Por favor, descreva como o projeto tem sido bem sucedido e como esse sucesso é medido.
PCAF’s clinics use a Quarterly Reporting Form to measure progress. Clinics stratify the total number of cases by diagnosis, age, gender, location; and treatment and study outcomes by test-retest methods. PCAF’s Director of Research, Dr. Ethel Nakimuli-Mpungu, a psychiatric epidemiologist completing her PhD at the Bloomberg School of Public Health at Johns Hopkins, analyzes and compiles this data for senior staff.
Based on this information, PCAF knows who is coming to the clinics, the frequency of their visits, and the treatments provided (kind of counseling, drugs prescribed, etc.). The data is used to inform decision-making and adjustments to clinic management. For example, when a high number of patients with HIV were identified, PCAF was able to respond by training staff in how to counsel HIV-positive patients, as well as work to institute HIV screening at all clinics. Similarly, when it was reported that too few patients were being referred for spiritual healing, PCAF conducted a training workshop for senior clinic staff to teach the importance and effectiveness of spiritual healing.
PCAF also learned from the data that patient attrition had to be addressed: many patients did not return for treatment after more than one or two visits. A three-phase qualitative evaluation of this problem included surveying clinic staff, returning patients and non-returning patients for reasons for attrition. Barriers to return included: travel distance to the clinic and lack of transportation; lack of financial support; and family resistance. Based on this data, PCAF allocated additional funds for social-worker outreach and patient follow-up, and hope to be in a position to increase this program in 2012.
Outcomes Study: A one-year study on outcomes for 113 patients at the PCAF’s Gulu, Uganda clinic used psychiatric assessment tools at baseline, 3 months, 6 months, 9 months and 1 year to measure depression and anxiety symptom load, as well as social functioning and physical functioning scales. Mean total scores were compared over time, and analyzed for subgroups based on demographics, trauma history, and visit frequency.
Data demonstrated that all patients who received psychotropic drugs and psychotherapy had an excellent sustained decline in depression and PTSD symptom load and sustained an increase in social functioning (such as being able to perform work and home activities, maintain sound finances and socialize with family and friends). These findings were despite differences in demographic characteristics, trauma history and diagnosis.
Independent University Studies: PCAF has begun to work with two prominent academic research institutions, Johns Hopkins University and University of Brighton, to begin rigorous independent studies of patient outcomes at its Cambodia and Uganda clinics.