慢性病患者使用心理健康和成服务
Arrti A Bhasin1, Amber O Molnar1,2,3,4, Eric McArthur2,5
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
概括
患有慢性病 (CKD) 的患者使用心理健康服务的频率较低,因为他们的功能下降. 这项在加拿大安大略省的研究发现,晚期CKD和透析患者的利用率较低.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 焦虑和抑郁等心理健康问题在慢性病 (CKD) 患者中很普遍.
- 这些情况会对患者的生活质量,治疗坚持和死亡率产生负面影响.
- 了解在CKD中使用心理健康服务至关重要,但仍然在很大程度上是未知的.
研究的目的:
- 调查功能不同阶段的心理健康和成服务的利用模式.
- 为了确定不同程度的慢性病患者在服务获取方面的差异.
主要方法:
- 在加拿大安大略省 (2009-2017年) 使用链接的医疗保健数据库进行了基于人口的横截面研究.
- 在前3年内使用心理健康和成服务的患病率被分析为eGFR水平 (≥60,45-59,30-44,15-29,<15毫升/分钟/1.73米2,以及维持透析).
- 计算了调整后的流行率 (PRs),控制了人口统计和临床因素.
主要成果:
- 在近600万成年人中,9%的eGFR<60毫升/分钟/1.73米2或在透析中.
- 具有eGFR<60毫升/分钟/1.73平方米的个体,与具有eGFR≥60毫升/分钟/1.73平方米 (35%) 的个体相比,其整体心理健康和成服务利用率较低 (28-31%).
- 在晚期的CKD中观察到显著较低的利用率:eGFR 15-29 (aPR 0.86),eGFR <15 (aPR 0.81),以及维持透析 (aPR 0.83),主要是由于门诊服务使用减少.
结论:
- 在CKD患者中,使用心理健康和成服务是常见的,但在晚期病中显著下降.
- 功能较差的人,特别是透析患者或EGFR非常低的人,使用这些服务的频率较低.
- 可能需要有针对性的干预措施来改善晚期CKD患者获得心理健康服务的机会.
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