School of Nursing, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada.
Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada.
Int J Ment Health Nurs. 2019 Apr;28(2):369-389. doi: 10.1111/inm.12584. Epub 2019 Feb 27.
This review aimed to identify the main factors influencing the adoption of the role of care manager (CM) by nurses when implementing the collaborative care model (CCM) for common mental illnesses in primary care settings. A total of 19 studies met the inclusion criteria, reporting on 14 distinct interventions implemented between 2000 and 2017 in five countries. Two categories of factors were identified and described as follows: (i) strategies for the CCM implementation (e.g. initial care management training and supervision by a mental health specialist) and (ii) context-specific factors (e.g. organizational factors, collaboration with team members, nurses' care management competency). Identified implementation strategies were mainly aimed towards improving the nurse's care management competency, but their efficacy in developing the set of competencies needed to fulfil a CM role was not well demonstrated. There is a need to better understand the relationship between the nurses' competencies, the care management activities, the strategies used to implement the CCM and the context-specific factors. Strategies to optimize the adoption of the CM role should not be solely oriented towards the individual's competency in care management, but also consider other context-specific factors. The CM also needs a favourable context in order to perform his or her activities with competency.
本综述旨在确定影响护士在基层医疗环境中实施共病精神卫生协作护理模式(CCM)时担任护理经理(CM)角色的主要因素。共有 19 项研究符合纳入标准,报告了 2000 年至 2017 年间在五个国家实施的 14 项不同干预措施。确定了以下两个类别的因素:(i)CCM 实施策略(例如,初始护理管理培训和心理健康专家的监督)和(ii)特定于环境的因素(例如,组织因素、与团队成员的协作、护士的护理管理能力)。确定的实施策略主要旨在提高护士的护理管理能力,但它们在培养履行 CM 角色所需的一系列能力方面的效果并未得到很好的证明。需要更好地理解护士的能力、护理管理活动、用于实施 CCM 的策略与特定于环境的因素之间的关系。优化 CM 角色采用的策略不应仅针对个人的护理管理能力,还应考虑其他特定于环境的因素。CM 还需要一个有利的环境才能胜任地开展其活动。