促进澳大利亚失眠患者持续获得认知行为疗法:系统级实施方案。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY
Alexander Sweetman, R Doug McEvoy, Michael S Frommer, Robert Adams, Ching Li Chai-Coetzer, Sallie Newell, Vivienne Moxham-Hall, Sally Redman
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引用次数: 0

摘要

研究目的:失眠症是一种发病率很高且使人衰弱的疾病。失眠认知行为疗法(CBTi)是推荐的 "一线 "治疗方法,但只有少数失眠症患者能够接受这种治疗。本文介绍了一项旨在改善澳大利亚 CBTi 使用情况的系统级实施计划,为其他地方实施 CBTi 提供参考:从 2019 年到 2023 年,我们开展了一项工作计划,以促进澳大利亚在获取 CBTi 方面的持续变革。三个不同的阶段包括:1)确定范围并绘制获取 CBTi 的障碍图;2)分析并综合障碍和促进因素,以制定变革目标;3)有组织地促进和协调变革。我们采用了系统级方法、知识中介和共同设计,并借鉴了定性、定量和实施科学方法:结果:我们从失眠症患者、初级保健临床医生和医疗系统的角度出发,确定了获得 CBTi 的障碍。我们召集了一个利益相关者咨询委员会,共同设计变革目标、识别可改变的障碍、设计项目逻辑并推动变革战略。我们启动了一项计划,通过提高初级保健临床医生对失眠症的认识和教育、自我指导干预措施以及向政府争取更多的 CBTi 资助机制,促进 CBTi 获取方面的系统级变革:该实施计划在改善澳大利亚 CBTi 的使用方面取得了重大进展。由于长期的系统性变革需要多方利益相关者投入大量持续的时间、精力和资源,因此需要持续开展工作以延续该计划。该计划可为其他地方的 CBTi 实施活动提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Promoting sustained access to cognitive behavioral therapy for insomnia in Australia: a system-level implementation program.

Study objectives: Insomnia is a highly prevalent and debilitating disorder. Cognitive behavioral therapy for insomnia (CBTi) is the recommended 'fist line' treatment, but is accessed by a minority of people with insomnia. This paper describes a system-level implementation program to improve access to CBTi in Australia to inform CBTi implementation in other locations.

Methods: From 2019 to 2023, we conducted a program of work to promote sustained change in access to CBTi in Australia. Three distinct phases included 1) Scoping and mapping barriers to CBTi access, 2) Analysis and synthesis of barriers and facilitators to devise change goals, and 3) Structured promotion and coordination of change. We used a system-level approach, knowledge brokerage, and co-design, and drew on qualitative, quantitative, and implementation science methods.

Results: We identified barriers to CBTi access from the perspectives of people with insomnia, primary care clinicians, and the health system. A stakeholder advisory committee was convened to co-design change goals, identify modifiable barriers, devise program logic and drive change strategies. We commenced a program to promote system-level change in CBTi access via; improved awareness and education of insomnia among primary care clinicians, self-guided interventions, and advocating to Government for additional CBTi funding mechanisms.

Conclusions: This implementation program made significant progress toward improving access to CBTi in Australia. Ongoing work is required to continue this program, as long-term system-level change requires significant and sustained time, effort and resources from multiple stakeholders. This program may be used to inform CBTi implementation activities in other locations.

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来源期刊
CiteScore
6.20
自引率
7.00%
发文量
321
审稿时长
1 months
期刊介绍: Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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