在门诊烧伤诊所对成人实施心理社会筛查工具

Implementation of a Psychosocial Screener for Adults in an Outpatient Burn Clinic.

作者信息

Thomas Ben D, Ford Cameron G, Addicks Sarah H, Williford Desireé N, Manegold Ellen M, Randall Cameron L, Aballay Ariel M, Hajduk Gina M, Duncan Christina L

机构信息

Department of Psychology, West Virginia University, Morgantown, West Virginia.

Department of Family Medicine, University of Minnesota School of Medicine, Rochester, Minnesota.

出版信息

J Burn Care Res. 2019 Apr 26;40(3):331-335. doi: 10.1093/jbcr/irz020.

Abstract

Burn injuries are significant medical traumas often resulting in substantial psychosocial distress. Early identification of psychosocial concerns is crucial to developing individualized treatments to improve psychosocial functioning. Few studies have examined the prevalence of a broad range of psychosocial concerns in an adult outpatient burn setting. In this study, they developed and implemented a screening instrument to identify patients experiencing acute psychosocial distress/risk and patients with mental health difficulties necessitating a psychology consult. The instrument assessed depression, anxiety, substance abuse, posttraumatic stress, perceived safety at home, and suicidal ideation. Adult patients (N = 178) completed the screener during an initial outpatient clinic visit. Responses on the screener were used to identify patients as "high risk" (ie, endorsing suicidal ideation and/or feeling unsafe at home), "moderate risk" (ie, endorsing no-acute mental health symptoms), or "low risk" (ie, few to no symptoms endorsed). Patients in the "high risk" category were immediately evaluated by the attending physician, who then determined whether emergency treatment was needed. Patients in the "moderate risk" category were referred to the on-site psychology team for in-person or phone consultation within 3 days of screener completion. Of the 178 individuals screened, a majority endorsed low to no psychosocial distress (N = 124; 69.7%). About one-third (N = 52) indicated moderate levels of psychosocial distress, and two patients (1.1%) endorsed acute psychosocial distress. This novel screening tool was effectively implemented in an outpatient burn clinic and demonstrates considerable promise for identifying psychosocially vulnerable patients in an adult burn survivor population.

摘要

烧伤是严重的医学创伤,常常导致巨大的心理社会困扰。尽早识别心理社会问题对于制定个性化治疗方案以改善心理社会功能至关重要。很少有研究探讨成年门诊烧伤患者中广泛的心理社会问题的患病率。在本研究中,他们开发并实施了一种筛查工具,以识别经历急性心理社会困扰/风险的患者以及需要心理咨询的心理健康困难患者。该工具评估了抑郁、焦虑、药物滥用、创伤后应激、在家中的安全感以及自杀意念。成年患者(N = 178)在首次门诊就诊时完成了筛查。筛查结果用于将患者分为“高风险”(即认可自杀意念和/或在家中感觉不安全)、“中度风险”(即认可无急性心理健康症状)或“低风险”(即认可很少或没有症状)。“高风险”类别的患者由主治医生立即进行评估,然后主治医生确定是否需要紧急治疗。“中度风险”类别的患者在完成筛查后3天内被转介到现场心理团队进行面对面或电话咨询。在178名接受筛查的个体中,大多数认可低至无心理社会困扰(N = 124;69.7%)。约三分之一(N = 52)表示存在中度心理社会困扰,两名患者(1.1%)认可急性心理社会困扰。这种新型筛查工具在门诊烧伤诊所得到了有效实施,并显示出在识别成年烧伤幸存者群体中心理社会脆弱患者方面具有很大的前景。

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