psychiatric nursing

精神病学护理
  • 文章类型: Journal Article
    背景:家庭参与精神保健是精神疾病管理中的一种治疗性干预措施。长期心理健康的全球关注是,当他们的亲人被接纳接受护理时,家庭很难接受精神疾病,治疗和康复。
    目的:描述护士在长期机构中让家庭成员参与心理健康护理使用者护理的看法。
    方法:采用定量描述性设计。人口包括在三个精神卫生机构(MHI)工作的护士。采用概率简单随机抽样方法选取360名受访者。使用自我管理问卷收集数据。
    结果:调查结果显示,大多数护士(86.9%)承认挑战会影响家庭在精神保健方面的参与。共有91.4%的护士抱怨家庭成员的参与不足,(80.6%)表明家庭接触不良会影响提供优质的精神卫生保健。因此,受访者认为,家庭的参与对精神疾病的管理有影响。
    结论:让家庭成员参与精神卫生保健有助于卫生专业人员和家庭参与以患者为中心的护理和精神卫生保健服务。然而,MHCU在家人参与时受益。贡献:该研究为心理健康护理做出了贡献,因为其结果可用于衡量卫生服务改善的质量,在亲人住院期间让家庭成员参与精神保健。
    BACKGROUND:  Family involvement in mental health care is a therapeutic intervention in the management of mental illness. The global concern in long-term mental health is that families find it difficult to accept mental illness when their loved ones are admitted to receive care, treatment and rehabilitation.
    OBJECTIVE:  To describe nurses\' perceptions of involving family members in the care of mental health care users in long-term institutions.
    METHODS:  A quantitative descriptive design was used. The population comprised nurses working at three mental health institutions (MHIs). Probability simple random sampling was used to select 360 respondents. Data were collected using self-administered questionnaires.
    RESULTS:  The findings revealed that most (86.9%) of the nurses acknowledged that challenges affect families\' involvement in mental health care. A total of 91.4% of nurses complained that family members\' involvement was insufficient and (80.6%) indicated that poor family contact affects the provision of quality mental health care. Therefore, the respondents believed that the families\' involvement has an impact on the management of mental illness.
    CONCLUSIONS:  Engaging family members in mental health care helps both health professionals and families to participate in patient-centred care and mental health care services. However, MHCUs benefit when their families are involved.Contribution: The study contributed to mental health nursing as its results can be used to measure the quality of health services improvements, by involving the family members during hospitalisation of their loved ones for mental health care.
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  • 文章类型: Journal Article
    目的:本研究旨在调查精神科护士体面劳动现状并分析其影响因素。
    方法:2024年2月,对杭州某三级甲等精神病医院358名护士进行了整群抽样的横断面研究,浙江省,中国。使用定制的护士人口统计量表收集数据以收集人口统计信息。努力-回报失衡问卷(ERIQ)用于通过努力-回报比(ERR)评估努力与回报之间的不平衡。社会支持评定量表(SSRS)衡量的是主观支持,客观支持,并支持利用。体面工作感知量表(DWPS)用于评估护士对体面工作的感知。T-tests,单向方差分析,皮尔逊相关分析,采用多元线性回归分析进行数据分析。
    结果:研究发现体面工作与社会支持呈正相关(r=0.360,p<0.001),而努力奖励失衡为负(r=-0.584,p<0.001)。影响对体面工作的看法的因素包括多年的工作经验(β=-0.164,p=0.046,<5年;β=-0.157,p=0.040,>25年),社会支持(β=0.259,p<0.001),和努力-回报失衡(β=-0.458,p<0.001)。这些因素共同解释了对体面工作的看法差异的40.2%。此外,社会支持在努力-回报失衡和体面工作之间起中介作用(β=-0.062,Bootstrap95%CI:-0.107,-0.023)。
    结论:研究结果表明,多年的工作经验,社会支持,努力-回报失衡是影响精神科护士体面工作的因素。通过提供职业发展机会,培养支持性的工作环境,并确保公平的赔偿,我们可以授权精神科护士有效地应对工作挑战,并在工作中保持体面。
    OBJECTIVE: This study aimed to investigate the current status of decent work among psychiatric nurses and analyze its influencing factors.
