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加强初级保健环境中提供心理健康保健服务的策略:证据图谱。

Strategies to strengthen the provision of mental health care at the primary care setting: An Evidence Map.

机构信息

Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Occupational Therapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

PLoS One. 2019 Sep 6;14(9):e0222162. doi: 10.1371/journal.pone.0222162. eCollection 2019.

Abstract

In a deinstitutionalised mental health care system, those with mental illness require complex, multidisciplinary and intersectoral care at the primary or community service setting. This paper describes an Evidence Map of different strategies to strengthen the provision of mental health care at the primary health care (PHC) setting, the quality of the evidence, and knowledge gaps. Electronic and reference searching yielded 2666 articles of which 306 qualified for data extraction. A systematic review methodology identified nine different strategies that strengthen the provision of mental healthcare and these strategies are mapped in line with the outcomes they affect. The top three strategies that were reported the most, included strategies to empower families, carers and patients; integration of care or collaborative interventions; and e-health interventions. The least reported strategy was task shifting. The Evidence Map further shows the amount and quality of evidence supporting each of the listed strategies, and this helps to inform policy design and research priorities around mental health. This is the first systematic Evidence Map to show the different strategies that strengthen the provision of mental healthcare at PHC setting and the impact these strategies have on patient, hospital and societal level indicators.

摘要

在去机构化的精神卫生保健系统中,精神疾病患者需要在初级或社区服务环境中接受复杂的、多学科和跨部门的护理。本文描述了一份证据图谱,图谱中展示了不同的策略,这些策略旨在加强初级卫生保健(PHC)环境中的精神卫生保健服务提供,图谱还描述了证据的质量和知识空白。电子和参考文献检索共产生了 2666 篇文章,其中 306 篇符合数据提取标准。系统评价方法确定了九种不同的策略,这些策略可加强精神卫生保健服务的提供,并且这些策略是根据它们所影响的结果进行映射的。报告最多的前三种策略包括:增强家庭、照顾者和患者的权能的策略;护理整合或协作干预;以及电子卫生干预。报告最少的策略是任务转移。证据图谱还展示了支持所列每种策略的证据的数量和质量,这有助于为精神卫生政策设计和研究重点提供信息。这是第一份系统的证据图谱,展示了在 PHC 环境中加强精神卫生保健服务提供的不同策略,以及这些策略对患者、医院和社会层面指标的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f51f/6731011/dbc1bc4f3b6f/pone.0222162.g001.jpg

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