Lucena Ricardo J M, Lesage Alain, Elie Robert, Lamontagne Yves, Corbière Marc
Universidade Federal da Paraíba, Brazil.
Can J Psychiatry. 2002 Oct;47(8):750-8. doi: 10.1177/070674370204700806.
The description of collaboration models and the key underlying principles provide important information for designing services. However, to apply this broad corpus of information to clinical services and policymaking, we need to know which key principles (or strategies) of collaboration are the most accepted by local physicians.
In this context, we designed a survey that included 2 objectives: 1) to collect the opinions of practising general practitioners (GPs) and psychiatrists in Montreal with respect to strategies for improving collaboration between these 2 groups and 2) to identify demographic and practice characteristics of those physicians associated with the acceptance of such strategies. We designed a questionnaire to specifically elicit physicians' opinions about strategies involving communication, continuing medical education (CME) for GPs in psychiatry, and access to consulting psychiatrists, as well as to identify the profiles of the respondent physicians. We mailed the questionnaire to 203 GPs and 203 psychiatrists who were randomly selected.
The response rate was 86% for GPs and 87% for psychiatrists. Physicians expressed favourable opinions about most strategies involving 1) the improvement of communication and 2) the organization of CME activities concerning GP practices in the field of psychiatry. On the other hand, they did not indicate acceptance of the strategies involving on-site collaboration between GPs and psychiatrists. Physician age, sex, place of practice, type of practice (such as seeing patients with or without appointments), and responsibility for administrative duties associated significantly with the degree of acceptance of the proposed strategies.
Communication and CME strategies for GPs in psychiatry can be an option to improve collaboration between GPs and psychiatrists. However, strategies of access to consulting psychiatrists require significant alterations to established clinical routines and professional roles.
协作模式及关键基本原则的描述为服务设计提供了重要信息。然而，要将这一广泛的信息应用于临床服务和政策制定，我们需要了解哪些协作的关键原则（或策略）最受当地医生认可。
在此背景下，我们设计了一项调查，包含两个目标：1）收集蒙特利尔执业全科医生（GP）和精神科医生对于改善这两组人员协作策略的意见；2）确定与接受此类策略相关的医生的人口统计学和执业特征。我们设计了一份问卷，专门引出医生对于涉及沟通、针对精神科全科医生的继续医学教育（CME）以及精神科会诊医生可及性的策略的意见，同时确定应答医生的概况。我们将问卷邮寄给随机挑选的203名全科医生和203名精神科医生。
全科医生的回复率为86%，精神科医生为87%。医生们对大多数涉及1）沟通改善和2）组织关于精神科领域全科医生执业的继续医学教育活动的策略表达了赞同意见。另一方面，他们并未表示接受涉及全科医生和精神科医生现场协作的策略。医生的年龄、性别、执业地点、执业类型（如是否预约看诊）以及行政职责与对所提议策略的接受程度显著相关。
针对精神科全科医生的沟通和继续医学教育策略可以作为改善全科医生和精神科医生协作的一个选择。然而，精神科会诊医生可及性策略需要对既定的临床常规和专业角色进行重大改变。
