Pediatric Primary Care Perspectives on Integrated Mental Health Care for Autism.
Pediatric Primary Care Perspectives on Integrated Mental Health Care for Autism.
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DOI：
10.1016/j.acap.2020.03.006
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发表时间：
2020-11
影响因子：
3.1
通讯作者：
Brookman-Frazee L
中科院分区：
文献类型：
--
作者：
Stadnick NA;Martinez K;Aarons GA;Lee DA;Van Cleave J;Brookman-Frazee L
及时识别心理健康需求并与服务联系对于为自闭症谱系障碍 (ASD) 儿童提供全面护理至关重要。儿科初级保健能够通过综合护理方法促进这一过程。作为心理健康整合的第一步，本研究应用探索、准备、实施和维持框架来描述实施自闭症谱系障碍综合护理实践的决定因素。来自 3 个组织的 60 名儿科初级保健提供者和领导者完成了焦点小组和调查，以确定自闭症谱系障碍儿童的心理健康需求和获得心理健康服务的机会。整合研究结果以检查收敛性（即，这两种方法是否确认或发现相似的结果）和扩展（即，这两种方法是否提供了超出任何一种方法单独的见解）。结果集中在对自闭症谱系障碍综合护理实践的 3 个主要影响方面：1）针对自闭症谱系障碍的专业心理健康转诊选择有限，2）心理卫生系统独特的结构特征成为获得护理的障碍，3）护理人员对同时发生的心理健康状况和寻求推荐服务的理解程度不同。定性结果通过强调基于初级保健特征的独特实施考虑因素（例如，与医疗保健提供优先事项和价值观保持一致）来提供扩展。研究结果证实，需要采取量身定制的方法，将自闭症谱系障碍儿童与适当的心理健康治疗联系起来。结果深入了解了支持综合护理的组织能力需求，并为针对自闭症谱系障碍儿童调整综合心理健康护理模式提供了方向。
Timely identification of mental health needs and linkage to services is critical to provide comprehensive care for children with autism spectrum disorder (ASD). Pediatric primary care is well-positioned to facilitate this process through integrated care approaches. As a first step toward mental health integration, this study applied the Exploration, Preparation, Implementation, and Sustainment framework to characterize determinants of implementing integrated care practices for ASD. Sixty pediatric primary care providers and leaders from 3 organizations completed focus groups and surveys about identification of mental health needs in children with ASD and access to mental health services. Findings were integrated to examine convergence (ie, do the 2 methods confirm or find similar results) and expansion (ie, do the 2 methods provide insights beyond either method alone). Results converged regarding 3 primary influences to integrated care practices for ASD: 1) limited specialized mental health referral options for ASD, 2) unique structural characteristics of the mental health system act as barriers to accessing care, and 3) caregivers differ in the degree to which they understand co-occurring mental health conditions and pursue recommended services. Qualitative results provided expansion by highlighting unique implementation considerations (eg, alignment with health care delivery priorities and values) based on primary care characteristics. Findings confirm need for a tailored approach for linking children with ASD to appropriate mental health treatment. Results yield insight into the needs for organizational capacity to support integrated care and provide direction toward adapting an integrated mental health care model for children with ASD.
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影响因子：
3.9
作者：
Meera, S. S.;Kaipa, Ramesh;Shivashankar, N.
通讯作者：
Shivashankar, N.
影响因子：
25.8
作者：
Brookman-Frazee, Lauren;Roesch, Scott;Ganger, William
通讯作者：
Ganger, William
影响因子：
8
作者：
Ibrahim SH;Voigt RG;Katusic SK;Weaver AL;Barbaresi WJ
通讯作者：
Barbaresi WJ
影响因子：
8
作者：
Lavelle TA;Weinstein MC;Newhouse JP;Munir K;Kuhlthau KA;Prosser LA
通讯作者：
Prosser LA
影响因子：
8
作者：
Buie, Timothy;Campbell, Daniel B.;Winter, Harland
通讯作者：
Winter, Harland