University of Kansas School of Medicine-Wichita, Department of Family and Community Medicine, Wichita, KS.
Department of Family and Community Medicine, and Family Medicine Residency Program at Ascension Via Christi, University of Kansas School of Medicine-Wichita, Wichita, KS.
Fam Med. 2022 May;54(5):389-394. doi: 10.22454/FamMed.2022.541800.
Physicians are increasingly confronted with patients' interrelated psychosocial and physiological issues. To assist physicians in managing the psychosocial needs of patients, integrated behavioral health (IBH) has become increasingly common. This study was completed in a large, Midwestern family medicine residency program where the authors sought to (1) identify physicians' perceptions of IBH implementation and areas of needed IBH improvement, and (2) recognize educational needs to be addressed when providing behavioral health training to resident physicians.
The authors utilized a pre/post design to measure physician perception of access and quality of an integrated behavioral health program. For quantitative data, we performed standard descriptive statistics, likelihood ratio χ2 tests, independent sample t test, and linear mixed-model analysis. For qualitative data, we completed phenomenological analysis, derived from a focus group.
Physician satisfaction with access and quality of behavioral health services significantly improved after the implementation of the IBH (P<.01). Perception of behavioral health management also improved, including the commitment of the residency program to mental health well-being, benefit from consultations with BHPs, and physician ownership of managing patients' mental health needs. Themes from the focus group indicated a desire for increased communication with BHPs, as well as additional assessment and intervention skills to manage psychiatric disorders.
Family physicians value IBH in supporting patients' behavioral health treatment, and resident physicians hone behavioral health management skills through collaborating with BHPs and completing behavioral health training. Residencies should increase focus on teaching essential skills in behavioral health management.
医生越来越多地面对患者相关的心理社会和生理问题。为了帮助医生满足患者的心理需求，综合行为健康（IBH）已变得越来越普遍。本研究在一个大型中西部家庭医学住院医师培训项目中完成，作者试图（1）确定医生对 IBH 实施的看法以及需要改进的 IBH 领域，以及（2）认识到在向住院医师提供行为健康培训时需要解决的教育需求。
作者使用了预/后设计来衡量医生对综合行为健康计划的可及性和质量的看法。对于定量数据，我们进行了标准描述性统计、似然比 χ2 检验、独立样本 t 检验和线性混合模型分析。对于定性数据，我们完成了现象学分析，这是从焦点小组中得出的。
在实施 IBH 后，医生对行为健康服务的可及性和质量的满意度显著提高（P<.01）。对行为健康管理的看法也有所改善，包括住院医师项目对心理健康的承诺、从与 BHP 的咨询中受益，以及医生对管理患者心理健康需求的所有权。焦点小组的主题表明，医生希望增加与 BHP 的沟通，并获得更多评估和干预技能来管理精神疾病。
家庭医生重视 IBH，以支持患者的行为健康治疗，住院医师通过与 BHP 合作并完成行为健康培训来磨练行为健康管理技能。住院医师培训应更加注重教授行为健康管理的基本技能。
