Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder
Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder
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DOI：
10.1016/j.genhosppsych.2013.12.004
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发表时间：
2014-05-01
影响因子：
7
通讯作者：
Hotopf, M.
中科院分区：
文献类型：
--
作者：
Rayner, L.;Matcham, F.;Hotopf, M.
目的：评估常规的基于网络的筛查在综合医院设置的可行性和可接受性，并描述常见的精神disords.Method水平：一个服务开发平台，以整合精神和身体的医疗保健，在六个专业（风湿病，肢体重建，丙型肝炎，银屑病，成人先天性心脏病（ACHD），慢性疼痛）在伦敦，英国的三家综合医院。在服务条件下，病人完成了一个基于网络的问卷调查，包括精神和身体病人报告的结果措施，而等待他们的任命。可行性量化为完成问卷的患者比例。可接受性被量化为拒绝筛选的患者比例和需要帮助完成问卷的比例。可能的抑郁和焦虑的患病率表示为患者健康问卷-9和广泛性焦虑问卷-7确定的病例的百分比。结果：筛查的患者比例在不同专业之间差异很大（40.1-98.2%）。下降率很低（0.6-9.7%），少数人需要援助（11.7-40.4%）。可能抑郁的患病率从慢性疼痛的60.9%到ACHD的6.6%不等。可能的焦虑的患病率范围从25.1%，在风湿病ACHD.Conclusion：基于网络的筛查是可以接受的患者，可以有效地嵌入到日常实践中的11.4%。综合医院的患者患常见精神障碍的风险增加，常规筛查可能有助于确定需求，告知护理和监测结果。2014作者Elsevier Inc.出版这是CC BY-NC-ND许可下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/3.0/）。
Objective: To assess the feasibility and acceptability of routine web-based screening in general hospital settings, and describe the level of common mental disorder.Method: A service development platform to integrate mental and physical healthcare was implemented in six specialties (rheumatology, limb reconstruction, hepatitis C, psoriasis, adult congenital heart disease (ACHD), chronic pain) across three general hospitals in London, UK. Under service conditions, patients completed a web-based questionnaire comprising mental and physical patient-reported outcome measures, whilst waiting for their appointment. Feasibility was quantified as the proportion of patients who completed the questionnaire. Acceptability was quantified as the proportion of patients declining screening, and the proportion requiring assistance completing the questionnaire. The prevalence of probable depression and anxiety was expressed as the percentage of cases determined by the Patient Health Questionnaire-9 and Generalised Anxiety Disorder Questionnaire-7.Results: The proportion of patients screened varied widely across specialties (40.1-98.2%). The decline rate was low (0.6-9.7%) and the minority required assistance (11.7-40.4%). The prevalence of probable depression ranged from 60.9% in chronic pain to 6.6% in ACHD. The prevalence of probable anxiety ranged from 25.1% in rheumatology to 11.4% in ACHD.Conclusion: Web-based screening is acceptable to patients and can be effectively embedded in routine practice. General hospital patients are at increased risk of common mental disorder, and routine screening may help identify need, inform care and monitor outcomes. c 2014 The Authors. Published Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).