PDF(Pubmed)
Abstract：
Electronic patient portals represent a promising means of integrating mental health assessments into HIV care where anxiety and depression are highly prevalent. Patient attitudes toward portal-based mental health screening within HIV clinics have not been well described. The aim of this formative qualitative study is to characterize the patient-perceived facilitators and barriers to portal-based anxiety and depression screening within HIV care in order to inform implementation strategies for mental health screening. Twelve adult HIV clinic patients participated in semi-structured interviews that were audio recorded and transcribed. The transcripts were coded using constructs from the Consolidated Framework for Implementation Research and analyzed thematically to identify the barriers to and facilitators of portal-based anxiety and depression screening. Facilitators included an absence of alternative screening methods, an approachable design, perceived adaptability, high compatibility with HIV care, the potential for linkage to treatment, an increased self-awareness of mental health conditions, the ability to bundle screening with clinic visits, and communicating an action plan for results. The barriers included difficulty navigating the patient portal system, a lack of technical support, stigmatization from the healthcare system, care team response times, and the novelty of using patient portals for communication. The patients in the HIV clinic viewed the use of a portal-based anxiety and depression screening tool as highly compatible with routine HIV care. Technical difficulties, follow-up concerns, and a fear of stigmatization were commonly perceived as barriers to portal use. The results of this study can be used to inform implementation strategies when designing or incorporating portal-based mental health screening into other HIV care settings.
摘要：
电子患者门户代表了将心理健康评估整合到焦虑和抑郁非常普遍的HIV护理中的一种有希望的方法。尚未很好地描述患者对HIV诊所中基于门户的心理健康筛查的态度。这项形成性定性研究的目的是表征HIV护理中患者感知的促进者和基于门户的焦虑和抑郁筛查的障碍，以便为心理健康筛查的实施策略提供信息。12名成年HIV门诊患者参加了半结构化访谈，并进行了音频记录和转录。使用实施研究综合框架的结构对转录本进行编码，并进行主题分析，以确定基于门户的焦虑和抑郁筛查的障碍和促进者。促进者包括缺乏替代的筛查方法，平易近人的设计，感知的适应性，与艾滋病毒护理高度兼容，与治疗联系的潜力，对精神健康状况的自我意识增强，将筛查与诊所就诊捆绑在一起的能力，并传达结果的行动计划。障碍包括难以导航患者入口系统，缺乏技术支持,医疗系统的污名化，护理团队响应时间，以及使用患者门户进行交流的新颖性。HIV诊所的患者认为使用基于门户的焦虑和抑郁筛查工具与常规HIV护理高度兼容。技术难题,后续关注，对污名化的恐惧通常被认为是门户使用的障碍。这项研究的结果可用于在设计或将基于门户的心理健康筛查纳入其他HIV护理环境时提供实施策略。
