Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia.
Fam Pract. 2010 Aug;27(4):447-58. doi: 10.1093/fampra/cmq016. Epub 2010 Apr 8.
The World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialists.
The reorder study aimed to gather diverse patient and community perspectives to inform the development of an effective system of depression care.
Five hundred and seventy-six patients completed computer-assisted telephone interviews. Two hundred and seventy-six community stakeholders completed a modified two round Delphi. Responses were analysed to identify tasks and these were synthesised into a conceptual design.
Fifteen core tasks were identified, 5 were agreed upon and a further 10 identified by each group but not agreed upon. Listen, understand and empathize, provide thorough and competent diagnosis and management, follow-up and monitor patients, be accessible and do not rush appointments and provide holistic approach and tailor care to individual needs were agreed on. Other tasks included: develop plans with patients, assess for severity and suicide risk, account for social factors, be well trained in depression care and offer a range of treatment options, appropriate and timely referral, support and reassurance, educate patients about depression, prescribe appropriately and manage medication and be positive and encouraging.
The tasks form the basis of a conceptual design for developing a primary care response to depression. They fit within three domains of care: the relational, competency and systems domains. This illustrates tasks for GPs beyond prescription and referral.
世界卫生组织和世界家庭医生组织呼吁将心理健康纳入初级保健，实现“可行”和“有限”的任务。关于全科医生在建议开处方和转介专家之外可以承担的任务，提供的信息很少。
重新排序研究旨在收集不同患者和社区的观点，为制定有效的抑郁症护理系统提供信息。
576 名患者完成了计算机辅助电话访谈。276 名社区利益相关者完成了两轮修改后的德尔菲法。对回复进行了分析，以确定任务，并将这些任务综合成一个概念设计。
确定了 15 项核心任务，其中 5 项得到了两组的同意，另外 10 项由每组确定但未达成一致。倾听、理解和共情、提供全面和胜任的诊断和管理、随访和监测患者、方便且不急于预约以及提供整体方法并根据个人需求调整护理得到了一致同意。其他任务包括：与患者制定计划、评估严重程度和自杀风险、考虑社会因素、接受过抑郁症护理的良好培训并提供一系列治疗选择、适当和及时的转介、提供支持和安慰、教育患者了解抑郁症、适当开具处方和管理药物以及保持积极和鼓励。
这些任务构成了开发针对抑郁症的初级保健反应的概念设计的基础。它们符合三个护理领域：关系、能力和系统领域。这说明了全科医生除了开处方和转介之外的任务。
