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患者与从业者对以文化为中心的综合护理以解决初级保健中健康差异问题的看法。

Patient and Practitioner Perspectives on Culturally Centered Integrated Care to Address Health Disparities in Primary Care.

作者信息

Wrenn Glenda, Kasiah Fatima, Belton Allyson, Dorvil Sheena, Roberts Kristin, Mcgregor Brian, Holden Kisha

机构信息

Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta, GA.

Fellow in the Department of Child and Adolescent Psychiatry at the University of Alabama at Birmingham.

出版信息

Perm J. 2017;21:16-018. doi: 10.7812/TPP/16-018.

Abstract

INTRODUCTION

Addressing the multifaceted health and mental health needs of ethnically and culturally diverse individuals is a challenge within the current health care system. Integrated care provides a promising approach to improve mental health treatment-seeking disparities; however, adaptation of care models to impact African Americans is lacking. Although resources to support engagement of diverse populations in depression care exist, little has been developed to tailor patient preferences in accessing and engaging mental health services that are integrated into primary care.

OBJECTIVE

Our research seeks to add a cultural focus to the existing literature concerning integrated health care models to help address depression and selected co-occurring chronic health conditions in primary care settings.

METHODS

Thirty-two adult patients of an integrated primary care clinic participated in focus groups discussing their individual health experiences. Nine health care practitioners/administrators from five different integrated practice settings in the Atlanta, GA, area participated in key informant interviews.

MAIN OUTCOME MEASURES

Transcripts were analyzed for key themes related to depression care, perceived unmet cultural needs, and desired adaptations.

RESULTS

Common themes emerged such as the importance of peer-support and community engagement as areas of patient interest. Participants had good knowledge in recognizing depressive symptoms but were less knowledgeable about treatment options and expectations of treatment. The administrative and practitioner perspective suggests that patient preferences are valued and perceived as valid.

CONCLUSION

It is critical that strategies and models are developed to improve health care among underserved minorities because current models offer variable efficacy among this population.

摘要

引言

在当前的医疗体系中,满足不同种族和文化背景个体多方面的健康及心理健康需求是一项挑战。综合护理为改善寻求心理健康治疗方面的差异提供了一种有前景的方法;然而,目前缺乏针对非裔美国人调整护理模式的相关举措。尽管存在支持不同人群参与抑郁症护理的资源,但在根据患者偏好来定制融入初级护理的心理健康服务的获取和参与方面,进展甚微。

目的

我们的研究旨在为现有关于综合医疗保健模式的文献增添文化视角,以帮助解决初级护理环境中的抑郁症及某些并发的慢性健康问题。

方法

一家综合初级护理诊所的32名成年患者参与了焦点小组讨论,分享他们的个人健康经历。来自佐治亚州亚特兰大地区五个不同综合医疗机构的9名医疗从业者/管理人员参与了关键信息人访谈。

主要观察指标

对访谈记录进行分析,找出与抑郁症护理、未得到满足的文化需求感知以及期望的调整相关的关键主题。

结果

出现了一些共同主题,比如同伴支持和社区参与作为患者感兴趣领域的重要性。参与者在识别抑郁症状方面有较好的认知,但对治疗选择和治疗期望的了解较少。从行政人员和从业者的角度来看,患者的偏好受到重视且被视为合理。

结论

制定策略和模式以改善弱势群体的医疗保健至关重要,因为当前模式在这一人群中的疗效参差不齐。

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