Kadam U T, Croft P, McLeod J, Hutchinson M
Primary Care Sciences Research Centre, School of Postgraduate Medicine, Keele University, Staffordshire.
Br J Gen Pract. 2001 May;51(466):375-80.
In the management of patients with anxiety and depression in general practice, the emphasis has been on improving detection and appropriate use of drug therapies by health professionals. Patients' own perceptions of their problems and what services they would prefer have not often been sought.
To explore patient perspectives in relation to their healthcare needs in anxiety and depression.
Semi-structured individual and focus group interviews.
A total of 27 patients from an urban four-partner group general practice who were identified as having anxiety and depression by a practice population questionnaire survey.
All interviews were transcribed and the major themes were summarised using grounded theory analysis.
Patients seek many different ways of coping with their problems but view their general practice as a focal point for help. Their experiences are dominated by the struggle to control unwelcome and intrusive thoughts and to live in a hostile and threatening world. They also have distinct preferences regarding their health needs and there is universal scepticism about drug therapies.
Patients describe personal and professional barriers to seeking help and have particular views on the treatment options. This perspective contrasts with the current professional emphasis on detection and drug use. This view is therefore central to informing the debate on management of neurotic disorders in primary care and on improving the care of these patients.
在全科医疗中对焦虑和抑郁患者的管理方面,重点一直是提高医护人员对药物治疗的检测和合理使用。患者自身对其问题的看法以及他们更喜欢何种服务,却常常未被探寻。
探讨患者对焦虑和抑郁相关医疗需求的看法。
半结构化的个人访谈和焦点小组访谈。
来自一个城市四合伙人团体全科诊所的27名患者,他们是通过诊所人群问卷调查被确定为患有焦虑和抑郁的。
所有访谈均被转录,并采用扎根理论分析总结主要主题。
患者寻求多种不同方式来应对他们的问题,但将其全科诊所视为寻求帮助的焦点。他们的经历主要是努力控制不受欢迎且侵扰性的想法,并生活在一个充满敌意和威胁的世界中。他们对自身的健康需求也有明确的偏好,并且对药物治疗普遍持怀疑态度。
患者描述了寻求帮助时的个人和专业障碍,并且对治疗选择有特定看法。这种观点与当前专业上对检测和药物使用的重点形成对比。因此,这一观点对于为初级保健中神经症性障碍的管理辩论以及改善这些患者的护理提供信息至关重要。