心理健康临床医生对慢性病风险行为预防保健提供的态度及其与保健提供的关联。
Mental health clinician attitudes to the provision of preventive care for chronic disease risk behaviours and association with care provision.
作者信息
Bartlem Kate, Bowman Jenny, Ross Kate, Freund Megan, Wye Paula, McElwaine Kathleen, Gillham Karen, Doherty Emma, Wolfenden Luke, Wiggers John
机构信息
Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia.
School of Psychology, Faculty of Science and Information Technology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
出版信息
BMC Psychiatry. 2016 Mar 2;16:57. doi: 10.1186/s12888-016-0763-3.
BACKGROUND
Preventive care for chronic disease risk behaviours by mental health clinicians is sub-optimal. Little research has examined the association between clinician attitudes and such care delivery. This study aimed to explore: i) the attitudes of a multi-disciplinary group of community mental health clinicians regarding their perceived role, perception of client interest, and perceived self-efficacy in the provision of preventive care, ii) whether such attitudes differ by professional discipline, and iii) the association between these attitudes and clinician provision of such care.
METHOD
A telephone survey was conducted with 151 Australian community mental health clinicians regarding their attitudes towards provision of assessment, advice and referral addressing smoking, nutrition, alcohol, and physical activity, and their reported provision of such care. Logistic regression was used to examine the association between attitudes and care delivery, and attitudinal differences by professional discipline.
RESULTS
Most clinicians reported that: their manager supported provision of preventive care; such care was part of their role; it would not jeopardise their practitioner-client relationships, clients found preventive care acceptable, and that they had the confidence, knowledge and skills to modify client health behaviours. Half reported that clients were not interested in changing their health behaviours, and one third indicated that the provision of preventive care negatively impacted on time available for delivery of acute care. The following attitudes were positively associated with the provision of preventive care: role congruence, client interest in change, and addressing health risk behaviours will not jeopardise the client-clinician relationship.
CONCLUSIONS
Strategies are required to translate positive attitudes to improved client care and address attitudes which may hinder the provision of preventive care in community mental health.
背景
心理健康临床医生对慢性病风险行为的预防护理并不理想。很少有研究探讨临床医生态度与此类护理提供之间的关联。本研究旨在探讨：i）一组多学科社区心理健康临床医生对其感知角色、对客户兴趣的看法以及在提供预防护理方面的自我效能感的态度；ii）这些态度是否因专业学科而异；iii）这些态度与临床医生提供此类护理之间的关联。
方法
对151名澳大利亚社区心理健康临床医生进行了电话调查，询问他们对提供针对吸烟、营养、酒精和身体活动的评估、建议和转诊的态度，以及他们报告的此类护理的提供情况。使用逻辑回归来检验态度与护理提供之间的关联以及专业学科之间的态度差异。
结果
大多数临床医生报告称：他们的经理支持提供预防护理；此类护理是他们职责的一部分；这不会损害他们与患者的关系，患者认为预防护理是可以接受的，并且他们有信心、知识和技能来改变患者的健康行为。一半的临床医生报告称患者对改变健康行为不感兴趣，三分之一的临床医生表示提供预防护理对提供急性护理的可用时间产生了负面影响。以下态度与提供预防护理呈正相关：角色一致性、患者对改变的兴趣以及解决健康风险行为不会损害患者与临床医生的关系。
结论
需要采取策略将积极态度转化为改善患者护理，并解决可能阻碍社区心理健康中预防护理提供的态度问题。
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