Miles Leslie W, Williams Nathalia, Luthy Karlen E, Eden Lacey
Leslie W. Miles, DNP, APRN, PMHNP-BC, Brigham Young University, Provo, UT, USA.
Nathalia Williams, MS, FNP, Brigham Young University, Provo, UT, USA.
J Am Psychiatr Nurses Assoc. 2020 Mar/Apr;26(2):172-180. doi: 10.1177/1078390319831763. Epub 2019 Mar 13.
Adults who suffer with severe and persistent mental illness (SPMI) rarely access medical care to receive preventive vaccines. To increase the rate of vaccines among the SPMI population in an outpatient community mental health center (CMHC). A review of the literature identified a gap between the general population and SPMI clients in receiving preventive vaccinations. An initial mixed-method convenience survey of SPMI clients ( = 392) provided information on current vaccination status, demographics, beliefs, and interest in receiving vaccines. A vaccination program was developed to address identified barriers and increase vaccination rates. Postintervention data were collected through a mixed-method convenience survey of SPMI clients ( = 60) who participated in immunizations clinics to evaluate client satisfaction. A partnership between the health department and CMHC was developed to deliver vaccines in a nontraditional site. Vaccines administered included annual influenza; hepatitis A; hepatitis B; herpes zoster; measles, mumps, and rubella; pneumococcal; and tetanus, diphtheria, and pertussis (Tdap). More than 1,000 vaccines were administered in the first 8 months, with a significant increase in vaccination rates over baseline for individual vaccines ranging from 18.75% to 83%. Postintervention survey results found a 95% satisfaction rate. Implementation of a vaccination program in a nontraditional site that facilitates access for SPMI clients can promote an overwhelming increase in the vaccination rates for this underserved population. Results suggest that the integration of mental health and CMHC services can have a profound positive effect on SPMI population health.
患有严重持续性精神疾病(SPMI)的成年人很少就医接种预防性疫苗。为了提高门诊社区心理健康中心(CMHC)中SPMI人群的疫苗接种率,我们进行了此项研究。文献综述发现,普通人群与SPMI患者在接受预防性疫苗接种方面存在差距。对392名SPMI患者进行了初步的混合方法便利抽样调查,以了解他们目前的疫苗接种状况、人口统计学特征、信念以及接种疫苗的意愿。我们制定了一项疫苗接种计划,以克服已识别的障碍并提高疫苗接种率。干预后,通过对60名参与免疫接种诊所的SPMI患者进行混合方法便利抽样调查来收集数据,以评估患者满意度。卫生部门与CMHC建立了合作伙伴关系,在一个非传统场所提供疫苗。接种的疫苗包括年度流感疫苗、甲型肝炎疫苗、乙型肝炎疫苗、带状疱疹疫苗、麻疹、腮腺炎和风疹疫苗、肺炎球菌疫苗以及破伤风、白喉和百日咳(Tdap)疫苗。在最初的8个月内接种了1000多剂疫苗,个别疫苗的接种率比基线水平有显著提高,增幅从18.75%到83%不等。干预后调查结果显示满意度为95%。在一个非传统场所实施疫苗接种计划,方便了SPMI患者接种,可促使这一服务不足人群的疫苗接种率大幅提高。结果表明,心理健康服务与CMHC服务的整合可对SPMI人群的健康产生深远的积极影响。