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贫困城市地区的青少年心理健康:关于全科医生在早期干预中作用的德尔菲研究

Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention.

作者信息

Schaffalitzky E, Leahy D, Cullen W, Gavin B, Latham L, O'Connor R, Smyth B P, O'Dea E, Ryan S

机构信息

Graduate Entry Medical School, University of Limerick, Limerick, Ireland.

UCD School of Medicine, Dublin, Ireland.

出版信息

Ir J Med Sci. 2015 Dec;184(4):831-43. doi: 10.1007/s11845-014-1187-z. Epub 2014 Sep 6.

Abstract

BACKGROUND

GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas.

AIMS

To inform a complex intervention to support GPs in this important role, we aim to identify the key areas in which general practice can help address youth mental health and strategies to enhance implementation.

METHODS

We conducted a modified Delphi study which involved establishing an expert panel involving key stakeholders/service providers at two deprived urban areas. The group reviewed emerging literature on the topic at a series of meetings and consensus was facilitated by iterative surveys.

RESULTS

We identified 20 individual roles in which GPs could help address youth mental health, across five domains: (1) prevention, health promotion and access, (2) assessment and identification, (3) treatment strategies, (4) interaction with other agencies/referral, and (5) ongoing support. With regard to strategies to enhance implementation, we identified a further 19 interventions, across five domains: (1) training, (2) consultation improvements, (3) service-level changes, (4) collaboration, and (5) healthcare-system changes.

CONCLUSIONS

GPs have a key role in addressing youth mental health and this study highlights the key domains of this role and the key components of a complex intervention to support this role.

摘要

背景

全科医生作为年轻人经常接触的医疗保健专业人员,在心理健康问题的早期干预中起着核心作用。然而,成功履行这一职责具有挑战性,在贫困的城市地区尤其如此。

目的

为了为一项支持全科医生履行这一重要职责的复杂干预措施提供信息,我们旨在确定全科医疗可以帮助解决青少年心理健康问题的关键领域以及加强实施的策略。

方法

我们开展了一项改良的德尔菲研究,其中包括在两个贫困城市地区建立一个由关键利益相关者/服务提供者组成的专家小组。该小组在一系列会议上审查了关于该主题的最新文献,并通过反复调查促进达成共识。

结果

我们确定了全科医生可以在五个领域帮助解决青少年心理健康问题的20项个人职责:(1)预防、健康促进和就医机会,(2)评估和识别,(3)治疗策略,(4)与其他机构的互动/转诊,以及(5)持续支持。关于加强实施的策略,我们在五个领域确定了另外19项干预措施:(1)培训,(2)咨询改进,(3)服务层面的改变,(4)合作,以及(5)医疗系统的改变。

结论

全科医生在解决青少年心理健康问题方面起着关键作用,本研究突出了这一作用的关键领域以及支持这一作用的复杂干预措施的关键组成部分。

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