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基于证据的门诊自杀治疗的新型远程医疗适应措施:危机护理计划的可行性和有效性。

Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program.

作者信息

O'Neill J Conor, O'Callaghan Erin T, Sullivan Scott, Winsberg Mirène

机构信息

Brightside Health, 2471a Peralta Street, Oakland, CA 94607, USA.

出版信息

Healthcare (Basel). 2023 Dec 13;11(24):3158. doi: 10.3390/healthcare11243158.

Abstract

Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients ( = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.

摘要

在过去20年里,美国的自杀率急剧上升,仍然是主要的死亡原因之一。循证护理的可及性有限,而远程医疗有能力提供新的护理解决方案。危机护理项目是一个针对自杀的治疗项目,在全国门诊远程医疗环境中实施,采用数字化改编版的自杀行为协作评估与管理(CAMS)作为护理框架。本研究调查了危机护理作为一种可扩展的针对自杀的治疗模式的可行性和初步有效性。在16周内对一组患者(n = 130)的患者参与度、症状减轻情况和护理结果进行了检查。通过患者参与度评估实施的可行性。使用PHQ-9、GAD-7和CAMS SSF-4评分量表测量临床结果。超过85%的登记患者在入院时被批准接受危机护理,83%的患者至少完成了四次治疗(毕业所需的最少次数)。所有患者亚组的抑郁症状、焦虑症状、自杀意念频率和自杀特定风险因素均有所下降。结果支持危机护理作为一种针对自杀的护理解决方案的可行性和初步有效性,该方案可在门诊远程医疗环境中的分级护理模式下提供。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f796/10743225/a9f4dbaa90a3/healthcare-11-03158-g001.jpg

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