Day Crispin, Davis Hilton
South London and Maudsley NHS Trust, London, UK.
Br J Clin Psychol. 2006 Nov;45(Pt 4):439-52. doi: 10.1348/014466505X79986.
Little evidence has been available about the functioning and outcomes of child mental health services operating at the primary care interface. This study investigated the effectiveness and quality of one particular model of outreach clinic.
The study used a quasi-experimental design comparing outcomes of children attending the outreach clinics with a waiting list comparison. The intervention group (n=88) was assessed at referral, four months and twelve months later. The comparison group (n=99) completed measures at referral and four months.
The main carers of participant children completed self-report measures of problem severity, impact, burden, parental stress and parent satisfaction. Clinicians provided clinical activity information.
There were significant reductions in children's problem severity, distress and impairment, particularly for behavioural difficulties. In contrast, the results showed no effect upon the outcomes of children's emotional problems or parental stress. High ratings of satisfaction were obtained for many aspects of care.
The children receiving care through this system of decentralised, outreach clinics derived clinical benefits that were maintained over time. The outreach clinics received strong consumer support suggesting the service offered a high level of acceptability to parents.
关于在基层医疗界面开展的儿童心理健康服务的运作情况和成果，几乎没有可用的证据。本研究调查了一种特定模式的外展诊所的有效性和质量。
该研究采用准实验设计，将参加外展诊所的儿童的结果与等待名单对照组进行比较。干预组（n = 88）在转诊时、四个月后和十二个月后接受评估。对照组（n = 99）在转诊时和四个月时完成测量。
参与研究的儿童的主要照顾者完成了关于问题严重程度、影响、负担、父母压力和父母满意度的自我报告测量。临床医生提供了临床活动信息。
儿童的问题严重程度、痛苦和损害有显著降低，尤其是行为困难方面。相比之下，结果显示对儿童情绪问题或父母压力的结果没有影响。在护理的许多方面都获得了很高的满意度评分。
通过这种分散式外展诊所系统接受护理的儿童获得了临床益处，并且随着时间的推移得以维持。外展诊所获得了消费者的大力支持，表明该服务得到了家长的高度认可。
