Fernández Sánchez Anna, Sánchez-Carracedo David, Navarro-Rubio M Dolors, Pinto-Meza Alejandra, Moreno-Küstner Berta
Parc Sanitari Sant Joan de Déu, Fundación Sant Joan de Déu, Barcelona, Spain.
Aten Primaria. 2010 Nov;42(11):552-8. doi: 10.1016/j.aprim.2009.11.006. Epub 2010 Jun 15.
To explore the views on clinical practice guidelines (CPG) of general practitioners (GP), psychiatrists, and psychologists.
Descriptive-exploratory qualitative study based on semi-structured individual and group interviews.
Public primary health care and mental health centres in Barcelona, Sabadell, Cornellà de Llobregat and Gavà.
A total of 31 health professionals (10GPs, 11 psychiatrists, and 10 psychologists) interviewed at their work place or at the research unit between October 2007 and June 2008.
Convenience sample. Participants were heterogeneous as regards sex, age, experience and workplace. Interviews were recoded and transcribed. Content analysis. Triangulation between techniques and results comparisons with participants was carried out as quality control.
The main advantages of CPGs were that they helped in decision making and gave security. On the other hand, participants were sceptical about the objectivity of GPC and considered that recommendations could not be applied to their individual patients. Additionally, they perceived CPG as inflexible. At the time of the study, GPs did not know of any CPG for depression. Specialists knew several CPGs but they did not use them as they prioritise their own experience.
There are some erroneous ideas about what a CPG is. If we want to implement CPGs, it is important to carry out some previous work presenting what a CPG is, what it is not and when it could be useful.
探讨全科医生、精神科医生和心理学家对临床实践指南(CPG)的看法。
基于半结构化个人访谈和小组访谈的描述性探索性定性研究。
巴塞罗那、萨瓦德尔、略夫雷加特河畔科尔内利亚和加瓦的公共初级卫生保健和心理健康中心。
2007年10月至2008年6月期间,共有31名卫生专业人员(10名全科医生、11名精神科医生和10名心理学家)在其工作场所或研究单位接受访谈。
便利抽样。参与者在性别、年龄、经验和工作场所方面存在差异。访谈进行录音和转录。进行内容分析。作为质量控制,在技术之间进行三角验证,并将结果与参与者进行比较。
临床实践指南的主要优点是有助于决策并提供安全感。另一方面,参与者对临床实践指南的客观性持怀疑态度,并认为这些建议不适用于他们的个体患者。此外,他们认为临床实践指南缺乏灵活性。在研究期间,全科医生不知道任何关于抑郁症的临床实践指南。专科医生知道一些临床实践指南,但他们没有使用,因为他们更看重自己的经验。
对于临床实践指南是什么存在一些错误观念。如果我们想实施临床实践指南,重要的是事先开展一些工作,介绍临床实践指南是什么、不是什么以及何时可能有用。