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服务使用者与专业人员合作开展一项针对诊断为严重精神疾病患者的心血管风险管理新计划的开发与评估:法国多中心定性研究及可行性研究

A collaboration between service users and professionals for the development and evaluation of a new program for cardiovascular risk management in persons with a diagnosis of severe mental illness: French multicenter qualitative and feasibility studies.

作者信息

Baleige Antoine, Besnard Jean-François, Meunier-Beillard Nicolas, Demassiet Vincent, Monnier Alain, Ouezini Amel, Lambert Olivier, Charrel Claire, Mazas Olivier, Oberlin Joël, Roelandt Jean-Luc, Denis Frédéric

机构信息

EPSM Lille-Métropole, WHO Collaborating Centre for Research and Training in Mental Health, 211 Rue Salengro, 59260 Hellemmes, France.

EPSM Lille-Métropole, 104 Rue Général Leclerc, 59280 Armentières, France.

出版信息

Int J Ment Health Syst. 2019 Dec 27;13:74. doi: 10.1186/s13033-019-0331-6. eCollection 2019.

Abstract

BACKGROUND

Persons with a diagnosis of severe mental illness have a life expectancy that is 20 years lower than the general population, and they are disproportionately affected by cardiovascular disorders. Improving the management of cardiovascular risk is one of the main challenges for the public health system. In the care pathway of persons with a diagnosis of severe mental illness, a better understanding of limiting and facilitating factors is required. The objective was to include persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals in the creation and evaluation (feasibility) of a health promotion program designed to improve cardiovascular risk management through empowerment.

METHODS

This study combines a mixed methodology with qualitative and quantitative components. A multicenter prospective qualitative study was conducted in seven mental health units in France and was coordinated by a steering committee composed of persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals.

RESULTS

This health promotion program must enable persons with a diagnosis of severe mental illness to assert their right to self-determination and to exercise greater control over their lives, beyond their diagnosis and care. Following a preliminary feasibility study, the effectiveness of this new tool will be evaluated using a randomized controlled trial in a second study.

CONCLUSIONS

The findings can be used by health organizations as a starting point for developing new and improved services for persons with a diagnosis of severe mental illness. Clinical Trials Gov NCT03689296. Date registered September 28, 2018.

摘要

背景

被诊断患有严重精神疾病的人群预期寿命比普通人群低20岁,且他们受心血管疾病的影响尤为严重。改善心血管疾病风险的管理是公共卫生系统面临的主要挑战之一。在对被诊断患有严重精神疾病的患者的护理过程中,需要更好地了解限制因素和促进因素。目标是让被诊断患有严重精神疾病的患者、护理人员以及初级和心理健康专业人员参与到一个健康促进项目的创建和评估(可行性)中,该项目旨在通过赋权来改善心血管疾病风险管理。

方法

本研究采用了一种结合定性和定量成分的混合方法。在法国的七个精神卫生单位开展了一项多中心前瞻性定性研究,由一个由被诊断患有严重精神疾病的患者、护理人员以及初级和心理健康专业人员组成的指导委员会进行协调。

结果

这个健康促进项目必须使被诊断患有严重精神疾病的患者能够维护他们的自决权,并在诊断和护理之外,对自己的生活有更大的掌控权。在初步可行性研究之后,将在第二项研究中通过随机对照试验来评估这个新工具的有效性。

结论

研究结果可供卫生组织用作起点,为被诊断患有严重精神疾病的患者开发新的和改进的服务。临床试验注册编号:NCT03689296。注册日期:2018年9月28日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7089/6933686/b55ea4752ce6/13033_2019_331_Fig1_HTML.jpg

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