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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >From consultation-liaison psychiatry to integrated care for multiple and complex needs.
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From consultation-liaison psychiatry to integrated care for multiple and complex needs.

机译：从咨询联络精神病学到综合护理，满足多种复杂需求。

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The aim of the present study was to review the ways in which contemporary medicine addresses physical/psychiatric multimorbidity, to review the underlying concepts and methodologies used, and to propose a novel approach that may help consultation-liaison psychiatry (CLP) position itself better in the health-care field. A Medline search of the terms 'consultation-liaison psychiatry', 'integrated care', 'quality assurance' and 'qualitative methodology', was complemented by study of the literature on complexity theory and by discussions with colleagues in both the health science and sociology fields. There is a growing realization that presentation with multimorbidity of both physical and psychiatric disorders is the norm. Other health-care disciplines have responded quickly to meeting the multiple and complex needs of such patients, attracting funding to an extent that CLP has been unable to achieve. Uncritical application, however, of integrated care technology based on evidence from randomized controlled trials has produced disappointing results. There is a growing realization that such quantitative methods need to be complemented by in-depth exploration using non-traditional methods including qualitative ones, and drawing on complexity theory. The Cochrane Collaboration is exploring this. As CLP and other medical and health-care disciplines face the challenge of patients with multimorbidity, they need to find acceptable answers to the question of what works for whom in what context for patients with multiple and complex needs. CLP can contribute its rich experience in the qualitative approaches that will be needed in research addressing this question, but needs help from other disciplines to refine its techniques so that its contributions are considered valid. The context for implementing effective interventions derived from such studies will in future be that of transdisciplinary teams whose mode of working is empirically based and transparent. CLP is well placed by dint of its psychodynamic and systems theory roots to provide leadership in this transformation in health-care delivery.
机译：本研究的目的是回顾当代医学解决物理/精神病多发病的方法，回顾所使用的基本概念和方法，并提出一种新颖的方法，以帮助咨询精神病学（CLP）更好地定位自身。卫生保健领域。在Medline中对“咨询联络精神病学”，“综合护理”，“质量保证”和“定性方法论”进行了搜索，并通过研究复杂性理论文献以及与卫生科学和社会学领域的同事进行了讨论领域。越来越多的人意识到，身体和精神疾病多发病的表现是很规范的。其他医疗保健学科对满足此类患者的多种复杂需求做出了快速反应，吸引的资金达到了CLP无法实现的程度。然而，基于随机对照试验的证据，综合护理技术的非关键性应用产生了令人失望的结果。越来越多的人意识到，这种定量方法需要通过使用包括定性方法在内的非传统方法并利用复杂性理论进行深入探索来加以补充。 Cochrane合作组织正在对此进行探索。随着CLP以及其他医学和卫生保健学科面临多种疾病患者的挑战，他们需要找到对于在哪些情况下对多种和复杂需求患者适用于谁的问题的可接受答案。 CLP可以在解决此问题的研究中需要的定性方法中贡献其丰富的经验，但是需要其他学科的帮助来完善其技术，这样才能认为其贡献是有效的。将来，从此类研究中实施有效干预措施的环境将是跨学科团队，其工作模式是基于经验的且透明的。 CLP凭借其良好的心理动力学和系统理论基础而处于有利位置，可以在医疗服务的这一转变中发挥领导作用。

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