为患有严重精神疾病的个体整合行为健康护理：一项同伴健康导航干预的随机对照试验。
Integrating behavioral healthcare for individuals with serious mental illness: A randomized controlled trial of a peer health navigator intervention.
作者信息
Kelly Erin, Duan Lei, Cohen Heather, Kiger Holly, Pancake Laura, Brekke John
机构信息
School of Social Work, University of Southern California, 669 West 34th Street, Montgomery Ross Fisher Building, Los Angeles, CA 90089, USA; Health Services Research Center, University of California, Los Angeles, Los Angeles, CA 90023, USA.
School of Social Work, University of Southern California, 669 West 34th Street, Montgomery Ross Fisher Building, Los Angeles, CA 90089, USA.
出版信息
Schizophr Res. 2017 Apr;182:135-141. doi: 10.1016/j.schres.2016.10.031. Epub 2016 Oct 25.
OBJECTIVE
Individuals with serious mental illness also have high rates of comorbid physical health issues. To address those issues, this population needs interventions that improve self-management of health and healthcare.
METHODS
In order to improve the health and healthcare of individuals with serious mental illnesses, 151 consumers with serious mental illness were randomized to receive either usual mental healthcare plus the Bridge intervention (n=76) or usual mental healthcare while on a 6month waitlist (n=75). The waitlist group received the intervention after the waitlist period.
RESULTS
Change score comparisons (difference of differences) of the treatment vs the waitlist groups revealed that the treated group showed significantly greater improvement in access and use of primary care health services, higher quality of the consumer-physician relationship, decreased preference for emergency, urgent care, or avoiding health services and increased preference for primary care clinics, improved detection of chronic health conditions, reductions in pain, and increased confidence in consumer self-management of healthcare.
CONCLUSIONS
Peer providers using a manualized intervention can be an important part of the efforts to address the general medical care of individuals with serious mental illnesses.
目的
患有严重精神疾病的个体同时患有躯体健康问题的比例也很高。为解决这些问题，这一人群需要能改善健康自我管理及医疗保健的干预措施。
方法
为改善患有严重精神疾病个体的健康状况及医疗保健水平，151名患有严重精神疾病的消费者被随机分为两组，一组接受常规精神医疗保健加桥梁干预（n = 76），另一组在6个月的等候名单上接受常规精神医疗保健（n = 75）。等候名单组在等候期结束后接受干预。
结果
治疗组与等候名单组的变化分数比较（差异的差异）显示，治疗组在初级保健健康服务的可及性和使用、医患关系质量、对急诊、紧急护理或回避健康服务的偏好降低以及对初级保健诊所的偏好增加、慢性健康状况的检测改善、疼痛减轻以及消费者对医疗保健自我管理的信心增强等方面有显著更大的改善。
结论
使用标准化干预措施的同伴提供者可以成为解决患有严重精神疾病个体的一般医疗护理问题努力的重要组成部分。
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