Child and Adolescent Division, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.
Cystic Fibrosis Center, Seattle Children's Hospital, Seattle, Washington.
Pediatr Pulmonol. 2020 Dec;55(12):3328-3336. doi: 10.1002/ppul.24951. Epub 2020 Oct 16.
Guidelines to integrate mental health screening (MHS) into Cystic fibrosis (CF) care has increased adoption across the United States and European CF Centers, however, there has been limited discussion on specific strategies for implementation.
Share key strategies that led to successful MHS implementation in one pediatric CF center and report implementation and screening outcomes.
Parent partners, mental health experts from the Department of Psychiatry, and the CF clinic team codesigned interventions to support three major stakeholders: (a) patients and families (b) clinic team, and (c) hospital system. The mental health coordinator approached patients (12 and older) to introduce MHS and administered screening and reviewed results using an electronic tablet and digital measurement-feedback system. We used strategies that promoted visibility of screening progress and sharing of data with hospital administration. Descriptive statistics were used to assess prevalence of clinically significant symptoms of anxiety and depression and symptom severity within our sample.
Over the first 2 years of the project, we exceeded our goal of screening 80% of eligible patients per year (80%-95% screened) and are on a similar trajectory within the first 7 months of year 3. We identified high prevalence of clinically significant symptoms of depression (16%) and anxiety (14%) similar to those found in other chronic illness populations. These data helped us advocate hospital leadership to support the development of new mental health services to address identified needs at our center.
Leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
将心理健康筛查（MHS）纳入囊性纤维化（CF）护理的指南已经增加了美国和欧洲 CF 中心的采用率，但是，对于实施的具体策略的讨论有限。
分享导致一家儿科 CF 中心成功实施 MHS 的关键策略，并报告实施和筛查结果。
家长合作伙伴、来自精神病学部的心理健康专家以及 CF 诊所团队共同设计干预措施，以支持三大利益相关者：（a）患者和家庭，（b）诊所团队，和（c）医院系统。心理健康协调员向（12 岁及以上）患者介绍 MHS，并使用电子平板电脑和数字测量反馈系统进行筛查和审查结果。我们使用了促进筛查进展的可见性和与医院管理部门共享数据的策略。我们使用描述性统计来评估我们样本中焦虑和抑郁的临床显著症状以及症状严重程度的患病率。
在项目的头两年中，我们超过了每年筛查 80%合格患者的目标（筛查率为 80%-95%），并且在项目的第三年的前 7 个月内也处于类似的轨迹。我们发现了高比例的临床显著抑郁症状（16%）和焦虑症状（14%），与其他慢性疾病患者群体中的比例相似。这些数据帮助我们向医院领导层倡导，以支持开发新的心理健康服务，以解决我们中心的已识别需求。
利用共同生产来满足利益相关者的需求，导致了可持续的 MHS 流程的成功实施。
