Đánh giá Trước khi Triển khai Chương trình PARTNER-MH: Can thiệp về Chăm sóc Sức khoẻ Tâm thần cho Các cựu chiến binh Thiểu số trong Hệ thống Y tế của VHA

Administration in mental health - Tập 48 - Trang 46-60 - 2020
Johanne Eliacin1,2,3, Marianne S. Matthias1,3,4, Diana J. Burgess5, Scott Patterson6, Teresa Damush1,3,7, Mandi Pratt-Chapman8, Mark McGovern9, Matthew Chinman10, Tasneem Talib3, Caitlin O’Connor1, Angela Rollins1,2,3
1VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VAMC, Indianapolis, USA
2Psychology Department, ACT Center of Indiana, IUPUI, Indianapolis, USA
3Regenstrief Institute, Inc, Indianapolis, USA
4Department of Communication Studies, IUPUI, Indianapolis, USA
5Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, USA
6Department of Psychiatry, Richard L. Roudebush VAMC, Indianapolis, USA
7General Internal Medicine, Indiana University School of Medicine, Indianapolis, USA
8Institute for Patient-Centered Initiatives & Health Equity, George Washington University Cancer Center, Washington, USA
9Psychiatry & Behavioral Sciences; Medicine, Stanford University School of Medicine, Stanford, USA
10Veterans Integrated Service Network 4 Mental Illness Research, Education and Clinical Center and the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, USA

Tóm tắt

Để thiết kế PARTNER-MH, một chương trình hỗ trợ bệnh nhân do đồng nghiệp dẫn dắt nhằm triển khai trong các cơ sở chăm sóc sức khoẻ tâm thần của Cơ quan Quản lý Cựu chiến binh (VHA), chúng tôi đã thực hiện một đánh giá trước khi triển khai trong quá trình phát triển can thiệp để đánh giá quan điểm của các bên liên quan về can thiệp và khám phá các yếu tố triển khai quan trọng cho việc áp dụng trong tương lai. Đây là một nghiên cứu phương pháp hỗn hợp hội tụ bao gồm các cuộc phỏng vấn bán cấu trúc định tính và dữ liệu khảo sát. Việc thu thập dữ liệu được hướng dẫn bởi Khung Đánh giá Triển khai Hợp nhất (CFIR). Chúng tôi đã phỏng vấn và tiến hành khảo sát đối với 23 đồng nghiệp và 10 giám sát viên từ 12 cơ sở VHA ở khu vực miền Trung Tây. Chúng tôi đã sử dụng phương pháp phân tích suy diễn và quy nạp để phân tích dữ liệu định tính. Chúng tôi cũng đã thực hiện phân tích mô tả và Kiểm định Fisher Exact để so sánh phản hồi từ khảo sát của đồng nghiệp và giám sát viên. Chúng tôi đã tam giác hóa các phát hiện để hoàn thiện can thiệp. Tổng thể, các đối tượng phản hồi coi PARTNER-MH một cách tích cực. Tuy nhiên, họ nhìn nhận sự tập trung của can thiệp vào các cựu chiến binh thiểu số và khung sức khoẻ xã hội như những rào cản tiềm tàng, cho rằng điều này có thể ảnh hưởng tiêu cực đến cách thức triển khai can thiệp, làm phức tạp quy trình thực hiện và tác động đến việc áp dụng. Họ cũng xem cấu trúc phòng khám, tài nguyên hiện có, và khí hậu học tập như những rào cản tiềm tàng. Sự lựa chọn và thảo luận của đồng nghiệp và giám sát viên về các mục CFIR là tương tự nhau. Các phát hiện của chúng tôi đã cung cấp thông tin cho sự phát triển của PARTNER-MH và giúp xác định các yếu tố có thể tác động đến việc triển khai. Dự án này phản ứng với sự công nhận ngày càng cao về nhu cầu tích hợp khoa học thực thi vào nghiên cứu về sự chênh lệch trong chăm sóc sức khoẻ. Hiểu rõ sự kháng cự đối với sự tập trung của can thiệp vào các cựu chiến binh thiểu số và các rào cản tiềm tàng từ các yếu tố bối cảnh giúp chúng tôi điều chỉnh can thiệp trước khi thử nghiệm, với nỗ lực tối đa hoá sự thành công trong triển khai.

Từ khóa

#PARTNER-MH #cựu chiến binh #can thiệp sức khoẻ tâm thần #sự chênh lệch trong chăm sóc sức khoẻ #nghiên cứu khoa học thực thi #đánh giá trước khi triển khai

Tài liệu tham khảo

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