Snapshotofanintegratedpsychosocialgastroenterologyservice

摘要： AIM:Tocharacterizethepatientsutilizingagastroenterologybehavioralmedicineserviceandexaminetheeffectoftreatmentonhealthcareutilization.METHODS:Patientswerereferredbytheirgastroenterologistsforpsychologicaltreatmentduringa15moperiod.PatientsseenforanintakewithapsychologistcompletedtheBriefSymptomInventory(BSI)andachecklistofpsychosocialconcerns.Asubsetofpatientswithfunctionalboweldisordersalsocompletedadiseasespecificqualityoflifemeasure.Chartreviewwasconductedtoobtaininformationontypeandfrequencyofsessionswiththepsychologist,thenumberofoutpatientgastroenterologyvisits,andnumberofgastroenterology-relatedmedicalproceduresduringthe6mofollowingpsychologicalintake.RESULTS:Of259patientsreferredfortreatment,118(46%)completedanintakewithapsychologist.Diagnosesincluded:irritablebowelsyndrome(42%),functionaldyspepsia(20%),inflammatoryboweldiseases(20%),esophagealsymptoms(10%),andother(8%).Demographicvariablesanddiseasetypedidnotdifferentiatebetweenthosewhodidanddidnotscheduleanintake.Meant-scoresfortheBSIglobalscoreindexandthedepression,anxiety,andsomatizationsubscalesfellbelowthecutoffforclinicalsignificance(t=63).Treatmentswerepredominantlygut-directedhypnosis(48%)andcognitivebehavioraltherapy(44%).Averagelengthoftreatmentwas4sessions.Amongfunctionalgastrointestinal(GI)patients,thosepatientswhoinitiatedtreatmentreceivedsignificantlyfewerGI-relatedmedicalproceduresduringthe6mofollowingthereferralthanpatientswhodidnotscheduleanintake[t(197)=2.69,P<0.01].CONCLUSION:PatientsarereceptivetopsychologicalinterventionsforGIconditionsandthereispreliminaryevidencethattreatmentcandecreasehealth-careutilizationamongpatientswithfunctionalGIconditions. ... （共7頁(yè)）