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全面变革:一家卒中住院服务机构对新型临床神经心理学服务模式的体验

All change: a stroke inpatient service's experience of a new clinical neuropsychology delivery model.

作者信息

Boakye Ndidi T, Scott Richard, Parsons Aisling, Betteridge Shai, Smith Melody A, Cluckie Gill

机构信息

Department of Neuropsychology and Clinical Health, St George's University Hospitals, London, UK.

Stroke Service, Department of Neurosciences, St George's University Hospitals, London, UK.

出版信息

BMJ Open Qual. 2019 Jan 30;8(1):e000184. doi: 10.1136/bmjoq-2017-000184. eCollection 2019.

Abstract

Adults presenting to stroke services are frequently faced with the challenge of adjusting to a different life following a stroke. Difficulties often include cognitive impairments, such as memory deficits, attention and language difficulties, and mood disturbances such as anxiety and depression. It has been highlighted that psychological care for this group is just as important as physical rehabilitation. Psychological expertise may therefore be required for the multitude of problems that occur after a stroke. UK National guidelines recommend routine assessment and management of mood and cognition after stroke. The aim of this study was to evaluate a new stroke clinical neuropsychology service developed by the Department of Neuropsychology and Clinical Health Psychology, in order to meet the needs of stroke survivors and their families referred into a large acute hospital. This involved using a different skill mix of staff across one post delivering a service in an acute inpatient stroke unit. This model was evaluated and results revealed that the model delivered increased patient access to neuropsychological support, an expansion in provision of clinical work, along with positive multidisciplinary team feedback. This finding is key as where resources are limited, clinical services may benefit from adopting a 'skill mix' model to meet the varying needs of their patients in a timely manner. This model serves to raise the value of psychology to medical services.

摘要

前往中风服务机构就诊的成年人经常面临着中风后适应不同生活的挑战。困难通常包括认知障碍,如记忆缺陷、注意力和语言困难,以及情绪障碍,如焦虑和抑郁。有人强调,对这一群体的心理护理与身体康复同样重要。因此,对于中风后出现的众多问题,可能需要心理专业知识。英国国家指南建议对中风后的情绪和认知进行常规评估和管理。本研究的目的是评估神经心理学与临床健康心理学系开发的一项新的中风临床神经心理学服务,以满足被转诊到一家大型急症医院的中风幸存者及其家属的需求。这涉及在一个岗位上使用不同技能组合的工作人员,在急性住院中风单元提供服务。对该模式进行了评估,结果显示该模式增加了患者获得神经心理学支持的机会,扩大了临床工作的提供范围,同时得到了多学科团队的积极反馈。这一发现至关重要,因为在资源有限的情况下,临床服务可能会受益于采用“技能组合”模式,以便及时满足患者的不同需求。该模式有助于提高心理学在医疗服务中的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a12/6361325/a1a01b1f1561/bmjoq-2017-000184f01.jpg

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