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Psychosocial interventions for prevention of psychological disorders in law enforcement officers

  1. Valentina Peñalba1,*,
  2. Hugh McGuire2,
  3. Jose R Leite3

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 11 MAY 2008

DOI: 10.1002/14651858.CD005601.pub2


How to Cite

Peñalba V, McGuire H, Leite JR. Psychosocial interventions for prevention of psychological disorders in law enforcement officers. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005601. DOI: 10.1002/14651858.CD005601.pub2.

Author Information

  1. 1

    Universidade Federal de São Paulo, Psicobiologia, São Paulo, São Paulo, Brazil

  2. 2

    National Coordinating Centre for Women and Child Health, London, UK

  3. 3

    Escola Paulista de Medicina, Psicobiologia, São Paulo, São Paulo, Brazil

*Valentina Peñalba, Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros 925 1st floor, São Paulo, São Paulo, Brazil. vpenalba@gmail.com . vpenalba@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 JUL 2008

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Psychosocial interventions are widely used for the prevention of psychological disorders in law enforcement officers.

Objectives

To assess the effectiveness and comparative effectiveness of psychosocial interventions for the prevention of psychological disorders in law enforcement officers.

Search methods

CCDANCTR-References was searched on 12/5/2008, electronic databases were searched, reference lists of review articles and included studies were checked, a specialist journal was handsearched, specialist books were checked and we contacted experts and trialists.

Selection criteria

Randomised and quasi randomised controlled trials were eligible. The types of participants were people employed directly in law enforcement, including police officers and military police, regardless of gender, age and country of origin, and whether or not they had experienced some psychological trauma. All types of psychosocial intervention were eligible. The relevant outcome measures were psychological symptoms, adverse events and acceptability of interventions.

Data collection and analysis

Data was entered into Review Manager 4.2 for analysis, but this review was converted to RevMan 5.0 for publication. Quality assessments were performed. Two authors independently selected studies, extracted data and assessed the quality of studies. Summary effects were to be calculated using RevMan but no meta-analyses were possible. For individual studies, dichotomous outcome data are presented using relative risk, and continuous outcome data are presented using the weighted mean difference. These results are given with their 95% confidence intervals (CI).

Main results

Ten studies were included in the review but only five reported data that could be used. Three of the ten studies were related to exercise-based psychological interventions. Seven were related to psychological interventions. No meta-analyses were possible due to diversity of participants, interventions and outcomes. Two studies compared a psychosocial intervention versus another intervention. Three studies compared a psychosocial intervention to a control group. Only one primary prevention trial reported data for the primary outcomes and, although this study found a significant difference in depression in favour of the intervention at endpoint, this difference was no longer evident at 18 months. No studies of primary prevention comparing different interventions and reporting primary outcomes of interest were identified.

The methodological quality of the included studies was summarised. No study met our full quality criteria and one was regarded as low-quality. The remainder could not be rated because of incomplete data in the published reports and inadequate responses from the trialists.

Authors' conclusions

There is evidence only from individual small and low quality trials with minimal data suggesting that police officers benefit from psychosocial interventions, in terms of physical symptoms and psychological symptoms such as anxiety, depression, sleep problems, cynicism, anger, PTSD, marital problems and distress. No data on adverse effects were available. Meta-analyses of the available data were not possible. Further well-designed trials of psychosocial interventions are required. Research is needed on organization-based interventions to enhance psychological health among police officers.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Psychosocial interventions to prevent psychological problems in police officers

People working in law enforcement are subject to many things that can act as work stressors. These include aspects of their job that are linked to operational factors (job content) and aspects that are linked to organizational factors (job context). A wide variety of interventions are used to try to prevent psychological disorders in law enforcement officers. In view of the importance of the functions performed by law enforcement officers, and the fact that there is no definitive approach to deal with psychological problems they may develop, a systematic review of the evidence is needed to determine the effectiveness of psychosocial interventions in preventing these problems in this select population. We found ten randomised trials, but not of all these contributed useful data for this review and quantitative meta-analyses were not possible. No data on adverse effects were available. The available evidence is, therefore, limited to the analysis of single, small and low quality trials. This suggests that police officers may benefit from psychosocial interventions in terms of psychological symptoms and physical symptoms. Further well-designed trials of psychosocial interventions to enhance the psychological health of police officers are required. Trials of organisation-based interventions are also needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

