Mental health literacy in primary care: Canadian Research and Education for the Advancement of Child Health (CanREACH).

Evidence-Based Medicine Pub Date : 2017-08-01 Epub Date: 2017-07-22 DOI:10.1136/ebmed-2017-110714
Eden S N McCaffrey, Samuel Chang, Geraldine Farrelly, Abdul Rahman, David Cawthorpe
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引用次数: 18

Abstract

The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period. Referrals were analysed for evidence of change based on frequencies and measures of clinical urgency. Participants of the training programme also completed standardised baseline and outcome self-evaluations. Congruent with participants self-reported evaluative reports of improved knowledge and practice, analysis of referral frequency and the clinical urgency of referrals to paediatric psychiatric services over the study period indicated that trained physicians made more appropriate referrals (clinically more severe) and reduced referrals to emergency services. Quantitative clinical differences as completed by intake clinicians blind to referrals from the study group designations were observed within the trained physician group pretraining and post-training, and between the trained physician group and the unexposed physician group. The results illustrate a novel model for objectively measuring change among physicians based on training in paediatric mental health management.

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初级保健中的心理健康素养:加拿大促进儿童健康的研究和教育(CanREACH)。
为初级保健提供者设计的儿科精神药理学继续教育方案的有效性是客观衡量的,其基础假设是培训将导致转诊模式的可衡量变化和转诊患者的既定临床措施。自2002年以来,使用已建立的、有效的、可靠的临床紧急措施嵌入到区域医疗保健系统中,比较了参加培训的医生(n=99)在培训前和培训后转诊到儿童和青少年精神科服务的情况,并与同期未参加/未接受培训的转诊医生(n=7753)进行了比较。根据频率和临床急迫性措施分析转诊的变化证据。培训方案的参与者还完成了标准化的基线和结果自我评价。与参与者自我报告的关于知识和实践改进的评估报告一致,对研究期间转介到儿科精神科服务的频率和临床紧迫性的分析表明,经过培训的医生进行了更适当的转诊(临床上更严重),并减少了转介到急诊服务的次数。在训练有素的医生组训练前和训练后,以及训练有素的医生组和未暴露的医生组之间,通过对研究组指定的转诊不知情的摄入临床医生完成的定量临床差异被观察到。结果说明了一个新的模型,客观地衡量变化的医生在儿科心理健康管理培训的基础上。
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