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全科医疗心理健康培训的综合方法:背景的重要性。

An integrated approach to general practice mental health training: the importance of context.

作者信息

Hodgins Gene, Judd Fiona, Davis Julian, Fahey Anne

机构信息

School of Humanities and Social Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.

出版信息

Australas Psychiatry. 2007 Feb;15(1):52-7. doi: 10.1080/10398560601083019.

Abstract

OBJECTIVE

The high prevalence of mental disorders and the barriers to detection and treatment of these in general practice are well recognized. As such, the government has placed great emphasis on training general practitioners (GPs) in primary care mental health and on the provision of support for GPs in the delivery of such services. The current paper aims to evaluate a local, rural training program in mental health for GPs. We hypothesized that local 'context-driven' training would lead to increased knowledge and reported change in practice by GPs with mental health patients.

METHOD

Locally developed and delivered 'Level 1' training was offered to GPs through the Better Outcomes in Mental Health Care initiative. The training was provided with 6-hour workshops covering mental health assessment and management planning. The training was evaluated through pre- and 6-week post-questionnaires assessing attitudes and practice with respect to treatment of patients with mental health problems.

RESULTS

Forty-nine GPs from the Loddon Campaspe Southern Mallee region of Victoria participated in the training. Following the 6-hour workshop, there was an increase in reported use of psychoeducation for patients with depression, use of cognitive behavioural therapy for patients with anxiety, and ease in obtaining advice to assist with the management of psychosis.

CONCLUSIONS

GP mental health education should take into consideration the local context, cover systems issues as well as skills development, and aim to develop personal relationships between mental health clinicians and GPs to enhance outcomes.

摘要

目的

精神障碍的高患病率以及在全科医疗中对其进行检测和治疗的障碍已得到广泛认可。因此,政府高度重视对全科医生进行初级保健心理健康方面的培训,并在提供此类服务时为全科医生提供支持。本文旨在评估一项针对全科医生的地方农村心理健康培训项目。我们假设,地方“情境驱动”培训将增加全科医生在治疗精神疾病患者方面的知识,并促使其在实践中有所改变。

方法

通过“改善精神卫生保健成果”倡议,向全科医生提供本地开发并实施的“一级”培训。培训通过为期6小时的研讨会进行,内容涵盖心理健康评估和管理规划。通过培训前和培训后6周的问卷调查对培训进行评估,问卷涉及对精神疾病患者治疗的态度和实践。

结果

维多利亚州洛登坎帕斯普南部马勒地区的49名全科医生参加了培训。在为期6小时的研讨会之后,报告显示,对抑郁症患者进行心理教育的次数增加,对焦虑症患者使用认知行为疗法的情况增多,并且在获取协助管理精神病的建议方面更加容易。

结论

全科医生心理健康教育应考虑当地情况,涵盖系统问题以及技能发展,并旨在发展心理健康临床医生与全科医生之间的个人关系以提高治疗效果。

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