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一项针对儿科心脏病学研究员的新型心理健康课程试点:培养专科医生以扩充团队。

A Novel Mental Health Curriculum Pilot for Pediatric Cardiology Fellows: Preparing the Subspecialist to Expand the Team.

作者信息

McCormick Amanda D, Owens Sonal T, Lim Heang M, Vitale Carolyn, Dusing Catherine, Rea Kelly E, Pierce Jessica, Malas Nasuh, Cousino Melissa K

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, C. S. Mott Children's Hospital, Michigan Medicine, 1540 E Hospital Drive, Ann Arbor, MI, 48109, USA.

Division of Pediatric Psychology, Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA.

出版信息

Pediatr Cardiol. 2025 Jun;46(5):1157-1162. doi: 10.1007/s00246-024-03532-7. Epub 2024 Jun 5.

Abstract

Mental health (MH) is an important, yet understudied area of care for patients with congenital heart disease (CHD). Pediatric subspecialty fellows believe MH should be within their scope of practice, but few feel confident in their ability to appropriately screen, evaluate, manage, and make treatment referrals for youth with CHD and concurrent MH concerns. A 6-session, didactic-based curriculum was designed by an interprofessional team of experts. It was administered to pediatric cardiology fellows over 9 months during two academic years. Topics included the following: Introduction to MH and CHD, MH Screening and Clinic-Based Interventions, Psychopharmacology, Delirium, Trauma-Informed Care, and Adult CHD and Transitional Care. An investigator-designed survey was developed to assess fellow comfort with MH knowledge, screening, and treatment recommendation domains. Twenty-three fellows participated with 14 completing the pre-post survey (58% participation, 11/17 in year 1, 3/6 in year 2). Most participants were in their first year of training (9/14, 57%). Overall, fellow comfort with MH topics increased significantly (mean score 2.89 ± 0.46 vs. 3.4 ± 0.4, p = 0.0005), with improved comfort in the MH knowledge (p = 0.003) and treatment recommendation domains (p = 0.001). A didactic-based MH curriculum improves the comfort of pediatric cardiology fellows to address the MH concerns of their patients. The topics in this curriculum will continue to be refined over time and could be generalized to training programs, both nationally and across pediatric specialties, to improve MH care for high-risk populations.

摘要

心理健康(MH)是先天性心脏病(CHD)患者护理中一个重要但研究不足的领域。儿科亚专科住院医师认为心理健康应属于他们的执业范围,但很少有人对自己为患有CHD且同时存在心理健康问题的青少年进行适当筛查、评估、管理和进行治疗转诊的能力有信心。一个跨专业专家团队设计了一个为期6节的、以讲授为主的课程。该课程在两个学年的9个月内面向儿科心脏病学住院医师授课。主题包括:心理健康与先天性心脏病概论、心理健康筛查及基于门诊的干预、精神药理学、谵妄、创伤知情护理、成人先天性心脏病及过渡性护理。设计了一项由研究者设计的调查,以评估住院医师在心理健康知识、筛查和治疗建议领域的舒适度。23名住院医师参与,其中14名完成了前后调查(参与率58%,第一年11/17,第二年3/6)。大多数参与者处于培训的第一年(9/14,57%)。总体而言,住院医师对心理健康主题的舒适度显著提高(平均得分2.89±0.46对3.4±‍‍0.4,p=0.0005),在心理健康知识(p=0.003)和治疗建议领域的舒适度有所改善(p=0.001)。一个以讲授为主的心理健康课程提高了儿科心脏病学住院医师处理患者心理健康问题的舒适度。随着时间的推移,本课程中的主题将不断完善,并可推广到全国以及儿科各专科的培训项目中,以改善对高危人群的心理健康护理。

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