    METHODS: In February 2024, a cross-sectional study was conducted with a cluster sample of 358 nurses from a tertiary Grade A psychiatric hospital in Hangzhou, Zhejiang Province, China. Data were collected using a custom-made nurse demographic scale to gather demographic information. The Effort-Reward Imbalance Questionnaire (ERIQ) was used to assess the imbalance between effort and reward through the effort-reward ratio (ERR). The Social Support Rating Scale (SSRS) measured subjective support, objective support, and support utilization. The Decent Work Perception Scale (DWPS) was used to evaluate nurses\' perceptions of decent work. T-tests, one-way ANOVA, Pearson\'s correlation analysis, and multiple linear regression analyses were employed for data analysis.
    RESULTS: The study found that the correlation between decent work and social support was positive (r = 0.360, p < 0.001), while it was negative for effort-reward imbalance (r = -0.584, p < 0.001). Factors influencing perceptions of decent work included years of work experience (β = -0.164, p = 0.046 for < 5 years; β = -0.157, p = 0.040 for > 25 years), social support (β = 0.259, p < 0.001), and the effort-reward imbalance (β=-0.458, p < 0.001). These factors collectively explained 40.2% of the variance in perceptions of decent work. Furthermore, social support plays a mediating role between effort-reward imbalance and decent work (β=-0.062, Bootstrap 95% CI: -0.107, -0.023).
    CONCLUSIONS: The findings suggest that years of work experience, social support, and the effort-reward imbalance are factors influencing decent work among psychiatric nurses. By offering career development opportunities, fostering supportive work environments, and ensuring fair compensation, we can empower psychiatric nurses to navigate job challenges effectively and sustain a sense of decency in their work.
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  • 文章类型: Journal Article
    ED越来越被认为是预防自杀的关键环境。零自杀(ZS)是通过利用最佳实践消除医疗保健系统内所有患者自杀的理想目标。然而,在ED内部对ZS实施的探索有限。由于ED护士通过与有自杀风险的患者密切接触,在预防自杀方面发挥着重要作用,ZS的实施将受益于针对ED护士领导的量身定制策略。我们描述了ZS框架,并为护士领导者提供了适应成人ED中每个ZS组件的策略。
    The ED has been increasingly recognized as a key setting for suicide prevention. Zero Suicide (ZS) is an aspirational goal to eliminate suicide for all patients within a health care system through utilization of best practices. However, there has been limited exploration of ZS implementation within the ED. As ED nurses play an important role in suicide prevention through their close contact with patients at risk for suicide, ZS implementation would benefit from tailored strategies for ED nurse leadership. We describe the ZS framework and provides strategies for nurse leaders to adapt each ZS component in the adult ED.
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  • 文章类型: Journal Article
    针对医护人员的工作场所暴力已成为一个严重的全球公共卫生问题。精神科护士的工作场所暴力发生率高于所有其他医疗机构,每年高达84.2%。它不仅对医护人员生活的许多方面产生负面影响,而且破坏了护患关系的和谐,降低了护理质量。中国的精神科护士人数约为96,000人,远低于大多数其他国家,无法满足日益增长的精神卫生需求。然而,工作场所暴力的增加未来会加剧目前护士的短缺。因此,有必要制定有效的策略来防止精神科护士遭受工作场所暴力,从而减少护士流失,提高护理质量。在制定策略和采取措施之前,全面了解精神科护士预防工作场所暴力的偏好和优先事项是重要的前提。不幸的是,到目前为止,没有研究调查精神科护士的偏好。因此,一项离散选择实验(DCE)正在进行,以探索精神科护士对预防工作场所暴力的偏好。本文报告了DCE的方法细节。
    通过文献综述开发了六个属性,一对一访谈和焦点小组讨论。使用NGENE中的D-高效设计来生成选择集。SPSS24.0将用于社会人口学的描述性分析,Stata16.0将用于DCE数据分析。将使用多项logit模型来初步探索选择任务中包括的工作场所暴力预防特征之间的权衡。然后,在混合的logit模型中,我们计划选择一些任意定义的基础暴力预防计划,并将使用nlcom命令来评估替代暴力预防计划的可能性。
    该研究得到了相关伦理委员会的批准。我们的发现将强调基于精神科护士偏好的优先干预领域,并为医院制定和改进工作场所暴力预防策略提供参考。结果将通过研讨会分享,政策简报,同行评审的期刊文章和在线博客。
    UNASSIGNED: Workplace violence against healthcare workers has become a serious global public health problem. The incidence of workplace violence towards Psychiatric nurses is higher than in all other medical institutions, up to 84.2% per year. It not only negatively affects many aspects of healthcare workers\' lives, but also destroys the harmony of the nurse-patient relationship and reduces the quality of nursing care. The number of psychiatric nurses in China was approximately 96,000, far lower than most other countries and unable to meet the growing demand for mental health. However, the increase in workplace violence has future exacerbates the current shortage of nurses. Therefore, it is necessary to develop effective strategies to prevent psychiatric nurses from suffering from workplace violence, thereby to reduce nurse turnover and improve the quality of nursing care. A comprehensive understanding of psychiatric nurses\' preferences and priorities for preventing workplace violence is an important prerequisite before formulating strategies and taking measures. Unfortunately, to date, no research has investigated the psychiatric nurses\' preferences. Therefore, a discrete choice experiment (DCE) is conducting to explore the psychiatric nurses\' preferences for workplace violence prevention. This article reports on methodological details of the DCE.
