Hanrahan Megan, Graham Fiona, Tang Mei Yee
School of Psychology, Newcastle University, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2025 Jan 29;15(1):e080817. doi: 10.1136/bmjopen-2023-080817.
Shared medical appointments (SMAs) are an innovative care delivery method that provides delivery of clinical care while also supporting self-management. Their usefulness for mental health conditions has only briefly been explored, though early evidence demonstrates their utility for supporting mental health management. Therefore, this study set out to better understand the views that adults with anxiety and depression have towards SMAs as a way of receiving care to support self-management in primary care.
A qualitative study using 1:1 semi-structured interviews which were analysed thematically following Braun and Clarke's six-phase reiterative process. We employed a deductive, theory-informed approach to thematically analyse the data.
The final sample consisted of 17 predominantly White ethnic adults with a clinical diagnosis of anxiety and/or depression from five different regions in England. Participants represented a broad age group (22-74 years) and a range of socioeconomic backgrounds.
Three main themes were established: (1) motivation to attend an SMA, (2) barriers and challenges to SMA engagement and (3) implementation preferences. The concept of SMAs was largely acceptable to participants, although participants reported several factors that would influence their decision to attend an SMA. Participants held some reservations but were on the whole receptive to the idea. The main benefits reported were peer support, support for self-management and quicker access to care. Drawbacks reported included risks to patient confidentiality, negative impact on emotional well-being and the unsuitability of the group setting for some patients. Some salient preferences identified included face-to-face/hybrid delivery formatting and mental health specialist involvement.
SMAs in primary care to support anxiety and depression self-management would be acceptable to patients, contingent on the mode of delivery of the SMAs. Future acceptability research should explore SMA appropriateness for diverse patient populations of different ethnic backgrounds, to inform their potential wider roll-out in English primary care.
共享医疗预约（SMA）是一种创新的医疗服务提供方式，既能提供临床护理，又能支持自我管理。虽然其对心理健康状况的作用仅得到了初步探索，但早期证据表明其对支持心理健康管理具有效用。因此，本研究旨在更好地了解患有焦虑症和抑郁症的成年人对SMA作为一种在初级保健中获得支持自我管理护理方式的看法。
一项定性研究，采用一对一的半结构化访谈，并按照布劳恩和克拉克的六阶段迭代过程进行主题分析。我们采用了一种基于理论的演绎方法对数据进行主题分析。
最终样本包括17名主要为白人的成年人，他们来自英格兰五个不同地区，临床诊断为焦虑症和/或抑郁症。参与者代表了广泛的年龄组（22 - 74岁）和一系列社会经济背景。
确定了三个主要主题：（1）参加SMA的动机，（2）参与SMA的障碍和挑战，以及（3）实施偏好。SMA的概念在很大程度上为参与者所接受，尽管参与者报告了几个会影响他们参加SMA决定的因素。参与者有所保留，但总体上接受这个想法。报告的主要好处包括同伴支持、对自我管理的支持以及更快获得护理。报告的缺点包括患者保密性的风险、对情绪健康的负面影响以及团体环境对一些患者的不适用性。确定的一些显著偏好包括面对面/混合交付形式以及心理健康专家的参与。
在初级保健中支持焦虑和抑郁自我管理的SMA对患者来说是可以接受的，这取决于SMA的交付模式。未来的可接受性研究应探索SMA对不同种族背景的不同患者群体的适用性，以便为其在英国初级保健中的潜在更广泛推广提供信息。
