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流行病的影响与坚定的社区治疗服务忠诚度的系统性下降相比是微不足道的 - - 加拿大安大略省的一项省级研究
Samuel Law1,2,3, Aly Kassam4, Michaela Beder5,6
1MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. samuel.law@unityhealth.to.
Administration and policy in mental health
|April 16, 2024
概括
由于COVID-19大流行,加拿大安大略省的强烈社区治疗 (ACT) 质量略有下降,影响了服务和人员配置. 然而,ACT表现出了弹性,尽管在过去的十年中,整体忠诚度有所下降.
科学领域:
- 精神病学和心理健康服务研究研究
- 公共卫生和医疗保健业务 公共卫生和医疗保健业务
背景情况:
- 坚定的社区治疗 (ACT) 模式是社区心理健康护理的基石,用于严重精神疾病患者.
- 随着COVID-19的流行,医疗保健的提供受到严重干扰,尤其是基于外展服务的服务,如ACT.
- 达特斯ACT量表 (DACTS) 是一个验证的工具,用于评估ACT课程的质量和忠实性.
研究的目的:
- 量化评估COVID-19大流行对加拿大安大略省ACT服务质量的影响.
- 确定受大流行影响的ACT特定领域,并比较大流行前水平和历史趋势的变化.
主要方法:
- 在安大略省80个ACT团队的临床和行政领导人进行了使用达特斯ACT尺度 (DACTS) 的横截面在线调查.
- 评估了ACT质量在COVID爆发前的一年 (2018-2019) 和COVID爆发后的一年 (2020-2021) 的时间.
- 统计分析比较了跨领域和时间段的DACTS分数,考虑了面对面接触和人员配置等因素.
主要成果:
- 在安大略省,在COVID前,ACT的整体忠诚度为3.65.
- 流行病与所有DACTS领域的统计学显著下降有关:人力资源 (-4.92%),组织边界 (-1.03%),和服务性质 (-6.18%).
- 与大流行相关的总体下降幅度是温和的 (-3.84%),归因于人与人接触减少,服务提供和劳动力挑战.
结论:
- 虽然疫情导致了ACT质量领域的显著,具体的减少,但整体影响是温和的,表明模型的适应性和弹性.
- 在过去的15年中,ACT忠诚度下降的一个令人担忧的现有趋势被突出显示,COVID前的得分明显低于历史数据.
- 量化忠实性评估对于理解服务中断和解决社区心理健康护理系统性质量偏移至关重要.
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