Porcerelli John H, Jones John R, Grabowski Jillian E, Murdoch William
Department of Psychology, University of Detroit Mercy, 4001 W. McNichols Road, 142 Reno Hall, Detroit, MI, 48221, USA.
United States Air Force, 1538 Cable Ranch Road, Apt. 6203, San Antonio, TX, 78245, USA.
J Clin Psychol Med Settings. 2019 Jun;26(2):228-234. doi: 10.1007/s10880-018-9581-8.
The integration of psychologists and other behavioral health providers in primary care practice continues to evolve and reshape approaches to patient care. This study is a replication and extension of a 2013 study describing dual interviewing encounters involving psychology trainees and family medicine residents within an integrated primary care clinic as it relates to behavioral health assessments and interventions. Psychology trainees provided descriptions of 400 collaborative patient encounters involving 337 single and 63 repeat encounters. Psychology trainees coded the frequency of behavioral health assessments and interventions by the psychology trainee, family medicine resident, or both. Seventy-eight percent of encounters contained an assessment, and 20% contained interventions. Compared to the 2013 study, there were significantly fewer behavioral health interventions offered and a significantly greater number of psychoeducation/supportive interventions offered collaboratively. It was discovered that discussions between psychology trainees and family medicine residents immediately after patient encounters occurred 50% of the time and involved issues of case conceptualization. These informal discussions may be an important source of behavioral health education for family medicine residents. This study adds to efforts to better understand what occurs during these encounters.
心理学家和其他行为健康服务提供者融入初级保健实践的情况仍在不断发展，并重塑着患者护理的方式。本研究是对2013年一项研究的复制与扩展，该研究描述了在一家综合初级保健诊所中，心理学实习生与家庭医学住院医师之间的双重问诊情况，涉及行为健康评估和干预。心理学实习生提供了400次协作患者问诊的描述，其中包括337次单次问诊和63次重复问诊。心理学实习生对心理学实习生、家庭医学住院医师或双方进行行为健康评估和干预的频率进行了编码。78%的问诊包含评估，20%的问诊包含干预。与2013年的研究相比，提供的行为健康干预显著减少，而协作提供的心理教育/支持性干预显著增多。研究发现，患者问诊后，心理学实习生和家庭医学住院医师之间的讨论有50%的时间会立即进行，且涉及病例概念化问题。这些非正式讨论可能是家庭医学住院医师行为健康教育的重要来源。本研究有助于更好地了解这些问诊过程中发生的情况。
