Treating immigrant patients in psychiatric emergency rooms.
Treating immigrant patients in psychiatric emergency rooms.
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DOI：
10.1177/1363461520916697
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发表时间：
2021-03
影响因子：
2.5
通讯作者：
Alegría M
中科院分区：
文献类型：
--
作者：
Collazos F;Malagón-Amor Á;Falgas-Bague I;Qureshi A;Gines JM;Del Mar Ramos M;McPeck S;Hussain I;Wang Y;Alegría M
我们研究是否病人变量（地理来源，性别，西班牙语水平）和主观的临床医生方面在急诊科精神科的遭遇（即诊断的确定性，临床医生的舒适度与病人）与诊断和使用强制措施。使用描述性横断面设计，我们记录了2007年至2015年期间巴塞罗那医院精神病学急诊室（ER）的467次就诊（400名外国出生的患者和67名本土出生的患者）。我们首先评估了患者变量和主观的临床医生方面的精神病遭遇与服务使用的结果和精神疾病诊断的关联。拟合logistic模型预测服务使用结果的可能性，并估计接受每种诊断的倾向。零模型评估了患者的地理来源的作用，而完整的模型评估了患者的性别和语言的额外作用，临床医生对文化在诊断中的影响的评估，以及临床医生对两个结果的舒适度：患者的诊断和在ER中使用强制措施。与男子相比，妇女不太可能接受强制措施或肌肉注射药物。在接受某些诊断时发现了显著的民族/种族和性别差异。此外，患者的西班牙语水平较低与接受精神病诊断的可能性较高相关。临床医生的诊断确定性水平也与临床医生报告的患者舒适度呈正相关。总体而言，种族因素和精神病遭遇的主观方面影响诊断和强制措施的使用。因此，应该要求精神病急诊室设置的文化能力计划和口译服务。
We examine whether patient variables (geographic origin, gender, Spanish language proficiency) and subjective clinician aspects in emergency department psychiatric encounters (i.e. diagnostic certainty, clinician’s comfort level with patient) are associated with diagnosis and the use of coercive measures. Using a descriptive cross-sectional design, we recorded 467 visits (400 foreign-born and 67 native-born patients) in hospital psychiatry emergency rooms (ERs) in Barcelona between 2007 and 2015. We first assessed the association of patient variables and subjective clinician aspects of psychiatric encounters with service use outcomes and with mental illness diagnosis. Fitted logistic models predicted the likelihood of service use outcomes and estimated the propensity of receiving each diagnosis. The null model evaluated the role of patient’s geographical origin, while the full model evaluated the additional roles of patient’s gender and language, the clinician’s assessment of the influence of culture in diagnosis, and clinician comfort with two outcomes: patient’s diagnosis and use of coercive measures in the ER. Women were less likely to receive coercive measures or intramuscular medications compared to men. Significant ethnic/racial and gender differences were found in receiving certain diagnoses. Additionally, a patient’s lower Spanish proficiency was correlated with a higher probability of receiving a psychosis diagnosis. The clinician’s level of diagnostic certainty was also positively correlated with increasing clinician-reported comfort with patient. Overall, ethnic factors and the subjective aspects of psychiatric encounters influence diagnosis and the use of coercive measures. Cultural competency programs and interpreter services within psychiatric ER settings should thus be required.
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影响因子：
4.2
作者：
Darghouth, Sarah;Nakash, Ora;Miller, Alisa;Alegria, Margarita
通讯作者：
Alegria, Margarita
影响因子：
1.5
作者：
Enosh, Guy;Ben-Ari, Adital
通讯作者：
Ben-Ari, Adital
影响因子：
4.4
作者：
Iversen, VC;Morken, G
通讯作者：
Morken, G
影响因子：
3.8
作者：
De Benedictis, Luigi;Dumais, Alexandre;Lesage, Alain D.
通讯作者：
Lesage, Alain D.
DOI：
10.1186/1745-0179-3-30
发表时间：
2007-12-04
期刊：
Clinical practice and epidemiology in mental health : CP & EMH
影响因子：
--
作者：
Abderhalden, Christoph;Needham, Ian;Haug, Hans-Joachim
通讯作者：
Haug, Hans-Joachim