    UNASSIGNED: Six attributes were developed through a literature review, one-on-one interviews and focus group discussions. D-efficient design in NGENE was used to generate choice sets. SPSS 24.0 will be used for descriptive analysis of social Demography, and Stata 16.0 will be used for analysis of DCE data. A multinomial logit model will be used to preliminarily explore trade-offs between workplace violence prevention characteristics included in the choice tasks. Then, in a mixed logit model, we plan to choose some arbitrarily defined base violence prevention program and will use the nlcom command to evaluate the probability of an alternative violence prevention program.
    UNASSIGNED: The study was approved by the relevant ethics committees. Our findings will emphasize priority intervention areas based on the preferences of psychiatric nurses and provide references for hospitals to develop and improve workplace violence prevention strategies. The results will be shared through seminars, policy briefs, peer-reviewed journal articles and online blogs.
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  • 文章类型: Journal Article
    严重的精神疾病扰乱了日常功能,家庭照顾者的负担,他们经常采取精神应对策略。具有全面的技能,心理健康护士可以促进幸福感和心理健康。目的是开发和测试在家庭居住的精神疾病患者的家庭护理人员中的护理干预“促进精神应对”。本研究分两个不同阶段进行。最初,干预措施是根据《制定和评估复杂干预措施框架》第一阶段制定的。其次,干预方案在一项混合方法试验研究中进行了测试.制定了干预方案,并对10名家庭护理人员进行了测试。干预包括三场会议,并进行了前后评估。在结果方面观察到了显著的改善,看护者表示,讨论灵性和宗教信仰使他们受益。这种干预措施优先考虑了护士和家庭护理人员的治疗关系。创建了“促进精神应对”干预措施,并将其评估为心理健康护士在心理治疗背景下与精神疾病患者的家庭护理人员一起使用的合适方法。
    Severe mental illness disrupts daily functioning, burdening family caregivers, who often adopt spiritual coping strategies. With comprehensive skills, mental health nurses can promote well-being and mental health. The aim is to develop and test the nursing intervention \"promoting spiritual coping\" in the family caregivers of home-dwelling people with mental illness. This study was conducted in two distinct stages. Initially, the intervention was developed according to the first phase of the Framework for Developing and Evaluating Complex Interventions. Secondly, the intervention protocol was tested in a mixed-method pilot study. An intervention protocol was developed and tested on ten family caregivers. The intervention comprised three sessions, and before-and-after assessments were conducted. Significant improvements were observed in the outcomes, with caregivers expressing that discussing spirituality and religiosity benefited them. This intervention prioritized the therapeutic relationship of the nurses and family caregivers. The intervention \"promoting spiritual coping\" was created and evaluated as a suitable approach for mental health nurses to use in a psychotherapeutic context with family caregivers of individuals with mental illness.
