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评估技术在共病护理实施项目路径中的作用,以改善对物质使用和精神障碍共病的管理。

The evaluation of the role of technology in the pathways to comorbidity care implementation project to improve management of comorbid substance use and mental disorders.

作者信息

Uribe Guajardo Maria Gabriela, Baillie Andrew, Louie Eva, Giannopoulos Vicki, Wood Katie, Riordan Ben, Haber Paul, Morley Kirsten

机构信息

Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

National Health and Medical Research Council Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, The University of Sydney, Sydney, NSW, Australia.

出版信息

J Multimorb Comorb. 2022 Apr 23;12:26335565221096977. doi: 10.1177/26335565221096977. eCollection 2022.

Abstract

UNLABELLED

In substance use treatment settings, comorbid mental health problems can occur in up to 70% of people. An integrated approach for managing comorbidity, implementing evidence-based intervention in drug and alcohol settings, remains problematic. Technology can help in adopting evidence-based practice to implement effective treatment healthcare pathways. This study sought to examine aspects of tailored portal utilization (barriers and facilitators) by participants taking part in a program aimed at improving the implementation of evidence-based practice for comorbidity management Pathways to Comorbidity Care (PCC).

METHOD

A self-report questionnaire and a semi-structured interview were designed to measure clinician satisfaction with the PCC portal and e-resources throughout a 9-month intervention. An adapted version of the "Non-adoption, Abandonment, Scale-up, Spread and, Sustainability" (NASSS) framework facilitated discussion of the findings.

RESULTS

Twenty participants from drug and alcohol services responded to all measures. Facilitators included: (i). clinician acceptance of the portal; (ii). guidance from the clinical supervisor or champion to encourage e-resource use. Barriers included: (i). complexity of the illness ; (ii). participants' preference for face-to-face resources and training modes; and, (iii). lack of face-to-face training on how to use the portal ().

CONCLUSION

Based on the NASSS framework, we identified several barriers and facilitators of the use of the portal including the complexity of illness, lack of face-to-face training, and clinician preference for training mediums. Recommendations include ongoing organizational support, in-house clinical supervision, and consultation with clinical providers to assist in the development of tailored e-health resources and open training opportunities on how to operate and effectively utilize these resources.

摘要

未标注

在物质使用治疗环境中,高达70%的人可能会出现共病心理健康问题。在药物和酒精治疗环境中采用综合方法管理共病并实施循证干预仍然存在问题。技术有助于采用循证实践来实施有效的治疗保健途径。本研究旨在探讨参与一项旨在改善共病管理循证实践实施的项目(共病护理途径,PCC)的参与者对定制门户利用的各个方面(障碍和促进因素)。

方法

设计了一份自我报告问卷和一次半结构化访谈,以衡量临床医生在为期9个月的干预期间对PCC门户和电子资源的满意度。一个改编版的“未采用、放弃、扩大规模、传播和可持续性”(NASSS)框架促进了对研究结果的讨论。

结果

来自药物和酒精服务机构的20名参与者对所有测量指标都做出了回应。促进因素包括:(i)临床医生对门户的接受程度;(ii)临床主管或倡导者的指导以鼓励使用电子资源。障碍包括:(i)疾病的复杂性;(ii)参与者对面对面资源和培训模式的偏好;以及(iii)缺乏关于如何使用门户的面对面培训。

结论

基于NASSS框架,我们确定了使用该门户的几个障碍和促进因素,包括疾病的复杂性、缺乏面对面培训以及临床医生对培训媒介的偏好。建议包括持续的组织支持、内部临床监督以及与临床提供者协商,以协助开发定制的电子健康资源并提供关于如何操作和有效利用这些资源的开放培训机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35f/9106309/e6d0612678b7/10.1177_26335565221096977-fig1.jpg

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