背景:英格兰严重精神疾病患者的心血管疾病是导致过早死亡的主要可预防因素。为了解决这个问题,从2019年起,在伦敦的3个普通诊所中实施了护士和同伴教练提供的服务(Primrose-A)(在COVID-19期间继续实施).本研究旨在与患者和工作人员进行访谈,以确定以下各项的可接受性,和经验,月见草-A.
方法:对8名接受过Primrose-A治疗的患者进行半结构化录音访谈,还有3个护士,1个GP,并进行了1名同行教练,他们在伦敦的3次GP手术中交付了Primrose-A。反思性主题分析用于从转录的访谈中识别主题。
结果:总体而言,患者和工作人员对报春花A的看法是积极的,参与者描述了改善患者心理健康的成功,隔离,动机,和身体健康。医护人员和患者之间的治疗关系,长期定期预约是患者参与和接受干预的重要促进因素.确定了实施报春花A的几个障碍,包括培训,行政和沟通问题,时间和资源的负担,和COVID-19。
结论:干预可接受性可以通过提供更长期的连续性护理与更多的同伴辅导会议来建立积极的关系和促进持续的健康行为改变来提高。未来实施Primrose-A或类似干预措施应考虑:(1)培训充分性(涵盖身心健康,包括成瘾),(2)提供足够的人员来进行干预,(3)促进员工之间明确的沟通途径,(4)支持行政流程。
BACKGROUND: Cardiovascular disease among patients with severe mental illness in England is a major preventable contributor to premature mortality. To address this, a nurse and peer-coach delivered service (Primrose-A) was implemented in three London general practices from 2019 (implementation continued during COVID-19). This study aimed to conduct interviews with patient and staff to determine the acceptability of, and experiences with, Primrose-A.
METHODS: Semi-structured audio-recorded interviews with eight patients who had received Primrose-A, and 3 nurses, 1 GP, and 1 peer-coach who had delivered Primrose-A in three London-based GP surgeries were conducted. Reflexive thematic analysis was used to identify themes from the transcribed interviews.
RESULTS: Overall, Primrose-A was viewed positively by patients and staff, with participants describing success in improving patients\' mental health, isolation, motivation, and physical health. Therapeutic relationships between staff and patients, and long regular appointments were important facilitators of patient engagement and acceptance of the intervention. Several barriers to the implementation of Primrose-A were identified, including training, administrative and communication issues, burden of time and resources, and COVID-19.
CONCLUSIONS: Intervention acceptability could be enhanced by providing longer-term continuity of care paired with more peer-coaching sessions to build positive relationships and facilitate sustained health behaviour change. Future implementation of Primrose-A or similar interventions should consider: (1) training sufficiency (covering physical and mental health, including addiction), (2) adequate staffing to deliver the intervention, (3) facilitation of clear communication pathways between staff, and (4) supporting administrative processes.