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  • 文章类型: Journal Article
    术前焦虑,由于它的多因素起源,影响了广泛的手术患者,导致围手术期不良的生理和心理影响。定制,需要自主护理干预来满足个人需求.向门诊手术的转变强调了对重组护理方法的需求。现有文献表明,术前护理咨询提供了评估需求的机会,提供信息,并制定减少焦虑的策略。心理教育,心理健康和精神护理领域的专业技能,已被证明有效缓解术前焦虑和减少术后并发症。目的是获取和分析反映护士对设计理解的信息,结构,并实施心理教育计划以减少成人术前焦虑。
    定性的,探索性,进行了描述性研究。数据是通过ZoomMeetings视频会议平台在线举行的90分钟焦点小组会议收集的。建立了参与者选择的纳入标准。指导焦点小组考虑制定有效的心理教育干预措施的潜在策略。数据收集在达到理论饱和后停止,收集的信息已提交进行内容分析。确保了道德程序。
    在参与者中,10名是专科护士(7名从事精神卫生和精神护理,其余从事医疗外科护理),平均年龄41岁,在外科服务部门工作平均15年。护士选择了目标人群,心理教育会议的结构和内容,和资源,并解决了感知的重要性,有效性,以及所设计的心理教育计划的可行性。
    这项研究揭示了护士对心理教育计划设计的理解,该计划可能有效地减少成人术前焦虑。在门诊手术中。该结果将允许将产生的知识转移到护士的专业实践中,反映出更低的焦虑水平并促进更好的手术恢复。这是一项在葡萄牙进行的史无前例的研究,为护理学科增加大量知识。然而,建议进一步研究在外科背景下实施心理教育,旨在巩固国际上已经开展的研究结果。
    UNASSIGNED: Preoperative anxiety, with its multifactorial origins, affects a wide range of surgical patients, leading to adverse physiological and psychological effects in the perioperative period. Customized, autonomous nursing interventions are needed to address individual person needs. The shift toward outpatient surgery emphasizes the need for restructured nursing approaches. Existing literature suggests that preoperative nursing consultations offer opportunities for assessing needs, providing information, and prescribing anxiety-reduction strategies. Psychoeducation, a specialized skill within mental health and psychiatric nursing, has proven effective in alleviating preoperative anxiety and reducing postoperative complications. The aim is to obtain and analyze the information reflecting nurses’ understanding of the design, structure, and operationalization of a psychoeducation program to reduce preoperative anxiety in adults.
    UNASSIGNED: A qualitative, exploratory, descriptive study was conducted. Data were collected through a 90-min focus group session held online via Zoom Meetings videoconferencing platform. Inclusion criteria for the participant’s selection were established. The focus group was guided to deliberate on potential strategies for crafting effective psychoeducational interventions. Data collection ceased upon reaching theoretical saturation and gathered information was submitted for content analysis. Ethical procedures were ensured.
    UNASSIGNED: Of the participants, 10 were specialist nurses (7 working in mental health and psychiatric nursing and the remaining in medical-surgical nursing), with an average age of 41 and an average of 15 years working in surgical services. The nurses selected the target population, the structure and content of the psychoeducation sessions, and the resources and addressed the perceived importance, effectiveness, and feasibility of the designed psychoeducation program.
    UNASSIGNED: The study revealed the nurses’ understanding of the design of a psychoeducation program potentially effective in reducing preoperative anxiety in adults, in an outpatient surgery context. This result will allow the transfer of the produced knowledge to nurses’ professional practice reflecting lower levels of anxiety and promoting a better surgical recovery. This is an unprecedented study conducted in Portugal, adding substantial knowledge to the nursing discipline. However, further research into implementing psychoeducation in a surgical context is suggested aiming to consolidate the results of research already carried out internationally.
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  • 文章类型: Journal Article
    背景:本研究的目的是通过一项集群随机对照试验(cRCT),研究精神科访视护士提供的简短家庭心理教育(BFP)计划对精神分裂症患者家庭照顾者的照顾者负担的影响。
    方法:这项研究是一项双臂研究,平行组cRCT。将47个精神病访视护士机构随机分配到BFP计划组(干预组)或照常治疗组(TAU;对照组)。精神科探访护士使用随机排序的列表招募精神分裂症患者的照顾者。主要结果是照顾者负担,使用日文版的Zarit负担访谈来衡量。结果评估是在基线时进行的,1个月随访,6个月随访。进行了意向治疗分析,以检查BFP计划对护理人员负担的影响。
    结果:34个精神科探访护士机构和83名精神分裂症患者的家庭照顾者参与了这项研究。参与者流失率低于20%。对该计划的坚持率为100%。与TAU组相比,BFP方案组降低了护理人员的负担.然而,在1个月随访时(校正平均差值[aMD]=0.27,95%CI=-5.48~6.03,p=0.93,d=0.01)或6个月随访时(aMD=-2.12,95%CI=-7.80~3.56,p=0.45,d=0.11),这种改善并不显著.
    结论:精神科访视护士提供的BFP计划并未显著减轻护理人员的负担。这一结果可能是由于COVID-19大流行导致继续研究的困难,这阻止了我们实现满足统计能力要求所需的目标样本量,以及负担相对较低的护理人员的参与。然而,该方案的优点是对治疗计划的依从性高。应使用更大的样本量和更多样化的样本进行进一步的研究,其中包括护理负担较高的护理人员。
    背景:研究方案于2019/09/18在大学医院医学信息网络临床试验注册中心(UMIN000038044)中注册。
    BACKGROUND: The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT).
