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[德国IMPACT协作护理项目的实施:一项关于护理经理和主管视角的定性研究]

[Implementation of the GermanIMPACT collaborative care program: A qualitative study on the perspective of care managers and supervisors].

作者信息

Bjerregaard Frederike, Zech Julia, Frank Fabian, Hüll Michael, Stieglitz Rolf-Dieter, Hölzel Lars

机构信息

Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.

Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2018 Jul;134:42-48. doi: 10.1016/j.zefq.2018.04.001. Epub 2018 Jun 13.

DOI:10.1016/j.zefq.2018.04.001
PMID:29907445
Abstract

BACKGROUND

Collaborative Care programs like the Improving Mood Promoting Access to Collaborative Care Program (IMPACT) present an opportunity to support primary care for elderly depressed patients. The GermanIMPACT study evaluates whether this low-threshold model using short behavioral interventions that are conducted by care managers and supervised by a psychotherapist/psychiatrist, is as effective as in other countries. Besides effectiveness, the feasibility of the intervention is also essential for the implementation of the program.

METHOD

Care managers and supervisors were interviewed using a qualitative interview guide with questions concerning feasibility and effectiveness of the GermanIMPACT intervention, and the interviews were then evaluated using qualitative content analysis.

RESULTS

The interviewees provided important information on how to optimize the realization of the intervention by selecting patients more carefully and by providing case managers with more training. Moreover, the intervention was described as being supportive of patients and as providing relief for general practitioners. Whereas interviewees wanted the intervention to be expanded to other disorders, they simultaneously highlighted the limits of the intervention.

CONCLUSIONS

The present study provides practical information for implementing the GermanIMPACT model. Thus, specific recommendations for implementation into standard care can be derived.

摘要

背景

像改善情绪促进协同护理项目(IMPACT)这样的协同护理项目为支持老年抑郁症患者的初级护理提供了契机。德国IMPACT研究评估了这种由护理经理实施并由心理治疗师/精神科医生监督的、采用简短行为干预的低门槛模式是否与其他国家一样有效。除有效性外,干预措施的可行性对于该项目的实施也至关重要。

方法

使用定性访谈指南对护理经理和监督员进行访谈,问题涉及德国IMPACT干预措施的可行性和有效性,然后采用定性内容分析法对访谈进行评估。

结果

受访者提供了重要信息,涉及如何通过更谨慎地选择患者以及为个案管理员提供更多培训来优化干预措施的实施。此外,该干预措施被描述为对患者有支持作用,并为全科医生减轻了负担。尽管受访者希望将该干预措施扩展到其他疾病,但他们同时也强调了该干预措施的局限性。

结论

本研究为实施德国IMPACT模式提供了实用信息。因此,可以得出纳入标准护理的具体建议。

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Z Evid Fortbild Qual Gesundhwes. 2018 Jul;134:42-48. doi: 10.1016/j.zefq.2018.04.001. Epub 2018 Jun 13.
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引用本文的文献

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Impact of Collaborative Care on Depression in Patients Aged 60+: A Secondary Analysis of the GermanIMPACT Study on Behavioural Activation.协作护理对60岁及以上患者抑郁症的影响:德国行为激活IMPACT研究的二次分析
Behav Sci (Basel). 2025 Apr 3;15(4):462. doi: 10.3390/bs15040462.
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Types of Utilization and Types of Treatment Response in a Collaborative Care Approach for Depressive Disorders in Old Age in Primary Care.基层医疗中老年抑郁症协作照护模式下的利用类型及治疗反应类型
Front Psychiatry. 2020 Oct 23;11:565929. doi: 10.3389/fpsyt.2020.565929. eCollection 2020.
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Coordinated Treatment of Depression in Elderly People in Primary Care.
老年患者在初级保健中的抑郁协同治疗。
Dtsch Arztebl Int. 2018 Nov 2;115(44):741-747. doi: 10.3238/arztebl.2018.0741.