直接運用心理學治療睡眠障礙：創新醫院和醫療服務中的護理模式

Direct to psychology for sleep disorders: Innovating models of care in the hospital and health service

——《健康心理學雜誌》2025年第30卷第5期——

Volume 30, Issue 5, 2025

【摘要】為在澳大利亞布里斯班一家三級醫院的多學科睡眠障礙服務中實施“直接心理學失眠”治療方案，項目制定了一項實施科學原則和方法，以重新設計護理模式 (MoC)。項目組與12名多學科工作人員共同舉辦了一場共識小組研討會，採用名義小組技術 (NGT)，旨在制定新的MoC。研討會探討了“直接心理學”治療方案的納入和排除標準，包括患者流程和促成因素。團隊最終批准了一項利益相關方可接受且滿足服務水平要求的MoC。研究結果強調，患者的納入或排除應由睡眠醫生團隊和一位具備行為睡眠醫學專業知識的高級心理學家監督。此外，還考慮了通過初級保健提供者轉診的患者是否需要持續護理。研討會還確定了MoC變革面臨的障礙和風險，並為MoC的改進提供了參考。

【關鍵詞】睡眠，睡眠障礙，失眠，阻塞性睡眠呼吸暫停綜合徵，阻塞性睡眠呼吸暫停綜合徵，輔助醫療主導，直接面向心理學，睡眠心理學，健康心理學，行為睡眠醫學，護理模式再設計

[Abstract] A ‘Direct to Psychology Insomnia’ pathway was developed for implementation within a multidisciplinary sleep disorders service in a tertiary hospital in Brisbane, Australia. The project was informed by implementation science principles and methodology to re-design the model of care (MoC). A consensus group workshop using the Nominal Group Technique (NGT) with 12 multidisciplinary staff was undertaken to develop the new MoC. The workshop explored inclusion and exclusion criteria for a Direct to Psychology pathway including patient flow and enablers. The team endorsed a MoC that was acceptable to stakeholders and addressed service-level imperatives. The findings highlighted that patient inclusion or exclusion should be overseen by the Sleep Physician team and an Advanced Psychologist with behavioural sleep medicine expertise. Continuum of care for patients referred via primary care providers was considered. Barriers and risks to the MoC changes were identified which informed the refinement of the MoC.

[Key words] sleep, sleep disorders, insomnia, OSA, obstructive sleep apnoea, allied health led, direct to psychology, sleep psychology, health psychology, behavioural sleep medicine, model of care re-design

論文原文：Sara Winter, Sara Crocker, Irene Szollosi, et al. (2025) . Direct to psychology for sleep disorders: Innovating models of care in the hospital and health service. Journal of Health Psychology, Volume 30, Issue 5, Pages 989–1003.

https://doi.org/10.1177/13591053241267272

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