Shepardson Robyn L, Funderburk Jennifer S
Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Avenue (116C), Syracuse, NY, 13210, USA.
Department of Psychology, Syracuse University, Syracuse, NY, USA.
J Clin Psychol Med Settings. 2016 Sep;23(3):225-39. doi: 10.1007/s10880-016-9462-y.
Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed.
焦虑症在初级保健中很常见,但治疗不足。初级保健机构中的行为健康提供者可以帮助填补这一治疗缺口。关于焦虑症治疗偏好的指导将有助于为临床实践和新干预措施的调整提供信息,使其更以患者为中心,并提高治疗参与度。我们对144名未寻求治疗的退伍军人初级保健患者进行了调查(男性占82.6%,白人占85.4%,年龄M = 59.8岁,标准差SD = 13.9),这些患者在广泛性焦虑症-7问卷上报告了当前的焦虑症状(M = 13.87,标准差SD = 3.66),询问他们参与具有11种不同属性(方式、类型、地点、形式、提供者、就诊频率、就诊时长、治疗持续时间、心理治疗类型、症状重点以及主题/技能)的焦虑症治疗的可能性。参与者明确表示倾向于在初级保健机构接受一对一的面对面治疗,每月一次,每次至少30分钟,且至少持续三个疗程。他们还倾向于选择一种专注于睡眠问题或疲劳的压力管理方法,但所有主题/技能的评分相当。对于大多数属性而言,评分最高的选项与综合护理的特点一致。文中讨论了对研究和实践的启示。