技术在改善共病药物使用和精神障碍管理的共病护理实施项目中的作用评估

Maria Gabriela Uribe Guajardo, A. Baillie, Eva Louie, Vicki Giannopoulos, K. Wood, Ben Riordan, P. Haber, K. Morley
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引用次数: 3

摘要

在药物使用治疗环境中,多达70%的人可能会出现合并症心理健康问题。管理共病的综合方法,在药物和酒精环境中实施循证干预,仍然存在问题。技术可以帮助采用循证实践来实施有效的治疗-医疗保健途径。这项研究试图检查参与一项旨在改善共病管理循证实践实施情况的项目的参与者定制门户网站利用的各个方面(障碍和促进者)——共病护理途径(PCC)。方法设计自我报告问卷和半结构化访谈,在9个月的干预中测量临床医生对PCC门户网站和电子资源的满意度。“不采用、放弃、扩大、扩散和可持续性”(NASSS)框架的改编版本促进了对调查结果的讨论。结果20名来自毒品和酒精服务机构的参与者对所有措施做出了回应。调解人包括:(一)。临床医生接受入口;(ii)。临床监督或拥护者的指导,以鼓励使用电子资源。障碍包括:(i)。疾病(情况)的复杂性;(ii)。参与者对面对面资源和培训模式的偏好(采用者制度);以及(iii)。缺乏关于如何使用门户网站(技术和组织)的面对面培训。结论基于NASSS框架,我们确定了使用门户网站的几个障碍和促进因素,包括疾病的复杂性、缺乏面对面的培训以及临床医生对培训媒介的偏好。建议包括持续的组织支持、内部临床监督和与临床提供者的协商,以协助开发量身定制的电子健康资源,并就如何操作和有效利用这些资源提供公开培训机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The evaluation of the role of technology in the pathways to comorbidity care implementation project to improve management of comorbid substance use and mental disorders
In substance use treatment settings, comorbid mental health problems can occur in up to 70% of people. An integrated approach for managing comorbidity, implementing evidence-based intervention in drug and alcohol settings, remains problematic. Technology can help in adopting evidence-based practice to implement effective treatment healthcare pathways. This study sought to examine aspects of tailored portal utilization (barriers and facilitators) by participants taking part in a program aimed at improving the implementation of evidence-based practice for comorbidity management Pathways to Comorbidity Care (PCC). Method A self-report questionnaire and a semi-structured interview were designed to measure clinician satisfaction with the PCC portal and e-resources throughout a 9-month intervention. An adapted version of the “Non-adoption, Abandonment, Scale-up, Spread and, Sustainability” (NASSS) framework facilitated discussion of the findings. Results Twenty participants from drug and alcohol services responded to all measures. Facilitators included: (i). clinician acceptance of the portal; (ii). guidance from the clinical supervisor or champion to encourage e-resource use. Barriers included: (i). complexity of the illness (condition); (ii). participants’ preference (adopter system) for face-to-face resources and training modes; and, (iii). lack of face-to-face training on how to use the portal (technology and organization). Conclusion Based on the NASSS framework, we identified several barriers and facilitators of the use of the portal including the complexity of illness, lack of face-to-face training, and clinician preference for training mediums. Recommendations include ongoing organizational support, in-house clinical supervision, and consultation with clinical providers to assist in the development of tailored e-health resources and open training opportunities on how to operate and effectively utilize these resources.
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