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精神病早期干预服务中初级保健和专科保健界面的协作:一项定性研究。

Collaboration across the primary and specialist care interface in Early Intervention in Psychosis services: a qualitative study.

机构信息

School of Medicine, Keele University, Keele.

School of Medicine, Keele University, Keele; Research and Innovation Department, Midlands Partnership University NHS Foundation Trust, Stafford.

出版信息

Br J Gen Pract. 2024 Sep 26;74(747):e709-e716. doi: 10.3399/BJGP.2023.0558. Print 2024 Oct.

Abstract

BACKGROUND

People with new psychotic symptoms may be managed in an Early Intervention in Psychosis (EIP) service. They may be discharged back to primary care at the end of their time in an EIP service.

AIM

To explore the role of primary care in supporting people with psychosis in an EIP service.

DESIGN AND SETTING

Qualitative study, within a programme of work to explore the optimum duration of management in an EIP service in England.

METHOD

Semi-structured interviews were carried out with people in EIP services, carers, GPs, and EIP practitioners between September 2022 and September 2023. Data collection continued until information power was achieved. Data were thematically analysed using principles of constant comparison.

RESULTS

While most service users and carers described their experiences of EIP services as positive, there are issues around access to and discharge from the services. GPs reported difficulties in referring people into EIP services, having little contact with people who are supported by EIP services, and not being included in planning discharge from EIP services to primary care. Service users and carers described challenges at the point of discharge from EIP services to primary care, associated with feelings of abandonment.

CONCLUSION

This study suggests that GPs should have a role in the support of people in EIP services (in particular, monitoring and managing physical health) and their carers. Inclusion of GPs in managing discharge from EIP services is vital. We suggest that a joint consultation with the service user, their carer (if they wish), along with the EIP care coordinator and GP would make this transition smoother.

摘要

背景

出现新精神病症状的患者可能会在早期精神病干预 (EIP) 服务中得到管理。在 EIP 服务结束时,他们可能会被转回初级保健。

目的

探索初级保健在支持 EIP 服务中精神病患者的作用。

设计和设置

定性研究,旨在探索英格兰 EIP 服务管理的最佳时长的工作方案内进行。

方法

2022 年 9 月至 2023 年 9 月期间,对 EIP 服务中的患者、照顾者、全科医生和 EIP 从业者进行了半结构式访谈。数据收集持续到达到信息能力为止。使用恒定比较的原则对数据进行主题分析。

结果

尽管大多数服务使用者和照顾者描述他们对 EIP 服务的体验是积极的,但在服务的可及性和出院方面存在一些问题。全科医生报告说,他们在将患者转介到 EIP 服务方面存在困难,与由 EIP 服务支持的患者接触很少,并且不参与从 EIP 服务向初级保健的出院计划。服务使用者和照顾者描述了从 EIP 服务向初级保健出院时面临的挑战,这与被抛弃的感觉有关。

结论

本研究表明,全科医生应该在 EIP 服务中的患者(特别是监测和管理身体健康)及其照顾者的支持中发挥作用。将全科医生纳入 EIP 服务出院管理至关重要。我们建议,与服务使用者、他们的照顾者(如果他们愿意)、EIP 护理协调员和全科医生一起进行联合咨询,将使这一过渡更加顺利。

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