학술논문

Service users experience of psychological interventions in primary care settings: A qualitative meta‐synthesis.
Document Type
Article
Source
Clinical Psychology & Psychotherapy. Mar2022, Vol. 29 Issue 2, p400-423. 24p. 1 Color Photograph, 9 Charts.
Subject
*META-synthesis
*CINAHL database
*PSYCHOLOGY information storage & retrieval systems
*MEDICAL information storage & retrieval systems
*INFORMATION storage & retrieval systems
*MEDICAL databases
*SYSTEMATIC reviews
*PATIENT-centered care
*MENTAL health
*PATIENTS' attitudes
*PRIMARY health care
*THEMATIC analysis
*MEDLINE
*PSYCHOTHERAPY
Language
ISSN
1063-3995
Abstract
Primary care mental health services play a crucial role in public mental health by providing local and accessible psychological interventions that meet individuals' needs. Despite growing research investigating service users' perspectives of psychological interventions, a qualitative systematic review in this context is not available. The present meta‐synthesis collates the existing articles and gives a thematic synthesis of qualitative studies on service users' experience of psychological interventions in primary care. Multiple databases (CINAHL, EMBASE, PsychINFO, MEDLINE, and Cochrane Library) were searched for published qualitative studies of service users' experiences of psychological interventions delivered in primary care. Articles were included if they met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme tool. All types of psychological interventions were considered across model and delivery format (e.g., face‐to‐face, computerised programmes, and group). NVIVO was used to code the dataset and themes were extracted following thematic synthesis. Twenty‐two studies were included. Four analytical themes and 10 subthemes emerged. The identified themes were as follows: (1) 'Access and Acceptability: facilitators and barriers', (2) 'Structural aspects'; (3) 'Therapeutic process' and (4) 'Outcomes'. A model of interrelationships between themes is proposed. Findings suggest several 'essential ingredients' across psychological interventions and modalities. The crucial role of relational factors, the importance of assessing service users' perceptions of treatment features (e.g., remote delivery) and of tailoring the intervention to their needs were emphasised. Results also suggest involving service users more in discussions and decisions about psychological interventions offered might enhance access, acceptability, and engagement. Recommendations for practice and research are provided. [ABSTRACT FROM AUTHOR]