Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561University of Technology Sydney, Ultimo, NSW 2007, Australia.
St Vicent's Clinical School, University of New South Wales, Sydney, Australia.
J Palliat Care. 2022 Oct;37(4):535-544. doi: 10.1177/08258597221121453.
To ascertain palliative physicians' and consultation-liaison psychiatrists' perceptions of depression care processes in patients with very poor prognoses, exploring key challenges and postulating solutions. A qualitative focus group study involving three 1-h online focus groups (2 palliative medicine and 1 psychiatry) were conducted between November-December 2020. Fellows and trainees were recruited from Australian and New Zealand Society of Palliative Medicine (n = 11) and Royal Australian and New Zealand College of Psychiatrists (n = 4). Data underwent conventional qualitative content analysis. Participants perceived depression care to be complex and challenging. Perceived barriers included: inadequate palliative care psychiatry skills with variation in clinical approaches; lack of supportive health infrastructure (poor access to required interventions and suboptimal linkage between palliative care and psychiatry); lack of research support; and societal stigma. Suggested solutions included integrating care processes between palliative care and psychiatry to improve clinician training, establish supportive health systems and promote innovative research designs. Developing clinician training, supportive health systems and innovative research strategies centering on integrating palliative care and psychiatry care processes may be integral to optimising depression care when providing care to people with very poor prognoses.
为了确定姑息治疗医师和联络精神病学家对预后极差患者的抑郁护理过程的看法，探讨关键挑战并提出解决方案。 这项定性焦点小组研究于 2020 年 11 月至 12 月期间进行，涉及 3 个 1 小时的在线焦点小组（2 个姑息医学和 1 个精神病学）。 从澳大利亚和新西兰姑息医学学会（n=11）和澳大利亚和新西兰皇家精神病学院（n=4）招募了研究员和学员。 数据经过常规的定性内容分析。 参与者认为抑郁护理复杂且具有挑战性。 感知到的障碍包括：姑息治疗精神病学技能不足，临床方法存在差异；缺乏支持性的卫生基础设施（获得所需干预措施的机会有限，姑息治疗与精神病学之间的联系欠佳）；缺乏研究支持；以及社会耻辱感。 建议的解决方案包括整合姑息治疗和精神病学之间的护理流程，以改善临床医生的培训，建立支持性的卫生系统并促进创新的研究设计。 制定以整合姑息治疗和精神病学护理流程为重点的临床医生培训、支持性卫生系统和创新研究策略，对于优化预后极差患者的抑郁护理可能至关重要。
