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精神卫生保健临床医生参与即时检测;一项定性研究。

Mental healthcare clinician engagement with point of care testing; a qualitative study.

机构信息

Foundation Year 3 Physical Health Care, Department of Psychiatry, University of Oxford, Oxford, UK.

Core trainee Psychiatry, Oxford Health NHS Foundation Trust, Oxford, UK.

出版信息

BMC Psychiatry. 2021 Feb 4;21(1):73. doi: 10.1186/s12888-021-03067-8.

Abstract

BACKGROUND

Point of Care Testing (POCT) is being increasingly used to augment the delivery of physical health care in a variety of settings, but their use in mental health has been limited. Research into understanding the barriers faced for successful implementation of POCT in these settings is lacking. We aimed to identify factors affecting engagement and implementation of POCT within mental health teams by exploring the attitudes to POCT, and the perceived impact POCT has on the practice of mental healthcare clinicians.

METHODS

Alongside a study evaluating the impact of a point of care device in Community Mental Health Teams (CMHTs), qualitative interviews were carried out with CMHT clinicians using POCT as part of annual physical checks for patients with severe and enduring mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis.

RESULTS

Fifteen clinicians were interviewed across a range of professional backgrounds. Clinicians identified usability of the technology, positive impact on their patient's experience and improved self-efficacy as drivers for successful implementation of POCT into their clinical practice. Issues with device functioning and the potential for a negative effect on the therapeutic relationship with their patients were identified as barriers. Level of physical heath training was not found to be a barrier by mental health professionals to using POCT.

CONCLUSIONS

Understanding barriers and drivers for engagement is important to allow co-production of POCT and guidelines to facilitate introduction of POCT into routine clinical practice.

摘要

背景

在各种环境中,床边检测(POCT)越来越多地被用于增强身体健康护理的提供,但在心理健康方面的应用有限。缺乏研究来了解在这些环境中成功实施 POCT 面临的障碍。我们旨在通过探索对 POCT 的态度以及 POCT 对心理健康护理临床医生实践的感知影响,来确定影响 POCT 在心理健康团队中参与和实施的因素。

方法

在一项评估社区精神卫生团队(CMHT)中床边检测设备影响的研究中,对使用 POCT 作为严重和持久精神疾病患者年度体检一部分的 CMHT 临床医生进行了定性访谈。使用半结构化访谈收集数据,并使用主题分析进行分析。

结果

对来自不同专业背景的 15 名临床医生进行了访谈。临床医生认为技术的易用性、对患者体验的积极影响以及提高自我效能感是将 POCT 成功纳入其临床实践的驱动力。设备功能问题以及对与患者治疗关系产生负面影响的可能性被认为是障碍。心理健康专业人员认为,物理健康培训水平并不是使用 POCT 的障碍。

结论

了解参与的障碍和驱动因素对于共同制定 POCT 指南以促进 POCT 引入常规临床实践非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/223b/7863427/4f4b63b22ce9/12888_2021_3067_Fig1_HTML.jpg

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