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呼吁精神科与心理学在会诊联络服务方面开展整合协作:一名心理学实习生的经历及协作护理建议

A Call for Integrated Psychiatry-Psychology Collaboration on Consult-Liaison Services: Experiences of a Psychology Extern and Recommendations for Collaborative Care.

作者信息

Nguyen Audrey D, Medrano Osmara, Syed Saba

机构信息

Psychiatry, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA.

Psychiatry, Olive View-University of California Los Angeles (UCLA) Medical Center, Los Angeles, USA.

出版信息

Cureus. 2023 Aug 21;15(8):e43874. doi: 10.7759/cureus.43874. eCollection 2023 Aug.

Abstract

Few institutions have integrated psychologists into consult-liaison (CL) psychiatry services caring for patients with medical conditions and comorbid serious mental illnesses (SMI). To our knowledge, no studies have explored the experiences of an integrated pre-doctoral psychologist on a CL psychiatry service and applications of collaborative care. The present study aims to 1) highlight the experiences of a psychology extern on an adult CL psychiatry service in a public academic hospital, and 2) apply a collaborative care framework to provide recommendations for implementing integrated psychiatry-psychology collaboration. A semi-structured qualitative interview was performed with the team's psychology extern to elicit practice goals and setting. As of June 2022, the psychology extern saw 76 inpatient adults over the year-long externship period. Through diverse case vignettes, we illustrate the extern's unique roles in providing psychotherapeutic interventions to enhance patients' coping skills. We further found that embedding a psychology extern within the CL psychiatry service follows the integrated model of collaborative care. We thus apply a collaborative care framework to guide CL services in using multidisciplinary teams to improve care quality for inpatient adults. Leveraging the expertise of a psychology extern in real-time collaboration with CL psychiatry teams can enhance patient-centered care and warrants broader institutional implementation. Future studies are needed to explore the efficacy of integrated psychiatry-psychology collaboration on provider perspectives and clinical outcomes.

摘要

很少有机构将心理学家纳入会诊联络(CL)精神病学服务,为患有躯体疾病和合并严重精神疾病(SMI)的患者提供护理。据我们所知,尚无研究探讨综合博士前心理学家在CL精神病学服务中的经历以及协作护理的应用。本研究旨在:1)突出一名心理学实习生在一家公立学术医院成人CL精神病学服务中的经历;2)应用协作护理框架为实施综合精神病学 - 心理学协作提供建议。对该团队的心理学实习生进行了半结构化定性访谈,以了解其实践目标和工作环境。截至2022年6月,该心理学实习生在为期一年的实习期间接待了76名成年住院患者。通过不同的病例 vignettes,我们展示了实习生在提供心理治疗干预以提高患者应对技能方面的独特作用。我们进一步发现,在CL精神病学服务中安排一名心理学实习生遵循了协作护理的综合模式。因此,我们应用协作护理框架来指导CL服务使用多学科团队提高成年住院患者的护理质量。利用心理学实习生的专业知识与CL精神病学团队进行实时协作,可以提高以患者为中心的护理水平,并值得在更广泛的机构中实施。未来需要研究探讨综合精神病学 - 心理学协作对提供者观点和临床结果的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cf/10511300/a3c29c977b19/cureus-0015-00000043874-i01.jpg

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