Unmet need for mental health and addictions care in urban community health clinics: frontline provider accounts.
Unmet need for mental health and addictions care in urban community health clinics: frontline provider accounts.
复制标题
城市社区卫生诊所对心理健康和成瘾护理的未满足需求：一线提供者账户。
DOI：
10.1176/ps.2009.60.4.505
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Roy-Byrne,PeterP
中科院分区：
文献类型：
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作者：
Cristofalo,Meg;Boutain,Doris;Schraufnagel,TrevorJ;Bumgardner,Kristin;Zatzick,Doug;Roy-Byrne,PeterP
目的为了促进改善社区卫生诊所护理服务的规划，本研究深入描述了为该环境中心理健康和成瘾治疗提供环境的社会、文化和组织因素。方法对 17 名社区卫生诊所提供者和工作人员进行了 45-90 分钟的开放式问题访谈，以了解他们一线提供者的经历。通过内容分析确定了答复的主要主题和副主题。结果对护理造成重大障碍的问题包括复杂的患者合并症和人口特征；诊所组织、资源和资金短缺；与专业心理健康和成瘾机构的沟通障碍；结论社区卫生保健环境中护理的独特障碍以及所服务患者的独特特征可能需要针对具体情况的解决方案。这些解决方案将决定现有慢性病管理模式（例如协作护理）在这种情况下的可行性。（Psychiatric Services 60：505-511，2009）
ObjectiveTo facilitate planning to improve care delivery in community health clinics, this study provides an in-depth description of the social, cultural, and organizational factors that create the context for mental health and addictions treatment delivery in this setting.MethodsSeventeen community health clinic providers and personnel were interviewed for 45–90 minutes with open-ended questions to elicit the context of their frontline provider experiences. Major themes and subthemes of responses were identified with content analysis.ResultsIssues that create significant barriers to care included complex patient comorbidity and demographic characteristics; clinic organization, resources, and funding shortfalls; communication barriers with specialty mental health and addictions agencies; and stigmatizing aspects of mental health, addictions, and disadvantaged status.ConclusionsThe unique barriers to care in the community health care setting, as well as the unique characteristics of patients served, are likely to require context-specific solutions. These solutions will determine the viability of existing chronic disease management models, such as collaborative care, when applied to this setting.(Psychiatric Services 60: 505–511, 2009)