[专业人员对在魁北克心理问题计划框架内实施指导性自助的看法]。

IF 0.4 Q4 PSYCHIATRY Sante Mentale au Quebec Pub Date : 2024-01-01
Quentin Bet, Alexane Gilbert, Juliette Bergeron, Isabelle Fournel, Josée Savard, Guillaume Foldes-Busque, Martin D Provencher
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引用次数: 0

摘要

目标 焦虑症和抑郁症等常见精神障碍会给个人和社会带来许多后果。针对这些疾病的治疗方法多种多样,包括药物治疗和认知行为疗法。当这些障碍属于轻度或中度时,心理治疗是推荐的一线治疗方法,因为心理治疗的长期疗效优于药物治疗。然而,实际情况并非如此:药物治疗比心理治疗使用得更广泛,而心理治疗的可及性却因漫长的等待名单而大打折扣。阶梯式护理模式是解决这些困难的另一种方法,其中包括指导自助。这些都是低强度的干预措施,使更多的人能够以较少的资源(如与专业人员会面的次数较少)获得治疗。魁北克精神障碍项目(PQPTM)是最近在魁北克的一些环境中实施的一种阶梯式护理模式。本研究的目的是收集一家综合社会福利中心(CI[U]SSS;社区精神健康中心)的社工(SWs)对实施 PQPTM 指导自助的看法。为此,我们与 13 名社工进行了三次焦点小组讨论,时间约为 1 小时 30 分钟。根据研究实施综合框架(CFIR)和参与者在焦点小组中的回答,采用主题定性归纳-演绎法对数据进行了编码和分析。结果 在 PQPTM 指导下实施自助的障碍和促进因素与不同的 CFIR 构建相关:干预特征(如监控、自助类型)、内部实施参数(如培训、组织压力)、护理者特征(如经验、适当时间)、使用者特征(如年龄、个性)和过程(如治疗完整性、监督)。这项定性研究的结果表明,社工对 PQPTM 引导式自助有不同的认识和看法:在讨论的主题中,64%有细微差别,25%完全被视为障碍,11%完全被视为促进因素。结论 这些结果揭示了有助于在魁北克省成功实施 PQPTM 引导式自助的因素,以期在当前研究的特定 CI(U)SSS 中心和魁北克省其他精神健康中心加以改进。在这方面提出了几项建议:例如,增加未来实施的上游规划,保持培训和监督的机会,以及保证自助指南的可用性和印刷。
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[Professionals' Perceptions Regarding the Implementation of Guided Self-help in the context of the Programme québécois pour les troubles mentaux].

Objective Common mental disorders, such as anxiety and depression, have many individual and societal consequences. Various treatments are available for people with these diagnoses, including medication and cognitive behavioral therapy. When these disorders are mild or moderate, psychotherapy is the recommended first-line treatment, given its greater long-term efficacy than pharmacotherapy. However, this is not what is observed in practice: medication is much more widely used than psychotherapy, the latter's accessibility being greatly reduced by long waiting lists. An alternative to these accessibility difficulties is the stepped-care model, which includes guided self-help. These are low-intensity interventions that enable more people to be treated with fewer resources (e.g., fewer meetings with a professional). The Programme québécois pour les troubles mentaux (PQPTM; Quebec Program for Mental Disorders) is a stepped-care model recently implemented in some settings in Quebec. The aim of this study is to gather the perceptions of social workers (SWs) in a Centre intégré (universitaire) de santé et de services sociaux (CI[U]SSS; Community mental health center) on the implementation of the PQPTM guided self-help. Methods To this end, three focus groups of approximately 1h30 were conducted with 13 SWs. The data were coded and analyzed using a thematic qualitative inductive-deductive approach, based on the Consolidated Framework for Implementing Research (CFIR) and the participants' responses obtained during the focus groups. Results The barriers and facilitators to PQPTM guided self-help implementation identified relate to different CFIR constructs: intervention characteristics (e.g., monitoring, type of self-help), internal implementation parameters (e.g., training, organizational pressures), caregiver characteristics (e.g., experience, appropriation time), user characteristics (e.g., age, personality) and process (e.g., treatment integrity, supervision). The results of this qualitative study show that SWs have varied perceptions and opinions of the PQPTM guided self-help: 64% of the themes discussed were nuanced, while 25% were considered exclusively as barriers and 11% exclusively as facilitators. Conclusion These results shed light on the factors that can contribute to the successful implementation of the PQPTM guided self-help in Quebec, with a view to improving it at the heart of the specific CI(U)SSS of the current study and in other mental health centers in Quebec. Several recommendations are made in this respect: for example, to increase upstream planning for future implementations, to maintain access to training and supervision, and to guarantee the availability and printing of self-help guides.

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来源期刊
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期刊介绍: In 1976, the community mental health centre (Centre de santé mentale communautaire) of Saint-Luc Hospital organized the first symposium on sector psychiatry. During deliberations, the participants expressed the idea of publishing the various experiences that were then current in the field of mental health. With the help of the symposium’s revenues and the financial support of professionals, the Centre de santé mentale communautaire edited the first issue of Santé mentale au Québec in September 1976, with both objectives of publishing experiences and research in the field of mental health, as well as facilitating exchange between the various mental health professionals.
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