背景:来自梅奥诊所的一个家庭医学团队,罗切斯特于2019年集结,为拉克鲁兹服务不足的患者提供家访和直接护理。哥斯达黎加。除了提供直接的病人护理,我们的团队有兴趣开展一项基于社区需求的评估,以利用当地反馈和医生数据,确定医疗机构教育工作的区域和当地医疗机构在慢性健康问题上的工作.基于该地区不断上升的自杀率以及有限的精神病学服务,自杀意识和预防被确定为优先事项。在一些主要的条件下,每100,000人中有约0.60名精神科医生。我们的小组为当地卫生工作者提供了为期半天的有关自杀意识的心理健康主题的教育课程。这项研究的主要目的是评估实践中任何持久的变化,信心,以及当地卫生工作者的知识归因于我们的培训,并增加了对这一主题的有限研究。方法通过当地提供者招募来自当地医院的两组参与者(81),并在一天内分为上午和下午两组。每个组包括初级保健提供者,护士,社会工作者,和财务官员。两者都得到了相同的教育演讲,可以广泛应用于每个不同的角色。我们的团队提供心理健康讲座,以及如何提高个人韧性。使用了当地医学培训的翻译人员。讲座前和课后调查收集了人口统计数据,这些心理健康问题的经验,以及解决心理健康问题的信心。讲座前和课后调查,包括开放式以及李克特量表和多项选择题,在每次讲座的开始和结束时都分发给所有参与者。使用SurveyMonkey通过电子邮件进行了四到六个月的跟踪调查,以评估教育材料的保留和影响。结果最初的两组参与者(n=81)年龄为23-60岁(平均:43),67%(39)为女性。工作经验从0到37年不等(平均:14),其中64%(37)进行直接患者护理。参与者(n=44)的初步演讲内容数据表明,与预测试相比,正确回答的总体增加了+15.4%(正确百分比,38.1%)后测(53.5%,p<0.01)。与以前没有接触过自杀的人相比,过去接触过自杀的人(n=55)更有可能报告询问患者自杀(56.3%vs.8.3%;p<0.01)。在对参与者进行为期六个月的随访中(n=11),当被问及他们对从之前的讲座中学习目标的信心时,低置信度下降,高置信度改善,但无统计学意义.受访者对心理健康问题的低信心率从35.2%下降到0%(p<0.01)。结论我们小组能够成功地向哥斯达黎加自称为精神健康问题的地区的卫生工作者的混合听众进行讲座。调查表明学习发生了。注意到一种趋势,表明随着时间的推移,教育内容提高了参与者的信心和知识成分。未来的服务旅行可能能够在这种初始经验的基础上,改进提高能力的方法,同时向有需要的地区提供直接护理。
Background A family medicine team based out of Mayo Clinic, Rochester assembled in 2019 to provide home visits and direct care to underserved populations of patients in La Cruz, Costa Rica. In addition to the provision of direct patient care, our team was interested in conducting a community needs-based assessment to identify an area for provider education efforts and the local providers on a chronic health issue using local feedback and physician data. Suicide awareness and prevention were identified as a priority based on rising suicide rates as well as limited psychiatry services in the area, with some major providences having ~0.60 psychiatrists available per 100,000 people. Our group provided a half-day educational course on mental health topics related to suicide awareness for local health workers. The primary objective of this study was to evaluate any lasting changes in practice, confidence, and knowledge among local health workers attributable to our training and add to the limited research on this topic. Methods Two groups of participants (81) from local hospitals were recruited via local providers and divided into two morning and afternoon groups on a single day. Each group comprised primary care providers, nurses, social workers, and finance officers. Both were given the same educational presentation that could be broadly applied to each various role. Our team provided lectures on mental health, as well as how to improve personal resilience. Locally medically trained translators were used. Pre and post-lecture surveys gathered demographic data, experience with these mental health issues, and confidence in addressing mental health concerns. Pre and post-lecture surveys, including open-ended as well as Likert scale and multiple-choice questions, were handed out at the beginning and end of each lecture to all participants. A four to six months follow-up survey was delivered by email using SurveyMonkey to evaluate retention and impact of educational materials. Results The initial two groups of participants (n = 81) were aged 23-60 years (mean: 43), and 67% (39) were female. Work experience ranged from 0 to 37 years (mean: 14) with 64% (37) doing direct patient care. Preliminary lecture content data from participants (n = 44) demonstrated an overall increase in correct responses by +15.4% from the pre-test (percent correct, 38.1%) to post-test (53.5%, p < 0.01). Individuals (n = 55) with past exposure to suicide were much more likely to report asking patients about suicide than those with no prior exposure (56.3% vs. 8.3%; p < 0.01). At the six-month follow-up with participants (n = 11), when asked about their confidence in learning objectives from the lecture given prior, the rates of low confidence decreased as well as the level of high confidence improved but was not statistically significant. The rate of low confidence of respondents\' confidence in asking about mental health concerns decreased from 35.2% to 0% (p < 0.01). Conclusions Our group was able to successfully deliver lectures to a mixed audience of health workers in a region self-identified as struggling with mental health issues in Costa Rica. The surveys suggested learning occurred. A trend suggestive that the educational content improved the participants\' confidence and knowledge components over time was noted. Future service trips may be able to build on this initial experience to improve on ways to raise capacity while delivering direct care to regions in need.