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“工作场所的心身医学咨询”:一种新的医疗模式,处于公司支持的心理健康护理和联络会诊心身医学的交叉点:一项混合方法实施研究的设计。

"Psychosomatic consultation in the workplace": a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study.

机构信息

Department of Psychosomatic Medicine, University Clinic of Ulm, Ulm University, Ulm, Germany.

出版信息

BMC Public Health. 2012 Sep 13;12(1):780. doi: 10.1186/1471-2458-12-780.

Abstract

BACKGROUND

Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of "psychosomatic consultation in the workplace". This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are:1) Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and2) A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care.In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach.

METHODS/DESIGN: The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280). For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS) as well as standardized questions about health care use. For data analysis, we will use uni- and multivariate analytical methods. Qualitative data analysis (expert interviews) will be carried out using Mayring's content analysis method.

DISCUSSION

The results of this study have the potential to provide evidence-based knowledge about an innovative model of psychotherapeutic outpatient care and to further promote tailored solutions for early psychotherapeutic interventions within the worksite.

TRIAL REGISTRATION

DRKS00003184.

摘要

背景

心理健康问题在社会和经济系统中的重要性日益增加。与此同时,德国心理健康保健系统的可及性和污名化可能会阻碍寻求帮助的行为,并延迟早期心理治疗干预。因此,在公司支持的健康促进和传统的心理健康保险赞助的门诊护理之间的接口处正在建立新的护理模式,为出现精神疾病的人提供服务。两家大型工业公司与两家身心诊所合作,最近建立了“工作场所心身咨询”模式。这种新的护理模式为在工业工作场所中,通过职业医学进行首次上门的心理治疗咨询提供了机会。本研究的主要实证目标是:1)描述在工业工作场所中使用这种新的诊断和治疗方法的患者与在传统区域门诊就诊的患者之间的差异,特别是在症状持续时间和严重程度、工作能力和人口统计学特征方面,2)首次评估与标准门诊护理相比,患者从这种新的护理模式中获益更多的情况。在研究的定性部分,将要求职业医生、身心治疗师、参与人员和参与公司的选定员工对这种新方法的经验发表评论。

方法/设计:实施研究将在乌尔姆和斯图加特进行,每个地点将研究一个区域传统的心身科门诊和一个工作场所的心身咨询服务。每个设置将招募 70 名连续患者(总共 n=280)。对于横断面研究和前后比较,我们将使用已建立和验证的调查工具(PHQ、SF-12、WAI、MBI、IS)以及有关医疗保健使用的标准化问题。数据分析将使用单变量和多变量分析方法。定性数据分析(专家访谈)将使用 Mayring 的内容分析方法进行。

讨论

这项研究的结果有可能提供有关心理治疗门诊护理创新模式的循证知识,并进一步促进在工作场所内进行早期心理治疗干预的针对性解决方案。

试验注册

DRKS00003184。

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