Preventive Counseling for Chronic Disease: Missed Opportunities in a Community Mental Health Center
Preventive Counseling for Chronic Disease: Missed Opportunities in a Community Mental Health Center
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DOI：
10.1016/j.psym.2012.10.003
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发表时间：
2013-07-01
期刊：
影响因子：
3.4
通讯作者：
Ickovics, Jeannette
中科院分区：
文献类型：
--
作者：
Chwastiak, Lydia;Cruza-Guet, Maria-Cristina;Ickovics, Jeannette
背景：严重精神疾病患者心血管风险的巨大负担强调了预防的迫切需要。初级保健临床医生的咨询增加了患者戒烟，体力活动和水果和蔬菜的消费。社区心理健康临床医生对心血管危险因素的咨询程度尚未报道。研究方法：这项横断面研究探讨了城市社区精神卫生中心（n = 154）的心理健康提供者对心血管危险因素的咨询率。Logistic回归分析确定了与50%以上的客户有关饮食，运动和吸烟的咨询相关的临床特征。结果如下：72%的临床工作人员回答了调查，样本为154名心理健康临床医生; 26.6%的临床医生每年为一半以上的客户提供有关所有三种心血管疾病（CVD）风险因素的咨询。Logistic回归显示，为客户提供CVD风险因素咨询的心理健康提供者不太可能肥胖，并且更有可能接受过关于如何为客户提供CVD风险咨询的正式培训。讨论内容：这是第一项研究，以探讨常规的临床实践，社区精神卫生临床医生在解决心血管疾病的风险在城市社区精神卫生中心。培训心理健康临床医生了解心血管疾病的风险，并支持改善临床医生的健康状况，可以改善社区心理健康中心为客户提供的预防性护理。
Background: The tremendous burden of cardiovascular risk among persons with serious mental illness underscores a critical need for prevention. Counseling by primary care clinicians increases patient smoking cessation, physical activity, and the consumption of fruits and vegetables. The extent to which community mental health clinicians counsel about cardiovascular risk factors has not been reported. Methods: This cross-sectional study examines the rates of counseling about cardiovascular risk factors by mental health providers at an urban community mental health center (n = 154). Logistic regression analyses identified clinician characteristics associated with counseling more than 50% of clients about diet, exercise, and smoking. Results: 72% of clinical staff members responded to the survey, for a sample of 154 mental health clinicians; 26.6% of the clinicians counseled more than half of their clients annually about all three cardiovascular disease (CVD) risk factors. Logistic regression showed that mental health providers who counseled clients about CVD risk factors were less likely to be obese, and were more likely to have received formal training about how to counsel clients about CVD risk. Discussion: This is the first study to examine the routine clinical practice of community mental health clinicians in addressing CVD risk at an urban community mental health center. Both training mental health clinicians about CVD risk and also support for improving clinician health status may improve the preventive care provided to clients at community mental health centers.