Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services
Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services
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DOI：
10.1097/jgp.0b013e3181c29495
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发表时间：
2010-06-01
影响因子：
7.2
通讯作者：
Petkus, Andrew
中科院分区：
文献类型：
--
作者：
Gum, Amber M.;Iser, Lindsay;Petkus, Andrew
目的：研究老龄化网络中接受家庭服务的老年人对行为健康服务的使用情况、治疗偏好以及服务使用的促进因素和障碍。设计：横断面调查。地点：访谈在参与者家中进行。参与者： 142 名接受居家养老服务的客户。测量：精神障碍诊断和统计手册的结构化临床访谈，第四版；简要症状清单-18；歧视贬值量表；利用行为健康服务；以及行为健康服务的偏好、促进因素和障碍。结果：精神药物的使用率很高（54.2%），主要在初级保健机构接受（58.8%），每年几次就诊（54.0%）。如果参与者年轻且是白人，他们更有可能服用精神药物。大约三分之一服用抗抑郁或抗焦虑药物的参与者仍然符合轴 I 障碍的标准。 21 名参与者 (14.8%) 报告在过去一年内接受过咨询，其中大多数 (57.1%) 每年接受过几次或更少的咨询。几乎所有人都愿意去看至少一名专业人士 (97.2%) 并尝试处方药物或咨询 (90.1%)。最常见的服务使用障碍是实际的：负担能力（71.8%）、出行困难（62.7%）和缺乏交通（45.8%）。结论：接受家庭服务的老年网络客户可以随时获得精神药物，但很少接受专业行为健康服务和药物监测就诊。他们愿意使用各种行为健康服务，并主要认为使用服务存在实际障碍。老化网络具有提高服务利用率的巨大潜力；讨论了将行为健康服务纳入老龄化网络的策略。 （《美国老年精神病学杂志》2010 年；18：491-501）
Objective: To examine use of behavioral health services, treatment preferences, and facilitators and barriers to service use in older adults receiving home-based services within the aging network. Design: Cross-sectional survey. Setting: Interviews were conducted in participants' homes. Participants: One hundred forty-two clients receiving home-based aging services. Measurements: Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; Brief Symptom Inventory-18; Discrimination-Devaluation Scale; utilization of behavioral health services; and preferences, facilitators, and barriers for behavioral health services. Results: Use of psychotropic medication was high (54.2%), primarily received in primary care settings (58.8%), with a few visits a year (54.0%). Participants were more likely to be taking psychotropic medication if they were younger and white. Approximately one-third of participants on antidepressant or antianxiety medication still met criteria for an Axis I disorder. Twenty-one participants (14.8%) reported receiving counseling within the past year, with a few visits or less a year for most (57.1%). Almost all were willing to see at least one professional (97.2%) and try prescribed medications or counseling (90.1%). The most common barriers to service use were practical: affordability (71.8%), difficulty traveling (62.7%), and lack of transportation (45.8%). Conclusions: Aging network clients receiving home-based services have ready access to psychotropic medications but receive very few specialty behavioral health services and medication monitoring visits. They are willing to use a variety of behavioral health services and perceive mainly practical barriers to using services. The aging network has significant potential to enhance access to service utilization; strategies for integrating behavioral health services in the aging network are discussed. (Am J Geriatr Psychiatry 2010; 18: 491-501)