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患者参与在初级保健中进行抑郁筛查后的随机对照试验 GET.FEEDBACK.GP 中制定以患者为目标的反馈干预措施。

Patient involvement in developing a patient-targeted feedback intervention after depression screening in primary care within the randomized controlled trial GET.FEEDBACK.GP.

机构信息

Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Member of the Participatory Research Team, Hamburg, Germany.

出版信息

Health Expect. 2021 May;24 Suppl 1(Suppl 1):95-112. doi: 10.1111/hex.13039. Epub 2020 Apr 14.

Abstract

BACKGROUND

Patient and public involvement (PPI) is increasingly required in mental health services research. To empower patients to actively address depression, the GET.FEEDBACK.GP study evaluates a patient-targeted feedback intervention after depression screening using the Patient Health Questionnaire (PHQ-9).

OBJECTIVE

To refine the patient-targeted feedback from a previous study within a participatory research team (PRT) by conducting workshops to investigate patients' needs and preferences for feedback. To evaluate the process and outcome of PPI.

DESIGN

Patient and public involvement was carried out on the levels of collaboration and consultation. A PRT of patient partners and researchers planned and conducted three workshops with patients. Patients' needs were investigated using a focus group. Participants prioritized needs, discussed feedback drafts and evaluated two drafts using cognitive debriefings. Researchers of the PRT communicated the results at project level. PPI was evaluated using the Public and Patient Engagement Evaluation Tools (PPEET).

SETTING AND PARTICIPANTS

A purposeful sampling of N = 12 patients with experiences of depression participated in at least one workshop.

RESULTS

Relevant content-related needs about feedback (eg no distinction between severe and moderate symptoms), recommendations for action and patient-relevant information were considered. Needs for comprehensible, valuing, nonstigmatizing language and design elements (eg dimensional bar) were implemented. Workshops and PRT were positively evaluated.

DISCUSSION AND CONCLUSIONS

Patient and public involvement influenced the content, wording and design of the feedback. Strengths include two levels of PPI, methodical diversity and purposeful sampling. Limitations include the lack of inclusion of patients who are unaware of their depression. The evaluated PPI concept can be useful for future studies.

摘要

背景

患者和公众参与(PPI)在精神卫生服务研究中越来越受到重视。为了增强患者积极应对抑郁的能力,GET.FEEDBACK.GP 研究在使用患者健康问卷(PHQ-9)进行抑郁筛查后,评估了一项针对患者的反馈干预措施。

目的

通过参与式研究团队(PRT)开展研讨会,调查患者对反馈的需求和偏好,对之前研究中的患者针对性反馈进行改进。评估 PPI 的过程和结果。

设计

患者和公众参与在合作和咨询层面上进行。一个由患者伙伴和研究人员组成的 PRT 计划并开展了三次与患者的研讨会。使用焦点小组调查患者的需求。参与者对需求进行了优先级排序,讨论了反馈草稿,并使用认知测验评估了两份草稿。PRT 的研究人员在项目层面上交流了结果。使用公众和患者参与评估工具(PPEET)评估 PPI。

地点和参与者

有抑郁经历的 N=12 名患者进行了有针对性的抽样,至少参加了一次研讨会。

结果

考虑到反馈的相关内容需求(例如,不区分严重和中度症状)、行动建议和与患者相关的信息。还实施了可理解性、重视、非污名化语言和设计元素(例如,维度条)的需求。研讨会和 PRT 得到了积极评价。

讨论和结论

患者和公众参与影响了反馈的内容、措辞和设计。优势包括 PPI 的两个层面、方法的多样性和有针对性的抽样。局限性包括缺乏对不知道自己抑郁的患者的纳入。评估的 PPI 概念可用于未来的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/488a/8137500/ea1426a87a96/HEX-24-95-g003.jpg

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