Phase I of the Detecting and Evaluating Childhood Anxiety and Depression Effectively in Subspecialties (DECADES) Study: Development of an Integrated Mental Health Care Model for Pediatric Gastroenterology.
Phase I of the Detecting and Evaluating Childhood Anxiety and Depression Effectively in Subspecialties (DECADES) Study: Development of an Integrated Mental Health Care Model for Pediatric Gastroenterology.
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DOI：
10.2196/10655
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发表时间：
2018-09-10
影响因子：
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通讯作者：
Bennett, William E Jr
中科院分区：
文献类型：
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作者：
Hullmann, Stephanie E;Keller, Stacy A;Bennett, William E Jr
背景：有胃肠道症状的儿童有很高的焦虑和抑郁发生率。快速识别同时存在的焦虑和抑郁对于有效治疗各种功能性胃肠道疾病至关重要。目的：本研究的目的是在胃肠病科(GI)就诊期间确定患者和父母对抑郁、焦虑和心理健康筛查的态度，并确定患者和父母在阳性筛查后交流结果和转诊至精神卫生服务提供者的偏好。方法：我们以患者为中心的设计方法扩展了标准的定性小组会议方法，以评估患者和父母的偏好。我们使用了多种具体的设计方法，包括卡片分类、投影法、经验图谱和建构法。结果：总共有11个家庭(11名患者和14名家长)参加了2次小组会议。总体而言，患者和他们的父母发现综合心理健康护理在专科设置中是可以接受的。患者主要关心的是他们的筛查结果的隐私和保密性。患者和他们的父母强调心理健康服务的重要性，不干扰胃肠道医生、心理学家和初级保健提供者之间的GI就诊和合作。结论：在儿科专科诊所，患者和他们的家人愿意接受综合心理健康护理。这项数十年研究的下一阶段将把患者和父母的偏好转化为一个综合的精神卫生保健系统，并在儿科GI办公室测试其有效性。
BACKGROUND: Children with gastrointestinal symptoms have a very high rate of anxiety and depression. Rapid identification of comorbid anxiety and depression is essential for effective treatment of a wide variety of functional gastrointestinal disorders.OBJECTIVE: The objective of our study was to determine patient and parent attitudes toward depression, anxiety, and mental health screening during gastroenterology (GI) visits and to determine patient and parent preferences for communication of results and referral to mental health providers after a positive screen.METHODS: We augmented standard qualitative group session methods with patient-centered design methods to assess patient and parent preferences. We used a variety of specific design methods in these sessions, including card sorting, projective methods, experience mapping, and constructive methods.RESULTS: Overall, 11 families (11 patients and 14 parents) participated in 2 group sessions. Overall, patients and their parents found integrated mental health care to be acceptable in the subspecialty setting. Patients' primary concerns were for the privacy and confidentiality of their screening results. Patients and their parents emphasized the importance of mental health services not interfering with the GI visit and collaboration between the GI physician, psychologist, and primary care provider.CONCLUSIONS: Patients and their families are open to integrated mental health care in the pediatric subspecialty clinic. The next phase of the DECADES study will translate patient and parent preferences into an integrated mental health care system and test its efficacy in the pediatric GI office.