退伍军人对 PARTNER-MH 的看法，这是一种由同行领导的患者导航干预措施，旨在提高患者在护理中的参与度和医患沟通：一项定性研究。
Veterans' views of PARTNER-MH, a peer-led patient navigation intervention, to improve patient engagement in care and patient-clinician communication: A qualitative study.
机构信息
National Center for PTSD, VA Boston Healthcare System, Boston, USA; HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, USA; Regenstrief Institute, Indianapolis, USA; Indiana University School of Medicine, Department of General Internal Medicine and Geriatrics, Indianapolis, USA.
HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, USA; Regenstrief Institute, Indianapolis, USA; Indiana University School of Medicine, Department of General Internal Medicine and Geriatrics, Indianapolis, USA.
出版信息
Patient Educ Couns. 2023 Sep;114:107847. doi: 10.1016/j.pec.2023.107847. Epub 2023 Jun 13.
OBJECTIVE
In this study, we report on participants' experiences of PARTNER-MH, a peer-led, patient-navigation intervention for racially and ethnically minoritized patients in Veterans Health Administration mental health services aimed at improving patient engagement in care and patient-clinician communication. Participants described their views of PARTNER-MH, barriers and facilitators to the intervention's implementation, and their application of varied intervention concepts to improve engagement in care and communication with their mental health clinicians.
METHODS
This is a qualitative analysis of the PARTNER-MH pilot randomized controlled trial. Participants participated in semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR). Rapid data analysis approach was used to analyze the data.
RESULTS
Participants (n = 13) perceived PARTNER-MH as an acceptable intervention, and viewed use of peers as interventionists, long-term outreach and engagement efforts, and navigation services favorably. Barriers to implementation included limited flexibility in peers' schedules and lack of peer/participant gender concordance, as well as limited options for program delivery modality. Three main themes summarized participants' views and perceived benefits of PARTNER-MH that contributed to improved patient-clinician communication: 1) increased patient engagement, 2) improved patient-clinician relationship, and 3) enhanced communication self-efficacy.
CONCLUSIONS
Participants viewed PARTNER-MH as beneficial and identified several intervention components that contributed to improved engagement in care, communication self-efficacy, and patient-clinician communication.
PRACTICE IMPLICATION
Some patients, especially minoritized patients and those who have been disenfranchised from healthcare systems may benefit from peer-led interventions that facilitate engagement in care and communication self-efficacy to improve patient-clinician communication and healthcare outcomes.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04515771.
目的
本研究报告了参与者对 PARTNER-MH 的体验，这是一项针对退伍军人事务部心理健康服务中少数族裔患者的同伴主导、患者导航干预措施，旨在提高患者对护理的参与度和医患沟通。参与者描述了他们对 PARTNER-MH 的看法、该干预措施实施的障碍和促进因素，以及他们应用各种干预概念来改善与心理健康临床医生的护理参与度和沟通。
方法
这是 PARTNER-MH 试点随机对照试验的定性分析。参与者参加了由实施研究综合框架（CFIR）指导的半结构化访谈。采用快速数据分析方法对数据进行分析。
结果
参与者（n=13）认为 PARTNER-MH 是一种可以接受的干预措施，他们对使用同伴作为干预者、长期外联和参与努力以及导航服务持积极态度。实施的障碍包括同伴日程安排的灵活性有限，缺乏同伴/参与者的性别一致性，以及方案交付方式的选择有限。三个主要主题总结了参与者对 PARTNER-MH 的看法和认为有益的方面，这些方面有助于改善医患沟通：1）增加患者参与度，2）改善医患关系，3）增强沟通自我效能。
结论
参与者认为 PARTNER-MH 是有益的，并确定了几个有助于改善护理参与度、沟通自我效能和医患沟通的干预措施。
实践意义
一些患者，特别是少数族裔患者和那些被医疗保健系统排斥的患者，可能会受益于同伴主导的干预措施，这些干预措施可以促进参与护理和沟通自我效能，从而改善医患沟通和医疗保健结果。
试验注册
ClinicalTrials.gov NCT04515771。
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