomlarını iyileştirmede daha etkili olacağı sonucuna varılmıştır.

Anahtar Kelimeler

Okul bazlı müdahaleler, Savaş, Doğal Afet, Depresyon, Anksiyete, TSSB

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