实施策略,以改善农村退伍军人的创伤后应激障碍护理
Nancy C Bernardy1,2,3, Lisa-Ann J Cuccurullo2, Macgregor Montano2
1White River Junction VA Medical Center Research Department, White River Junction, Vermont, USA.
概括
实施便利化显著增加了基于证据的心理治疗对患有创伤后应激障碍 (PTSD) 的农村退伍军人的影响. 这一战略有望改善资源不足的诊所的护理.
科学领域:
- 实施科学 实施科学
- 心理健康服务研究 心理健康服务研究
- 农村卫生 农村卫生
背景情况:
- 农村退伍军人患有创伤后应激障碍 (PTSD) 面临治疗不平等.
- 改善对基于证据的心理治疗 (EBP) 的准入对于这一群体至关重要.
- 现有的农村VA诊所通常对推的PTSD治疗范围有限.
研究的目的:
- 在2个农村VA医疗保健系统中增加推的PTSD治疗的交付 (覆盖范围).
- 利用实施便利化作为改善PTSD护理的战略.
- 识别农村环境中EBP交付的促进者和障碍者.
主要方法:
- 一个质量改进项目,涉及6个月为2个低范围的PTSD诊所提供便利.
- 与匹配的对照诊所进行比较,使用差异差异效应估计.
- 与诊所工作人员的采访,以确定实施促进者和障碍.
- 测量二二类药物处方和多药房,以评估处方实践的影响.
主要成果:
- 与对照诊所 (DID = 24.6) 的减少相比,以证据为基础的心理治疗在便利诊所的覆盖率增加了一倍以上.
- 在干预诊所中发现了类似的行政障碍,为改善提供了洞察力.
- 作为促进的一部分,学术细节对PTSD处方实践产生了积极的影响.
结论:
- 实施便利化是增加PTSD在农村VA诊所提供EBP的有希望的策略.
- 解决行政障碍是改善贫困地区护理的关键.
- 这种方法提供了一种可行的方法来增强农村退伍军人的心理健康服务.
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