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加强急诊室心理健康危机应对:综合模型的系统评价

Enhancing Emergency Room Mental Health Crisis Response: A Systematic Review of Integrated Models.

作者信息

Katiki Chiko, Ponnapalli V Jaswitha S, Desai Kesha J, Mansoor Sadia, Jindal Anushka, Badu Nana Yaw Afriyie

机构信息

Emergency Department, American International Medical School, Alpharetta, USA.

Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

出版信息

Cureus. 2024 Nov 19;16(11):e74042. doi: 10.7759/cureus.74042. eCollection 2024 Nov.

Abstract

The integration of psychiatric treatment into emergency services is critical to improving the management of severe mental health emergencies. Emergency departments (EDs) are frequently the initial point of contact for patients with mental emergencies, but they are not always prepared to offer adequate care. This systematic review aims to analyze the effectiveness of collaborative care models (CCMs), psychiatric consultation-liaison (C-L) teams, and telepsychiatry in enhancing psychiatric treatment in emergencies. We searched numerous databases, including PubMed, PsycINFO, EMBASE, and the Cochrane Library, for papers published between 2013 and 2023. A total of 18 studies matched our inclusion criteria, and the results show that integrated care models shorten hospital stays, enhance patient outcomes, and expand access to psychiatric treatments, particularly in remote locations. The limitations of this review include the heterogeneity of study designs and the underrepresentation of low-income countries. Future research should focus on developing standardized protocols for psychiatric integration into emergency services. This review bridges a critical gap in the literature by offering a comprehensive evaluation of various psychiatric care models in EDs and addressing existing barriers to implementation.

摘要

将精神科治疗纳入急诊服务对于改善严重精神卫生紧急情况的管理至关重要。急诊科常常是精神科紧急情况患者的首个接触点,但它们并不总是准备好提供充分的护理。本系统评价旨在分析协作护理模式(CCMs)、精神科会诊 - 联络(C - L)团队及远程精神病学在加强急诊精神科治疗方面的有效性。我们在多个数据库中进行了检索,包括PubMed、PsycINFO、EMBASE和Cochrane图书馆,以查找2013年至2023年期间发表的论文。共有18项研究符合我们的纳入标准,结果表明综合护理模式缩短了住院时间,改善了患者结局,并扩大了精神科治疗的可及性,尤其是在偏远地区。本评价的局限性包括研究设计的异质性以及低收入国家代表性不足。未来的研究应侧重于制定将精神科纳入急诊服务的标准化方案。本评价通过对急诊科各种精神科护理模式进行全面评估并解决现有的实施障碍,弥补了文献中的一个关键空白。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de22/11661900/a714b8c675d5/cureus-0016-00000074042-i01.jpg

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