對於執法人員預防心理疾病的心理社會處遇

心理社會處置通常廣泛的運用在預防執法人員產生心理疾病。

目標

評估預防執法人員產生心理疾病的心理社會處遇的效果及不同處遇間的比較效果。

搜尋策略

搜尋CCDANCTRReferences 到12/5/2008。搜尋電子資料庫,查詢回顧文獻及納入研究裡的參考文獻表。紙本搜尋專業期刊、專業書籍。和這領域的專家及研究者接觸。

選擇標準

挑選隨機和半隨機對照試驗。受試者的類型是直接在執法機構工作的人,包括警察、軍事警察,不管性別、年齡和國籍,不管是否有經歷一些心理創傷。納入所有型態的心理社會處遇。相關的結果測量是心理症狀,不良反應和對心理處遇的接受度。。

資料收集與分析

資料鍵入Review Manager 4.2 來分析,但是這個回顧文獻也會轉成RevMan 5.0 發表。也進行品質分析。兩位作者獨立選擇研究、摘錄資料、評估研究的品質。使用RevMan 計算摘要效果。在個別研究中,二分法變項以相對危險性來呈現。連續變項以加權平均數來呈現。以95%的信賴區間來呈現結果。

主要結論

在本文中採用10篇研究,只有5篇的資料可用。其中的3篇是以運動為基礎的心理處遇。7篇是有關心理處遇。由於受試者、處遇和結果的異質性,因此無法執行後設分析。2篇研究比較2種不同的心理社會處遇,3篇研究是比較控制組和一種心理社會處遇。只有一篇研究以初級預防為主要的結果,而這篇研究發現當研究結束時,接受處遇的憂鬱症患者有顯著的療效,但是這種差異在18個月後的追蹤已經不明顯。並沒有初級預防的研究是比較不同的處遇,也沒有研究是報告本文有興趣的主要結果。所採納的研究的方法學的品質整合裡,沒有一個研究完全符合我們的品質標準,甚至有一篇被認為是低品質的研究,其餘的研究無法被評價,因為在發表的報告中數據不完整,或研究者並沒有給予足夠的回答。

作者結論

只有來自個別、小的、低品質的研究中的少量資料的證據表明,警察人員能從心理社會處遇中獲得好處,特別在有身體症狀和心理症狀時,例如:焦慮,憂鬱,睡眠問題,好譏諷,憤怒,創傷後壓力症候群,婚姻問題和苦惱。目前沒有資料是有關不良反應的。所得的資料無法進行後設分析。有關於心理處遇的進一步精心設計的試驗是需要。所需要的研究是有關於加強警務人員的心理健康,以組織為基礎的心理處遇。

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

預防警察人員得到心理疾病的心理社會處遇:當人們進行執法工作時會遇到許多事情,而這些都可能是工作上的壓力。其中包括工作方面的業務相聯繫的因素(工作內容)及組織因素(工作環境內容)。因此,使用多樣化的的處遇來努力防止執法人員產生心理疾病。有鑑於執法人員在執行業務功能的重要性,及目前並沒有明確的方式來處理他們可能發展出的心理問題,因此系統性的審查目前可得的證據來確定針對這些受試所進行的預防心理疾病的心理處遇的有效性。我們發現 10個隨機試驗,但在本文中不是所有這些有用的數據能採用,而且也無法進行定量分析。目前也沒有資料是有關不良反應的。而現有的證據僅限於單一,少數,低質量的研究分析。而這些證據表明了在心理方面的症狀和身體症狀上,警察能從社會心理處遇獲得好處。進一步精心設計、以提高警務人員的心理健康的心理處遇的研究是必需的。而同樣也需要以組織為基礎的相關處遇的研究。