广东省综合医院身心同治的探索与实践
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何红波,男,主任医师,教授,博士研究生导 师。 中华医学会精神病学分会常委,广东省预防医学会精神卫生 专委会主任委员,广东省医学会精神医学分会副主任委员。 主要 研究方向:青少年抑郁患者的自杀预防与诊疗新技术研发;精神 卫生服务体系评价。

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广东省自然科学基金资助项目(编号: 2024A1515013133);广州市校(院)企联合资助项目(编号: 2024A03J0299)


Exploration and practice of physical and mental treatment in general hospitals of Guangdong province
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    摘要:

    综合医院住院患者心理健康问题发生率高达 20% ~ 40%,但识别与治疗率均低于 20%。 对已知的重点人群建立 有效的主动筛查和早期干预体系,是提升医疗机构心理健康服务能力的有效方法。 广东省于 2021 年开始“幸福医院”项目建 设,构建“两次筛查,分级干预”一体化体系。 采用简短的心理评估量表进行初筛,对阳性患者使用国际常用筛查量表精筛分 级,通过精神心理专家及经过培训的“幸福护士”协作开展分级干预,建立数字化管理平台实现全流程管理。 项目在 5 家试点 医院共纳入 2 万余名患者,其中广州医科大学附属番禺中心医院进行的前瞻性研究(n = 3685),在患者入院和出院前进行心理 评估干预,数据显示出院前心理健康问题检出率从入院时的 24. 0%降至 16. 6%,抑郁、焦虑、失眠检出率分别下降 4. 9%、2. 5%、5. 4%,自杀风险降低 0. 8%。 项目通过标准化工具、专职岗位设置和数字化管理平台建立,深化了综合医院非精神科医护 人员“身心同治”的服务理念,形成了可复制的“广东模式”。

    Abstract:

    The incidence of mental health problems among inpatients in general hospitals is as high as 20% ~ 40%. However,both recognition and treatment rates remain below 20%. Establishing effective proactive screening and early intervention systems forhigh-risk populations is an effective approach to enhancing mental health service capacity in healthcare institutions. Since 2021,Guangdong province has implemented a “Happiness hospital” program and developed an integrated model based on two-stage screeningand stepped care. Brief screening instruments are used for initial assessment, followed by secondary stratified assessment with interna-tionally validated scales for patients who screen positive. Stepped interventions are delivered through collaboration between mentalhealth specialists and specially trained “Happiness nurses”. A digital management platform to achieve full process management was established. Across five pilot hospitals, more than 20000 patients were enrolled. In a prospective study conducted at Panyu District Central Hospital (n = 3685), psychological assessments were performed at admission and prior to discharge. The results showed that the overall detection rate of mental health problems were decreased from 24. 0% at admission to 16. 6% before discharge. Specifically, detection rates of depression, anxiety and insomnia were decreased by 4. 9%, 2. 5% and 5. 4%, respectively. Suicide risk was reducedby 0. 8%. Through the establishment of standardized tools, dedicated roles and a digital management platform, the program hasstrengthened the service concept of " treating both body and mind" for non-psychiatric medical staff in general hospitals. Thereby, areplicable “Guangdong model” is formed.

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袁 帅,郑盈盈,刘靖雯,郑丽娇,欧阳玉霞,董丽娟,刘大亮,谭玉玲,冯惠强,何红波.广东省综合医院身心同治的探索与实践[J].实用医院临床杂志,2026,23(3):26-29

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  • 收稿日期:2026-01-30
  • 最后修改日期:2026-02-12
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  • 在线发布日期: 2026-05-26
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