    METHODS: The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden.
    RESULTS: Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = - 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = - 2.12, 95% CI = - 7.80 to 3.56, p = 0.45, d = 0.11).
    CONCLUSIONS: The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden.
    BACKGROUND: The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.
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  • 文章类型: Journal Article
    背景:由于工作的性质和工作的封闭环境,精神科护士很容易受到负面情绪的威胁。在这项研究中,目的调查精神科护士抑郁的发生率及影响因素。
    方法:采用横断面调查方法,对2022年6月至2023年6月在某医院精神科工作的64名护士进行了调查。贝克抑郁量表(BDI)问卷对所有参与者进行了调查,根据BDI评分分为抑郁组(>4分)和非抑郁组(≤4分)。测量了这两组的一般社会学和疾病相关特征,和有显著差异的项目通过logistic回归分析,得出影响精神科护士抑郁发生的因素。
    结果:被调查医院的12名精神科护士表现出抑郁症状,率18.75%。单因素分析揭示了抑郁组和非抑郁组之间在每日睡眠时间方面的差异,每周工作时间,职称,工作压力,体育锻炼,服务年限,和身体状况。通过逻辑回归的进一步分析显示,每天的睡眠时间,每周工作时间,和身体状况是影响精神科护士抑郁发生的因素。
    结论:精神科护士对抑郁症的脆弱性,这可能会受到日常睡眠时间的影响,每周工作时间,和身体状况,值得临床重视,以便制定早期干预对策。
    BACKGROUND: Psychiatric nurses are vulnerable to the menace of negative emotions due to the nature of their work and the closed environment in which they work. In this study, we aimed to investigate the incidence and influencing factors of depression among psychiatric nurses.
    METHODS: A cross-sectional survey method was adopted to investigate 64 nurses working in the psychiatric department of a hospital from June 2022 to June 2023. The Beck Depression Inventory (BDI) questionnaire was administered to all included respondents, who were divided into depressed group (>4 points) and non-depressed group (≤4 points) according to the BDI scores. General sociological and disease-related characteristics of these two groups were measured, and items with significant differences were analyzed by logistic regression to derive factors that have an impact on the occurrence of depression among psychiatric nurses.
    RESULTS: Twelve psychiatric nurses in the surveyed hospital exhibited signs of depressive symptoms, with a rate of 18.75%. The univariate analysis unveiled differences between the depressed group and the non-depressed group in terms of daily sleep time, weekly working hours, professional title, working pressure, physical exercise, length of service, and physical condition. Further analysis through logistic regression revealed that daily sleep time, weekly working hours, and physical condition were factors affecting the occurrence of depression among psychiatric nurses.
    CONCLUSIONS: The vulnerability of psychiatric nurses to depression, which are potentially influenced by daily sleep hours, weekly working hours, and physical condition, deserves clinical attention so that countermeasures can be developed for early intervention.
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  • 文章类型: Journal Article
    背景:在精神病和/或心理健康护理中缺乏独特且可衡量的结果,这对指导临床实践产生了负面影响,评估循证护理干预措施,确保面向未来的护理教育,并建立作为专业和学科的知名度。精神病学和/或心理健康护理努力证明患者报告的结果,以评估其实践的有效性。总结患者报告结果的系统评价,相关因素,测量护理/干预措施和使用的测量量表的精神和/或心理健康护理在成人人群中急性,医院的密集精神科病房和法医精神科病房将通过更好地了解对患者本身重要的事情和重要的事情来获取有关如何改善护理的重要信息。这个审查可以有助于设计,规划,提供和评估当前和未来的护理方法和分析的质量:该方案遵循Cochrane关于干预措施系统评价的方法学指导以及系统评价和荟萃分析方案的首选报告项目。搜索策略将通过与临床和方法学专家协商并探索文献来确定。OvidMEDLINE数据库,CINAHL,EMBASE,APA心理学,将搜索WebofScience和Scopus以获取所有已发表的研究。研究将根据人群中描述的标准进行筛选和选择,干预,在两名研究人员进行试点测试后,控制和结果格式。研究将分为两个阶段进行筛选:(1)标题和摘要筛选以及(2)全文筛选。基于JohannaBriggs研究所指南的数据提取和质量评估将由两名研究人员进行。数据将以叙述性综合呈现。
    背景:由于所有数据都已公开访问,因此不需要道德批准。这项工作的结果将发表在同行评审的科学杂志上。
    CRD42023363806。
