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心理健康护理中患者激活与赋权干预的评估。

Evaluation of a patient activation and empowerment intervention in mental health care.

作者信息

Alegría Margarita, Polo Antonio, Gao Shan, Santana Luz, Rothstein Dan, Jimenez Aida, Hunter Mary Lyons, Mendieta Frances, Oddo Vanessa, Normand Sharon-Lise

机构信息

Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, Massachusetts, USA.

出版信息

Med Care. 2008 Mar;46(3):247-56. doi: 10.1097/MLR.0b013e318158af52.

Abstract

BACKGROUND

Evidence suggests that minority populations have lower levels of attendance and retention in mental health care than non-Latino whites. Patient activation and empowerment interventions may be effective in increasing minority patients' attendance and retention.

OBJECTIVES

This study developed and evaluated a patient self-reported activation and empowerment strategy in mental health care.

RESEARCH DESIGN

The Right Question Project-Mental Health (RQP-MH) trainings consisted of 3 individual sessions using a pre/post test comparison group design with patients from 2 community mental health clinics. The RQP-MH intervention taught participants to identify questions that would help them consider their role, process and reasons behind a decision; and empowerment strategies to better manage their care.

SUBJECTS

A total of 231 participated, completing at least the pretest interview (n = 141 intervention site, 90 comparison site).

MEASURES

Four main outcomes were linked to the intervention: changes in self-reported patient activation; changes in self-reported patient empowerment; treatment attendance; and retention in treatment.

RESULTS

Findings show that intervention participants were over twice as likely to be retained in treatment and over 3 times more likely than comparison participants to have scheduled at least 1 visit during the 6-month follow-up period. Similarly, intervention participants demonstrated 29% more attendance to scheduled visits than comparison patients. There was no evidence of an effect on self-reported patient empowerment, only on self-reported patient activation.

CONCLUSIONS

Results demonstrate the intervention's potential to increase self-reported patient activation, retention, and attendance in mental health care for minority populations. By facilitating patient-provider communication, the RQP-MH intervention may help minorities effectively participate in mental health care.

摘要

背景

有证据表明,少数族裔人群在精神卫生保健方面的就诊率和持续治疗率低于非拉丁裔白人。患者激活和赋权干预措施可能有助于提高少数族裔患者的就诊率和持续治疗率。

目的

本研究开发并评估了一种精神卫生保健中患者自我报告的激活和赋权策略。

研究设计

“正确问题项目-精神卫生”(RQP-MH)培训包括3次个人课程,采用前后测试比较组设计,研究对象为来自2家社区精神卫生诊所的患者。RQP-MH干预教导参与者识别有助于他们思考自身角色、决策过程及原因的问题;以及更好地管理自身护理的赋权策略。

研究对象

共有231人参与,至少完成了预测试访谈(干预组141人,对照组90人)。

测量指标

与干预相关的4个主要结果为:自我报告的患者激活度变化;自我报告的患者赋权变化;治疗就诊情况;以及治疗持续情况。

结果

研究结果显示,干预组参与者在治疗中持续接受治疗的可能性是对照组的两倍多,在6个月随访期内至少安排1次就诊的可能性比对照组参与者高出3倍多。同样,干预组参与者按计划就诊的出勤率比对照组患者高29%。没有证据表明该干预对自我报告的患者赋权有影响,仅对自我报告的患者激活度有影响。

结论

结果表明该干预措施有潜力提高少数族裔人群在精神卫生保健方面自我报告的患者激活度、持续治疗率和就诊率。通过促进患者与提供者之间的沟通,RQP-MH干预可能有助于少数族裔有效参与精神卫生保健。

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