Horner Deborah, Asher Kim
Hornsby Ku-ring-gai Ryde Division of General Practice, Sydney, NSW, Australia.
Australas Psychiatry. 2005 Jun;13(2):176-80. doi: 10.1080/j.1440-1665.2005.02184.x.
The paper describes a shared care programme developed by mental health services and general practitioners for shifting patients with chronic psychiatric disorders to the care of a general practitioner. The programme is characterized by: (i) a dedicated mental health service general practitioner liaison position to manage the programme and provide support to both patients and doctors; (ii) a multidisciplinary care planning meeting that includes mental health staff, the patient, the general practitioner and a carer; and (iii) a jointly developed individual management plan that specifies patient issues, strategies to deal with these issues, persons responsible for monitoring and a review date.
The shared care protocol, the results of a review of patient mental health indicators and general practitioner satisfaction with the programme are described.
Outcomes to date suggest that patients' mental health is not compromised and may be enhanced by transfer to general practitioners within the shared care model. Indicators of mental health outcomes (Health of the Nation Outcome Scale and Life Skills Profile scores) show improved patient symptomatology and functioning in most cases.
The programme fits the model of recovery-based mental health services and complies with current local, state and Commonwealth policies that encourage integrated and collaborative approaches by mental health services and general practitioners in delivering mental health care to persons with chronic mental illness.
本文描述了一项由精神卫生服务机构和全科医生共同制定的共享护理计划,旨在将慢性精神疾病患者的护理工作转交给全科医生。该计划的特点包括:(i)设立一个专门的精神卫生服务全科医生联络职位,以管理该计划并为患者和医生提供支持;(ii)召开多学科护理规划会议,参会人员包括精神卫生工作人员、患者、全科医生和一名护理人员;(iii)共同制定一份个人管理计划,明确患者问题、处理这些问题的策略、负责监测的人员以及复查日期。
介绍了共享护理方案、患者精神卫生指标审查结果以及全科医生对该计划的满意度。
迄今为止的结果表明,在共享护理模式下将患者转交给全科医生,患者的精神健康不会受到损害,甚至可能得到改善。精神卫生结果指标(国民健康结果量表和生活技能概况得分)显示,在大多数情况下患者的症状和功能有所改善。
该计划符合基于康复的精神卫生服务模式,并且符合当前地方、州和联邦的政策,这些政策鼓励精神卫生服务机构和全科医生采用综合协作的方法为慢性精神疾病患者提供精神卫生护理。