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Stakeholder Experiences in a Stepped Collaborative Care Study Within US Army Clinics

机译：利益相关者在美国陆军诊所进行的协作医疗研究中的经验

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Objective: This article examines stakeholder experiences with integrating treatment for posttraumatic stress disorder (PTSD) and depression within primary care clinics in the U.S. Army, the use-of-care facilitation to improve treatment, and the speck therapeutic tools used within the Stepped Treatment Enhanced PTSD Services Using Primary Care study. Methods: We conducted a series of qualitative interviews with health care providers, care facilitators, and patients within the context of a large randomized controlled trial being conducted across 18 Army primary care clinics at 6 military installations. Results: Most of stakeholders' concerns clustered around the need to improve collaborative care tools and care facilitators and providers' comfort and abilities to treat behavioral health issues in the primary care setting. Conclusions: Although stakeholders generally recognize the value of collaborative care in overcoming barriers to care, their perspectives about the utility of different tools varied The extent to which collaborative care mechanisms are well understood, navigated, and implemented by providers, care facilitators, and patients is critical to the success of the model. Improving the design of the web-based therapy tools, increasing the frequency of team meetings and case presentations, and expanding training for primary care providers on screening and treatment for PTSD and depression and the collaborative care model's structure, processes, and offerings may improve stakeholder perceptions and usage of collaborative care.
机译：目的：本文探讨了利益相关者在美军基层医疗诊所整合创伤后应激障碍（PTSD）和抑郁症的治疗，使用护理促进措施以改善治疗的经验，以及逐步治疗增强中使用的斑点治疗工具的经验PTSD服务使用初级保健研究。方法：在一项大型随机对照试验的背景下，我们在6个军事机构的18个陆军基层医疗诊所进行了大规模的随机对照试验，对医疗服务提供者，护理服务提供者和患者进行了一系列定性访谈。结果：大多数利益相关者的关注都集中在以下方面：改进协作护理工具和护理促进者以及提供者的舒适度和能力，以治疗初级保健环境中的行为健康问题。结论：尽管利益相关者通常认识到协作式护理在克服护理障碍方面的价值，但他们对不同工具的效用的看法却各不相同。提供商，护理促进者和患者对协作式护理机制的理解，程度和实施程度是模型成功的关键。改善基于Web的治疗工具的设计，增加团队会议和病例介绍的频率，并扩大对初级保健提供者的PTSD和抑郁症筛查和治疗的培训，以及协作治疗模型的结构，流程和服务可能会改善利益相关者对合作医疗的看法和使用。

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