King Paul R, Beehler Gregory P, Buchholz Laura J, Johnson Emily M, Wray Laura O
Veterans Affairs Center for Integrated Healthcare, Veterans Affairs Western New York Healthcare System.
Veterans Affairs Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center.
Fam Syst Health. 2019 Mar;37(1):68-73. doi: 10.1037/fsh0000393. Epub 2019 Jan 7.
The Primary Care-Mental Health Integration program is a component of the Veterans Health Administration's patient-centered medical home, which emphasizes comprehensive, patient-centered care. One model of primary care-mental health integration, known as Primary Care Behavioral Health (PCBH), positions trained behavioral health providers as members of the primary care team. Whereas patient perspectives are essential to effective patient-centered care, little empirical information exists regarding patients' goals and priorities for addressing their biopsychosocial concerns in PCBH.
A regional mail survey of Veterans Health Administration patients was used. We collected data from 281 veterans (27% response rate) who received PCBH services in a northeastern region.
Respondents identified difficulty with sleep (80%), low energy/amotivation (78%), and managing stress (72%) as the most prevalent individual concerns, although the majority endorsed concerns in multiple domains of functioning. Overwhelmingly, patients who endorsed any biopsychosocial problem area reported that they did (53-93%) or would like to (56-81%) address that concern with a behavioral health provider. Respondents most frequently identified anger as a top priority for future care, followed by stress management, energy/motivation, and sleep disturbance. Whereas sample means signaled neutral or better quality of life in most individual domains, total Quality of Life Inventory scores suggested very low (32%) to average (30%) overall quality-of -life ratings for most participants.
In addition to symptom-focused PCBH assessments, providers should gather biopsychosocial data to identify and monitor functional and quality-of -life concerns and evaluate patient preferences in addressing these concerns over the course of clinical care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
初级保健与心理健康整合项目是退伍军人健康管理局以患者为中心的医疗之家的一个组成部分，该项目强调全面的、以患者为中心的护理。初级保健与心理健康整合的一种模式，即初级保健行为健康（PCBH），将经过培训的行为健康提供者定位为初级保健团队的成员。虽然患者的观点对于有效的以患者为中心的护理至关重要，但关于患者在PCBH中解决其生物心理社会问题的目标和优先事项的实证信息却很少。
对退伍军人健康管理局的患者进行了一项区域性邮件调查。我们收集了来自281名退伍军人（回复率为27%）的数据，这些退伍军人在东北地区接受了PCBH服务。
受访者将睡眠困难（80%）、精力不足/缺乏动力（78%）和压力管理（72%）确定为最普遍的个人问题，尽管大多数人在多个功能领域都有问题。绝大多数认可任何生物心理社会问题领域的患者报告说，他们已经（53 - 93%）或希望（56 - 81%）与行为健康提供者解决该问题。受访者最常将愤怒确定为未来护理的首要任务，其次是压力管理、精力/动力和睡眠障碍。虽然样本均值表明在大多数个人领域生活质量处于中性或更好水平，但总体生活质量量表得分表明，大多数参与者的总体生活质量评级非常低（32%）至平均水平（30%）。
除了以症状为重点的PCBH评估外，提供者还应收集生物心理社会数据，以识别和监测功能及生活质量问题，并在临床护理过程中评估患者在解决这些问题方面的偏好。（PsycINFO数据库记录（c）2019美国心理学会，保留所有权利）
