AlKhathami Abdullah Dukhail
Primary Mental Health Care Program, Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia.
Gen Psychiatr. 2022 Aug 24;35(4):e100693. doi: 10.1136/gpsych-2021-100693. eCollection 2022.
Mental health problems are prevalent among patients seeking primary healthcare. However, traditional patient interviews often fail to identify and manage these problems. Therefore, an improved patient interview process is needed to assess and treat mental health problems in primary care settings.
To assess the validity, reliability, sensitivity and specificity of a 5-Step Patient Interview approach for the screening, diagnosis and treatment of mental health problems.
This study compared a 5-Step Patient Interview approach (AlKhathami approach) with expert psychiatric interviews based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7) questionnaire from 1 January 2020 to 30 April 2020 in family practice or primary healthcare centres.
A total of 760 participants from five Saudi Arabian regions were selected using a multiclustered random sample of every third patient aged ≥18 years, drawn from the clinics' patient list.
A total of 732 patients agreed to participate, with a response rate of 96.3%; 396 (54.1%) were women; the mean (Standard Deviation) age was 41.28 (14.30) years (ranging from 18 to 84 years). Mental health problems were suspected in 40% of the participants. The 5-Step Patient Interview approach was shown to be comparable to an expert interview by a psychiatrist. Moreover, it was more accurate than the PHQ-9 and GAD-7 self-administered questionnaires in screening for stress and classifying it as mild, moderate to severe or severe. Additionally, the 5-Step Patient Interview approach improved physician-patient communication by encouraging the exploration of patients' perspectives.
The 5-Step Patient Interview approach is a valid, reliable tool that can aid the integration of mental healthcare into primary healthcare and family practice. Future studies should evaluate the implementation outcomes of the 5-Step Patient Interview approach.
心理健康问题在寻求初级医疗保健的患者中普遍存在。然而，传统的患者访谈往往无法识别和处理这些问题。因此，需要改进患者访谈流程，以评估和治疗初级保健环境中的心理健康问题。
评估五步患者访谈法在心理健康问题筛查、诊断和治疗中的有效性、可靠性、敏感性和特异性。
本研究于2020年1月1日至2020年4月30日在家庭医疗或初级保健中心，将五步患者访谈法（AlKhathami法）与基于《精神疾病诊断与统计手册》第五版的结构化临床访谈、患者健康问卷-9（PHQ-9）和广泛性焦虑症-7（GAD-7）问卷的专家精神科访谈进行了比较。
从五个沙特阿拉伯地区选取了760名参与者，采用多聚类随机抽样，从诊所患者名单中抽取每第三名年龄≥18岁的患者。
共有732名患者同意参与，应答率为96.3%；396名（54.1%）为女性；平均（标准差）年龄为41.28（14.30）岁（年龄范围为18至84岁）。40%的参与者被怀疑存在心理健康问题。五步患者访谈法被证明与精神科医生的专家访谈相当。此外，在筛查压力并将其分类为轻度、中度至重度或重度方面，它比PHQ-9和GAD-7自填问卷更准确。此外，五步患者访谈法通过鼓励探索患者观点改善了医患沟通。
五步患者访谈法是一种有效、可靠的工具，可有助于将精神卫生保健纳入初级卫生保健和家庭医疗。未来的研究应评估五步患者访谈法的实施效果。
