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开发饮食失调新服务:一项评估研究。

Developing new services for eating disorders: an evaluation study.

作者信息

Endacott Ruth, Kidd Susan, Deacon-Crouch Melissa, Judd Fiona, Menzel Michelle, Cornett Marian

机构信息

Clinical Nursing, La Trobe University, Bendigo, Vic., Australia.

出版信息

Australas Psychiatry. 2006 Mar;14(1):57-62. doi: 10.1080/j.1440-1665.2006.02246.x.

Abstract

OBJECTIVE

This paper aims to evaluate the structures and processes of eating disorders services in two regional cities in Australia.

METHOD

Stakeholder evaluation undertaken between 2002 and 2005 uses interviews, questionnaires and service delivery data to examine: structure and patient profile of the two services, barriers and success factors and local factors influencing development of the services.

RESULTS

The Bendigo service provided secondary consultation and specialist management with upskilling of primary care workers as a key goal. Patients were referred to the service via mental health triage. The Geelong service initially offered assessment only, with direct access for the general public. Treatment was offered from early 2004. The Bendigo service assessed 41 patients, 63% were diagnosed with anorexia nervosa or bulimia nervosa. Most patients had a moderate or severe eating disorder. The Geelong service assessed 186 patients, 55% were diagnosed with anorexia nervosa or bulimia nervosa and 80% of this subset had not previously been treated for an eating disorder. General practitioners identified barriers to development of the services as: problems with capacity building and unrealistic expectations. The success factors were providing a locally based service with credible clinicians and effective communication.

CONCLUSIONS

Activity analysis demonstrates that the goals for both services were met. There is a need to measure both short- and long-term patient outcomes in order to fully assess effectiveness and applicability to other settings. Local factors, such as availability of specialist providers, would need to be taken into account.

摘要

目的

本文旨在评估澳大利亚两个地区城市饮食失调服务的结构和流程。

方法

2002年至2005年进行的利益相关者评估采用访谈、问卷调查和服务提供数据,以考察:两项服务的结构和患者概况、障碍和成功因素以及影响服务发展的当地因素。

结果

本迪戈服务提供二级咨询和专科管理,以提升初级保健工作者的技能为关键目标。患者通过心理健康分诊被转介到该服务机构。吉朗服务最初仅提供评估,公众可直接就诊。从2004年初开始提供治疗。本迪戈服务机构评估了41名患者,63%被诊断为神经性厌食症或神经性贪食症。大多数患者患有中度或重度饮食失调症。吉朗服务机构评估了186名患者,55%被诊断为神经性厌食症或神经性贪食症,其中80%此前未接受过饮食失调症治疗。全科医生认为服务发展的障碍包括:能力建设问题和不切实际的期望。成功因素包括提供本地化服务、有可靠的临床医生以及有效的沟通。

结论

活动分析表明两项服务的目标均已实现。有必要衡量短期和长期的患者治疗效果,以便全面评估有效性以及对其他环境的适用性。需要考虑当地因素,如专科医疗服务提供者的可及性。

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