Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
Faculty of Medicine, Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Quebec, Canada.
Health Expect. 2021 Aug;24(4):1168-1177. doi: 10.1111/hex.13242. Epub 2021 May 5.
Widespread policy reforms in Canada, the United States and elsewhere over the last two decades strengthened team models of primary care by bringing together family physicians and nurse practitioners with a range of mental health and other interdisciplinary providers. Understanding how patients with depression and anxiety experience newer team-based models of care delivery is essential to explore whether the intended impact of these reforms is achieved, identify gaps that remain and provide direction on strengthening the quality of mental health care.
The main study objective was to understand patients' perspectives on the quality of care that they received for anxiety and depression in primary care teams.
This was a qualitative study, informed by constructivist grounded theory. We conducted focus groups and individual interviews with primary care patients about their experiences with mental health care. Focus groups and individual interviews were recorded and transcribed verbatim. Grounded theory guided an inductive analysis of the data.
Forty patients participated in the study: 31 participated in one of four focus groups, and nine completed an individual interview. Participants in our study described their experiences with mental health care across four themes: accessibility, technical care, trusting relationships and meeting diverse needs.
Greater attention by policymakers is needed to strengthen integrated collaborative practices in primary care so that patients have similar access to mental health services across different primary care practices, and smoother continuity of care across sectors. The research team is comprised of individuals with lived experience of mental health who have participated in all aspects of the research process.
在过去的二十年中，加拿大、美国和其他国家广泛进行政策改革，通过将家庭医生和护士从业者与一系列心理健康和其他跨学科提供者结合在一起，加强了初级保健的团队模式。了解患有抑郁症和焦虑症的患者如何体验新的基于团队的护理模式，对于探索这些改革的预期影响是否实现、确定仍然存在的差距以及为加强心理健康护理质量提供方向至关重要。
主要研究目的是了解患者对初级保健团队中焦虑和抑郁护理质量的看法。
这是一项基于建构主义扎根理论的定性研究。我们对初级保健患者进行了焦点小组和个人访谈，了解他们的心理健康护理体验。焦点小组和个人访谈进行了录音并逐字记录。扎根理论指导了对数据的归纳分析。
共有 40 名患者参与了这项研究：31 名患者参加了四个焦点小组中的一个，9 名患者完成了个人访谈。研究参与者描述了他们在四个主题下的心理健康护理体验：可及性、技术护理、信任关系和满足多样化需求。
政策制定者需要更加关注加强初级保健中的综合协作实践，以便患者在不同的初级保健实践中能够类似地获得心理健康服务，并在不同部门之间实现更顺畅的护理连续性。研究团队由具有心理健康经验的个人组成，他们参与了研究过程的各个方面。
