Cheshire Anna, Peters David, Ridge Damien
Department of Psychology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
Westminster Centre for Resilience, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
BMC Fam Pract. 2016 Feb 2;17:13. doi: 10.1186/s12875-016-0410-6.
Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men's Well-being Programme was designed to engage stressed/distressed men who were patients at a London-based GP surgery. Atlas encouraged GPs to identify and refer men for counselling and/or acupuncture by raising their awareness of men's distress. The aim of this pilot study was to evaluate Atlas in terms of patients' characteristics, service utilisation, patient outcomes and cost implications.
All patients using the Programme were asked to complete a questionnaire before and after their Atlas sessions. Outcome measures included the Hospital Anxiety and Depression scale, Perceived Stress Scale, Warwick-Edinburgh Mental Well-being Scale, a 11-point scale measuring physical health, and the Psychological Outcome Profiles (PSYCHLOPS), a patient-generated outcome measure. Additionally, for cost calculations, participants were asked about their employment, number of days off work due to illness, and their health and social care service use.
102 participants were recruited, 82 completed pre- and post-treatment questionnaires. Comparisons pre- and post-treatment revealed a statistically significant improvement in anxious mood (p <0.001), perceived stress (p < 0.001), positive well-being (p = <0.001), PSYCHLOPS (p = <0.001) and physical health (p = 0.001), though not depressed mood (p = 0.660). Additionally, reductions in costs related to lost employment and health and social care use, exceeded the cost of Atlas counselling and acupuncture sessions, with an average saving of nearly £700 per patient.
Atlas attendance was associated with improvements in patients' mental and physical health, and demonstrated likely cost savings. It is now important to understand patient and stakeholder perspectives. Further research could compare usual care with the Atlas approach, and investigate full cost-effectiveness.
在所有自杀案例中，超过四分之三是男性（英格兰和威尔士），尽管报告显示女性的焦虑和抑郁水平更高。这种差异部分可能是由于男性痛苦的非典型表现以及围绕寻求帮助的性别问题。因此，阿特拉斯男性幸福计划旨在让伦敦一家全科医生诊所的压力大/苦恼的男性患者参与进来。阿特拉斯计划通过提高全科医生对男性苦恼的认识，鼓励他们识别并推荐男性接受咨询和/或针灸治疗。这项试点研究的目的是从患者特征、服务利用情况、患者结果和成本影响方面评估阿特拉斯计划。
所有使用该计划的患者在参加阿特拉斯课程之前和之后都被要求填写一份问卷。结果指标包括医院焦虑和抑郁量表、感知压力量表、沃里克 - 爱丁堡心理健康量表、一个测量身体健康的11分制量表，以及心理结果概况（PSYCHLOPS），这是一种由患者生成的结果测量方法。此外，为了进行成本计算，参与者被问及他们的就业情况、因病缺勤天数以及他们使用的健康和社会护理服务。
招募了102名参与者，82人完成了治疗前和治疗后的问卷。治疗前后的比较显示，焦虑情绪（p <0.001）、感知压力（p <0.001）、积极幸福感（p = <0.001）、PSYCHLOPS（p = <0.001）和身体健康（p = 0.001）有统计学上的显著改善，尽管抑郁情绪没有改善（p = 0.660）。此外，与失业以及健康和社会护理使用相关的成本降低超过了阿特拉斯咨询和针灸课程的成本，平均每位患者节省近700英镑。
参加阿特拉斯计划与患者的身心健康改善相关，并显示出可能的成本节约。现在了解患者和利益相关者的观点很重要。进一步的研究可以将常规护理与阿特拉斯方法进行比较，并调查全面的成本效益。
