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艾滋病毒与抑郁症的协作护理模式:来自美国一家安全网诊所的患者观点与经历

The collaborative care model for HIV and depression: Patient perspectives and experiences from a safety-net clinic in the United States.

作者信息

Fuller Shannon M, Koester Kimberly A, Erguera Xavier A, Wilde Botta Emma, von Beetzen Fredrik, Steward Wayne T, Avery Ann

机构信息

Division of Prevention Sciences, Center for AIDS Prevention Studies, The University of California, San Francisco, San Francisco, CA, USA.

MetroHealth Medical Center, Cleveland, OH, USA.

出版信息

SAGE Open Med. 2019 Apr 2;7:2050312119842249. doi: 10.1177/2050312119842249. eCollection 2019.

Abstract

OBJECTIVES

Collaborative care models may improve outcomes for both HIV and depression. The model includes routine screening and re-assessment of depressive symptoms as well as care coordination services delivered by an ancillary provider focused on mental health. We sought to explore patient experiences and attitudes about the services received through the collaborative care model, including measurement-based care using the Patient Health Questionnaire-9.

METHODS

We conducted 17 qualitative interviews with patients in a collaborative care model implemented at an HIV primary care clinic in a safety-net hospital in the United States. Interviews were analyzed using Framework Analysis.

RESULTS

Our findings illustrate the ways in which the collaborative care model for depression may be meaningful to patients in HIV care settings. Participants appreciated the support offered through the collaborative care model. Most participants perceived measurement-based care as useful to their providers, and an additional subset used the Patient Health Questionnaire-9 for their own self-management and awareness of depression. Over time, the collaborative care model appeared to motivate some patients to address depressive symptoms.

CONCLUSION

The collaborative care model may be particularly helpful to patients in the way that it reinforces how depressive symptoms can be measured and managed. Furthermore, routine screening and re-measurement for depressive symptoms using the Patient Health Questionnaire-9 hold promise as an additional self-management tool to complement other clinical and supportive services.

摘要

目的

协作护理模式可能会改善艾滋病病毒(HIV)感染者和抑郁症患者的治疗效果。该模式包括对抑郁症状进行常规筛查和重新评估,以及由专注于心理健康的辅助医疗人员提供护理协调服务。我们试图探讨患者对通过协作护理模式获得的服务的体验和态度,包括使用患者健康问卷-9进行基于测量的护理。

方法

我们对美国一家安全网医院的HIV初级护理诊所实施的协作护理模式中的患者进行了17次定性访谈。访谈采用框架分析法进行分析。

结果

我们的研究结果说明了抑郁症协作护理模式在HIV护理环境中对患者可能具有意义的方式。参与者对通过协作护理模式提供的支持表示赞赏。大多数参与者认为基于测量的护理对他们的医疗服务提供者有用,另外一部分人将患者健康问卷-9用于自身的自我管理和抑郁症认知。随着时间的推移,协作护理模式似乎促使一些患者去解决抑郁症状。

结论

协作护理模式可能对患者特别有帮助,因为它强化了抑郁症状的测量和管理方式。此外,使用患者健康问卷-9对抑郁症状进行常规筛查和重新测量有望成为补充其他临床和支持服务的额外自我管理工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed41/6446432/607402fbed62/10.1177_2050312119842249-fig1.jpg

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