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初级保健心理健康工作者角色的实施:一项定性研究

Implementing the role of the primary care mental health worker: a qualitative study.

作者信息

England Elizabeth, Lester Helen

机构信息

Department of Primary Care and General Practice, Medical School, The University of Birmingham, Birmingham, UK.

出版信息

Br J Gen Pract. 2007 Mar;57(536):204-11.

Abstract

BACKGROUND

Primary care mental health workers are a new role recently introduced into primary care in England to help manage patients with common mental health problems.

AIM

To explore the views of GPs, primary care teams and patients on the value and development of the new role of primary care mental health workers in practice.

DESIGN OF STUDY

Qualitative study.

SETTING

The Heart of Birmingham Primary Care Teaching Trust in the West Midlands, UK.

METHOD

Thirty-seven semi-structured interviews involving seven primary care mental health workers, 21 patients and 11 focus groups involving 38 members of primary care teams were held with six teams with a worker. Two teams asked for the worker to be removed. Six practice managers also took part in the study.

RESULTS

A number of different approaches were used to implement this new role. Strategies that incorporated the views of primary care trust senior management, primary care teams and workers' views appeared most successful. Rapid access to a healthcare professional at times of stress and the befriending role of the worker were also highly valued. Workers felt that their role left them professionally isolated at times. A number of workers described tension around ownership of the role.

CONCLUSION

Primary care mental health workers appear to provide a range of skills valued by patients and the primary care teams and can increase patient access and choice in this area of health care. Successful implementation strategies highlighted in this study may be generalisable to other new roles in primary care.

摘要

背景

基层医疗心理健康工作者是英国近期引入基层医疗体系的一个新角色,旨在帮助管理患有常见心理健康问题的患者。

目的

探讨全科医生、基层医疗团队及患者对于基层医疗心理健康工作者这一新角色在实际工作中的价值及发展的看法。

研究设计

定性研究。

研究地点

英国西米德兰兹郡伯明翰市中心基层医疗教学信托机构。

方法

对六个配备了心理健康工作者的团队进行了研究,其中包括与七名基层医疗心理健康工作者、21名患者进行的37次半结构化访谈,以及与38名基层医疗团队成员进行的11次焦点小组访谈。有两个团队要求撤换该工作者。六名诊所经理也参与了研究。

结果

采用了多种不同方法来落实这一新角色。纳入基层医疗信托高级管理层观点、基层医疗团队观点及工作者自身观点的策略似乎最为成功。在患者压力大时能快速联系到医疗专业人员以及工作者所起到的友好陪伴作用也备受重视。工作者们觉得他们的角色有时让他们在职业上感到孤立。一些工作者描述了在该角色的职责归属方面存在紧张关系。

结论

基层医疗心理健康工作者似乎具备一系列患者和基层医疗团队所看重的技能,并且能够增加患者在这一医疗领域的就医机会和选择。本研究中突出的成功实施策略可能适用于基层医疗中的其他新角色。

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