RESUMO
A pilot evaluation study of the implementation of the Rapid Response Program, a program utilizing the ecosystemic structural family therapy model, in a rural area of Pennsylvania was conducted. This approach was implemented in children's mental health to supplant a costly model of care that had not proven to break the cycle of dependency for children with severe behavioral problems and their families. Initial results show that the Rapid Response Program appears to improve problematic family patterns and children's behavioral problems. The study results are limited by small sample size; however, the outcomes suggest that the program warrants further study using a more rigorous research design with a larger sample.
Assuntos
Transtornos do Comportamento Infantil/terapia , Serviços Comunitários de Saúde Mental/métodos , Terapia Familiar/métodos , Adolescente , Criança , Pré-Escolar , Ecossistema , Feminino , Serviços de Assistência Domiciliar , Humanos , Relações Interprofissionais , Masculino , Pennsylvania , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , População Rural , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To examine the role of patient, family, and treatment variables on self-reported engagement for physicians and nurses working with pediatric complex care patients. METHODS: Sixty-eight physicians and 85 registered nurses at a children's hospital reviewed eight case scenarios that varied by the patient and patient's family (each cooperative versus difficult) and the length of hospitalization (<30 days versus >30 days). Participants rated their engagement from highly engaged/responsive to distancing/disconnected behaviors. RESULTS: Nurses were more likely than physicians to engage in situations with a difficult patient/cooperative family but less likely to engage in situations with a cooperative patient/difficult family.Nurses were more likely to consult a colleague regarding the care of a difficult patient/difficult family,while physicians were more likely to refer a difficult patient/difficult family to a psychosocial professional. CONCLUSIONS: Differences were found for engagement with "difficult" patients/families, with physicians more likely to distance themselves or refer to a psychosocial professional, while nurses were more likely to consult with a colleague. PRACTICE IMPLICATIONS: Communication between health care team members is essential for optimal family-centered health care. Thus, interventions are needed that focus on communication and support for healthcare teams working with pediatric complex care patients and their families.
