Russell Paul Ss, Nair Muttathu Kc
Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore 632 002, India.
Asia Pac Fam Med. 2010 Feb 18;9(1):4. doi: 10.1186/1447-056X-9-4.
World Health Organization has identified Priority Mental Health Disorders (PMHD) of adolescence. To effectively address these disorders at the primary care level paediatricians have to be trained in the low-income countries, which often have paucity of mental health resources. We studied: (1) the need of psychiatric training required among paediatricians; (2) if the content and process of the model workshop suits them to identify and treat these disorders.
Forty-eight paediatricians completed evaluation questionnaire at the end of a 3-day workshop on adolescent psychiatry. They participated in a focused group discussion addressing the areas in psychiatry that needs to be strengthened in these workshops, the changes in the content and process of the workshop to bolster their learning. Qualitative and descriptive analyses were appropriately used.
Training in adolescent psychiatry was considered necessary among the paediatricians at zonal level frequently to develop their private practice, treat psychiatric disorders confidently, make correct referrals, and learn about counselling. Prioritizing training from under and postgraduate training, integrate psychiatry training with conference, conducting special workshops or Continuing Medical Education were suggested as ways of inculcating adolescent psychiatry proficiency. Mental status examination, psychopathology and management of the PMHD were considered by the respondents as important content that need to be addressed in the program but aspects of behavioural problems and developmental disabilities were also identified as areas of focus to gain knowledge and skill. Appropriate group size, flexibility in management decisions to fit the diverse clinical practice- settings was appreciated. Lack of skills in giving clinical reasoning in relation to PMHD, time management and feedback to individuals were identified as required components in the collaborative effort of this manner. Providing delegates with basic information on adolescent psychiatry prior to the workshop was suggested to make the workshop more valuable.
There is a need to expand training for paediatricians from various backgrounds in adolescent psychiatry to strengthen their clinical skills to address the PMHD at the primary-care level. The evaluation suggests that the design and collaborative approach evident in this programme have merit as a model for training paediatricians in adolescent psychiatry in countries with low human resource for health.
世界卫生组织已确定了青少年重点心理健康障碍(PMHD)。为在初级保健层面有效应对这些障碍,低收入国家的儿科医生必须接受培训,而这些国家往往缺乏心理健康资源。我们研究了:(1)儿科医生所需的精神病学培训需求;(2)示范工作坊的内容和流程是否适合他们识别和治疗这些障碍。
48名儿科医生在为期3天的青少年精神病学工作坊结束时完成了评估问卷。他们参加了焦点小组讨论,讨论了这些工作坊中需要加强的精神病学领域、工作坊内容和流程的变化以促进他们的学习。适当运用了定性和描述性分析。
区域层面的儿科医生经常认为青少年精神病学培训对于发展他们的私人执业、自信地治疗精神疾病、进行正确转诊以及学习咨询是必要的。建议将本科及研究生培训的优先级排序、将精神病学培训与会议相结合、举办特别工作坊或继续医学教育作为培养青少年精神病学专业能力的方式。受访者认为精神状态检查、PMHD的精神病理学和管理是该项目中需要涉及的重要内容,但行为问题和发育障碍方面也被确定为获取知识和技能的重点领域。合适的小组规模、管理决策的灵活性以适应不同的临床实践环境受到赞赏。在这种协作努力中,缺乏与PMHD相关的临床推理技能、时间管理和对个人的反馈被确定为所需的组成部分。建议在工作坊前为代表提供关于青少年精神病学的基本信息,以使工作坊更有价值。
有必要扩大对来自不同背景的儿科医生进行青少年精神病学培训,以增强他们在初级保健层面应对PMHD的临床技能。评估表明,该项目中明显的设计和协作方法作为在卫生人力资源匮乏国家培训儿科医生青少年精神病学的模式具有价值。