全科医生对改善初级卫生保健中心精神障碍治疗的看法。对 100 名挪威全科医生的访谈。
General practitioners' opinions on how to improve treatment of mental disorders in primary health care. Interviews with one hundred Norwegian general practitioners.
机构信息
Research Section for Mental Health Epidemiology, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway.
出版信息
BMC Health Serv Res. 2010 Feb 9;10:35. doi: 10.1186/1472-6963-10-35.
BACKGROUND
Improvements in treatment of mental disorders are repeatedly called for. General practitioners (GPs) are responsible for the majority of treatment of mental disorders. Consequently, we interviewed GPs about their opinions on how treatment of mental disorders in primary health care contexts could be improved.
METHODS
Among GPs affiliated within the Norwegian reimbursement system, we approached 353, and made contact with 246 GP's. One-hundred of these agreed to participate in our study, and 95 of them expressed opinions on how to improve treatment of mental disorders. The telephone interviews were based on open-ended questions, responses were transcribed continuously, and content analysis was applied. Results are presented both as frequency tables of common responses, and as qualitative descriptions and quotations of opinions.
RESULTS
Nearly all (95%) of the GPs had suggestions on how to improve treatment of mental disorders in primary health care. Increased capacity in secondary health care was suggested by 59% of GPs. Suggestions of improved collaboration with secondary health care were also common (57%), as were improvements of GPs' skills and knowledge relevant for diagnosing and treating mental disorders (40%) and more time for patients with mental disorders in GP contexts (40%).
CONCLUSIONS
The GPs' suggestions are in line with international research and debate. It is thought-provoking that the majority of GPs call for increased capacity in secondary care, and also better collaboration with secondary care. Some GPs made comparisons to the health care system for physical disorders, which is described as better-functioning. Our study identified no simple short-term cost-effective interventions likely to improve treatment for mental disorders within primary health care. Under-treatment of mental disorders is, however, also associated with significant financial burdens.
背景
精神障碍的治疗需要不断改进。全科医生（GP）负责大多数精神障碍的治疗。因此，我们采访了全科医生，了解他们对如何改善初级保健环境中精神障碍治疗的看法。
方法
在挪威报销系统中，我们联系了 353 名全科医生，与 246 名全科医生取得了联系。其中 100 名同意参与我们的研究，其中 95 名表达了改善精神障碍治疗的意见。电话访谈基于开放式问题，回答被连续转录，并应用内容分析。结果以常见回答的频率表以及意见的定性描述和引述呈现。
结果
几乎所有（95%）的全科医生都对如何改善初级保健中的精神障碍治疗提出了建议。59%的全科医生建议增加二级保健的能力。改善与二级保健合作的建议也很常见（57%），提高全科医生诊断和治疗精神障碍相关技能和知识（40%）以及在全科医生环境中为精神障碍患者提供更多时间（40%）也是如此。
结论
全科医生的建议与国际研究和讨论一致。有趣的是，大多数全科医生呼吁增加二级保健能力，并改善与二级保健的合作。一些全科医生将其与身体障碍的医疗保健系统进行了比较，后者被描述为运作更好。我们的研究没有发现简单的短期具有成本效益的干预措施，可能会改善初级保健中的精神障碍治疗。然而，精神障碍的治疗不足也与重大的经济负担有关。
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