哮喘联盟

   摘要
   目的：本研究选取美国退伍军人事务部医疗中心的创伤后应激障碍退伍军人群体，研究在常规疗法中结合使用综合护理（IC）协助其戒烟的可行性，同时，评估合作学习法（LC）对促进该疗法实施的作用。
   方法：我们组成一个包括来自12个退伍军人医疗中心的70名员工的多学科综合小组，制定了2种合作学习法，以协助综合护理法在戒烟过程中的实施。通过问卷的形式评估实施者对合作学习法的认知以及常规综合护理的有效性和可行性。通过病史档案资料统计实施综合护理法医疗人员及接受综合护理法退伍军人的数量。
   结果： >85%的退伍军人认为合作学习法是一个有效的培训和实施平台。大部分人认为综合护理法可有效地解决病人所需，并且应该加入到常规的创伤后应激障碍病人群体的医疗护理中去。所有参加合作学习法并进行综合护理的人均没有缺席（n = 52）。经过12个月的培训后，另外46名当地的医疗人员参加了综合护理，有395名退伍军人接受了综合护理。
   结论：合作学习法使综合护理得到了快速而广泛的实施。对于持续进行综合护理的有利因素及不利因素目前还未知，应对其进一步研究以阐明如何最好地对有心理障碍的患者群体进行持续循证戒烟治疗。
 

（刘国梁 审校）
Am J Public Health. 2014 Oct;104(10):1935-42. doi: 10.2105/AJPH.2013.301776. Epub 2014 Apr 17.


 

Use of a learning collaborative to support implementation of integrated care for smoking cessation for veterans with posttraumatic stress disorder.
 

Ebert L1, Malte C, Hamlett-Berry K, Beckham J, McFall M, Saxon A.
 

ABSTRACT
OBJECTIVES：We evaluated the feasibility of incorporating integrated care (IC) for smoking cessation into routine treatment for posttraumatic stress disorder (PTSD) at Department of Veterans Affairs (VA) Medical Centers and the utility of the Learning Collaborative (LC) model in facilitating implementation.
METHODS： We conducted 2 LCs aimed at implementing IC for smoking cessation using multidisciplinary teams comprising 70 staff members from 12 VA PTSD clinics. Using questionnaires, we evaluated providers' perceptions of the LC methodology and the effectiveness and feasibility of routine IC delivery. We assessed number of providers delivering and patients receiving IC using medical record data.
RESULTS： More than 85% of participating VA staff considered the LC to be an effective training and implementation platform. The majority thought IC effectively addressed an important need and could be delivered in routine PTSD care. All LC participants who planned to deliver IC did so (n = 52). Within 12 months of initial training, an additional 46 locally trained providers delivered IC and 395 veterans received IC.
CONCLUSIONS：The LC model effectively facilitated rapid and broad implementation of IC. Facilitators and barriers to sustained use of IC are unknown and should be identified to understand how best to promote ongoing access to evidence-based treatment for smoking cessation in mental health populations.
 

Am J Public Health. 2014 Oct;104(10):1935-42. doi: 10.2105/AJPH.2013.301776. Epub 2014 Apr 17.