Fishman M E, Kessel W, Heppel D E, Brannon M E, Papai J J, Bryn S D, Nora A H, Hutchins V L
Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services, Rockville, Maryland, USA.
Pediatrics. 1997 Apr;99(4):E5. doi: 10.1542/peds.99.4.e5.
In recent years there has been increasing emphasis on the mental health aspects of primary health care for children and adolescents. The Health Resources and Services Administration's Maternal and Child Health Bureau has contributed to efforts aimed at strengthening primary care not only in early identification and beginning intervention with mental disorders, but also in prevention of emotional and behavioral problems and in promotion of positive psychosocial development. The Collaborative Office Rounds (COR) Program is a noteworthy part of these efforts.
The COR program supports small discussion groups that meet at regular intervals over sustained periods of time to address the mental health aspects of pediatric care. The groups are jointly led by pediatricians and child psychiatrists. Although they vary in a number of ways, all are concerned with the day-to-day psychosocial issues that confront primary care providers serving children, adolescents, and their families.
COR groups have addressed a wide range of areas including numerous problems and disorders, health supervision issues, family and community topics, personal challenges and practical complexities, and clinical management issues. Evaluation information indicates a positive response on the part of participants and moderators. This is reflected in group stability, high attendance rates, universal readiness to recommend the COR experience, and a variety of collateral accomplishments.
Experience to date points to the COR group as a useful tool for addressing psychosocial issues in primary care. Its potential may be more fully realized by applying this approach more widely, even as further assessment is pursued.
近年来，儿童和青少年初级卫生保健的心理健康方面受到越来越多的重视。卫生资源与服务管理局的母婴健康局不仅在精神障碍的早期识别和早期干预方面，而且在预防情绪和行为问题以及促进积极的社会心理发展方面，为加强初级保健的努力做出了贡献。协作办公室查房（COR）计划是这些努力中值得注意的一部分。
COR计划支持小型讨论小组，这些小组在持续的时间段内定期开会，以讨论儿科护理的心理健康方面。这些小组由儿科医生和儿童精神科医生共同领导。尽管它们在许多方面存在差异，但都关注为儿童、青少年及其家庭提供初级保健的提供者所面临的日常社会心理问题。
COR小组涉及广泛的领域，包括众多问题和障碍、健康监督问题、家庭和社区主题、个人挑战和实际复杂性以及临床管理问题。评估信息表明参与者和主持人都有积极的反应。这体现在小组的稳定性、高出席率、普遍愿意推荐COR经历以及各种附带成就上。
迄今为止的经验表明，COR小组是解决初级保健中社会心理问题的有用工具。即使在进行进一步评估的同时，通过更广泛地应用这种方法，其潜力可能会得到更充分的实现。
