Bjerregaard Frederike, Zech Julia, Frank Fabian, Hüll Michael, Stieglitz Rolf-Dieter, Hölzel Lars
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2018 Jul;134:42-48. doi: 10.1016/j.zefq.2018.04.001. Epub 2018 Jun 13.
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.
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.
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.
The present study provides practical information for implementing the GermanIMPACT model. Thus, specific recommendations for implementation into standard care can be derived.
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。
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。
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。
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。