    BACKGROUND: There is a lack of distinct and measurable outcomes in psychiatric and/or mental health nursing which negatively impacts guiding clinical practice, assessing evidence-based nursing interventions, ensuring future-proof nursing education and establishing visibility as a profession and discipline. Psychiatric and/or mental health nursing struggle to demonstrate patient-reported outcomes to assess the effectiveness of their practice. A systematic review that summarising patient-reported outcomes, associated factors, measured nursing care/interventions and used measurement scales of psychiatric and/or mental health nursing in the adult population in acute, intensive and forensic psychiatric wards in hospitals will capture important information on how care can be improved by better understanding what matters and what is important to patients themselves. This review can contribute to the design, planning, delivery and assessment of the quality of current and future nursing care METHODS AND ANALYSIS: This protocol follows the Cochrane methodological guidance on systematic reviews of interventions and The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. The search strategy will be identified by consultations with clinical and methodological experts and by exploring the literature. The databases Ovid MEDLINE, CINAHL, EMBASE, APA PsychARTICLES, Web of Science and Scopus will be searched for all published studies. Studies will be screened and selected with criteria described in the population, intervention, control and outcomes format after a pilot test by two researchers. Studies will be screened in two stages: (1) title and abstract screening and (2) full-text screening. Data extraction and the quality assessment based on the Johanna Briggs Institute guidelines will be conducted by two researchers. Data will be presented in a narrative synthesis.
    BACKGROUND: No ethical approval is needed since all data are already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.
    UNASSIGNED: CRD42023363806.
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  • 文章类型: Journal Article
    背景:心理健康护士的部署,为需要荷兰一般实践中的精神保健的个人提供额外的医疗保健提供者,预计将替代基础和专业精神保健领域的全科医生和提供者的治疗(心理学家,心理治疗师,精神病医生,等。).这项研究的目的是调查一般实践中心理健康护士部署的程度与抑郁症患者的医疗保健利用模式相关的程度。
    方法:我们将国家健康保险公司的索赔数据与一般实践中的电子健康记录相结合。分析了2014年至2019年抑郁症患者的医疗保健利用模式(N=31,873)。根据一般实践中心理健康护士的部署程度,评估了抑郁症发作后接受治疗的个体比例的变化。
    结果:接受全科医生治疗的抑郁症患者的比例,在基础和专业精神卫生保健中,在具有高精神卫生护士部署的实践中,个体的比例较低。虽然精神卫生护士部署与基本精神卫生保健咨询之间的关联对于耗尽免赔额的个人而言较小,协会仍然很重要。在心理健康护士部署水平较高的情况下,全科医生的治疗量也较低。
    结论:在普通实践中接受护理的个人,在其他医疗保健环境中接受精神保健提供者治疗的可能性较低。需要更多的研究来评估从专业精神保健到一般实践的替代护理在多大程度上可能与专业精神保健的等待时间相关。
    BACKGROUND: The deployment of the mental health nurse, an additional healthcare provider for individuals in need of mental healthcare in Dutch general practices, was expected to substitute treatments from general practitioners and providers in basic and specialized mental healthcare (psychologists, psychotherapists, psychiatrists, etc.). The goal of this study was to investigate the extent to which the degree of mental health nurse deployment in general practices is associated with healthcare utilization patterns of individuals with depression.
    METHODS: We combined national health insurers\' claims data with electronic health records from general practices. Healthcare utilization patterns of individuals with depression between 2014 and 2019 (N = 31,873) were analysed. The changes in the proportion of individuals treated after depression onset were assessed in association with the degree of mental health nurse deployment in general practices.
    RESULTS: The proportion of individuals with depression treated by the GP, in basic and specialized mental healthcare was lower in individuals in practices with high mental health nurse deployment. While the association between mental health nurse deployment and consultation in basic mental healthcare was smaller for individuals who depleted their deductibles, the association was still significant. Treatment volume of general practitioners was also lower in practices with higher levels of mental health nurse deployment.
    CONCLUSIONS: Individuals receiving care at a general practice with a higher degree of mental health nurse deployment have lower odds of being treated by mental healthcare providers in other healthcare settings. More research is needed to evaluate to what extent substitution of care from specialized mental healthcare towards general practices might be associated with waiting times for specialized mental healthcare.
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