Elley Carolyn Raina, Dawes Diana, Dawes Martin, Price Morgan, Draper Haeli, Goodyear-Smith Felicity
Can Fam Physician. 2014 Nov;60(11):e527-34.
To assess the feasibility and acceptability of administering the validated Case-finding Health Assessment Tool (CHAT) in Canadian family practice waiting rooms to identify risk factors for depression, anxiety, anger control,smoking, drinking, other drug use, gambling, exposure to abuse, and physical inactivity.
Cross-sectional survey.
One urban academic family practice and one inner-city community health centre in British Columbia.
Convenience sample of consecutive adult patients (19 years of age or older) and their attending family physicians.
Rates of completion; positive responses to and wanting help with identified lifestyle and mental health risk factors; rates of objections to any questions; and positive and negative comments about the CHAT by participating physicians and patients.
A total of 265 eligible adults presented in the waiting rooms over 5 full days and 3 half-days, 176 (66%) of whom enrolled in the study; 161(91%) completed the CHAT, and 107 (66%) completed acceptability feedback forms. The prevalence of risk factors among patients in the academic and inner-city practice samples was different, with 20% and 63%, respectively,recording positive responses to both depression screening questions,34% and 60% positive for anxiety, 11% and 71% currently smoking, 6%and 22% feeling they needed to cut down on alcohol, 1% and 48% having used recreational drugs in the past year, and 11% and 65% with problems controlling anger. While many requested help with reducing risk factors,such as smoking (20%) and mental health symptoms (25% to 27%), a total of 35% (57 of 161) wanted help with an identified issue that day. Patients and physicians found the CHAT acceptable, with no patients objecting to any question except the alcohol question (2 objected). Most comments were positive.
The CHAT allowed efficient identification of 9 risk factors, as well as identification of those wanting help. It could be used to screen all or targeted adult Canadian primary care patients in waiting rooms.
评估在加拿大家庭医疗候诊室使用经过验证的病例发现健康评估工具(CHAT)来识别抑郁、焦虑、愤怒控制、吸烟、饮酒、其他药物使用、赌博、遭受虐待及身体活动不足等风险因素的可行性和可接受性。
横断面调查。
不列颠哥伦比亚省的一家城市学术性家庭医疗诊所和一家市中心社区健康中心。
连续就诊的成年患者(19岁及以上)及其主治家庭医生的便利样本。
完成率;对已识别的生活方式和心理健康风险因素的积极回应及寻求帮助的情况;对任何问题的反对率;参与的医生和患者对CHAT的正面和负面评价。
在5个整日和3个半日期间,共有265名符合条件的成年人出现在候诊室,其中176人(66%)参与了研究;161人(91%)完成了CHAT,107人(66%)完成了可接受性反馈表。学术性诊所和市中心诊所样本中患者的风险因素患病率有所不同,抑郁筛查问题的阳性回应率分别为20%和63%,焦虑的阳性回应率分别为34%和60%,目前吸烟率分别为11%和71%,感觉需要减少饮酒的比例分别为6%和22%,过去一年使用过消遣性药物的比例分别为1%和48%,存在愤怒控制问题的比例分别为11%和65%。虽然许多人要求帮助降低风险因素,如吸烟(20%)和心理健康症状(25%至27%),但当天共有35%(161人中的57人)希望就已识别的问题获得帮助。患者和医生认为CHAT是可接受的,除了酒精问题(2人反对)外,没有患者反对任何问题。大多数评论是积极的。
CHAT能够有效地识别9种风险因素,以及识别那些寻求帮助的人。它可用于对加拿大家庭医疗候诊室中的所有或目标成年初级护理患者进行筛查。