Davidsen Annette Sofie
Forskningsenheden for Almen Praksis, Øster Farimagsgade 5, Postboks 2099, 1014 København K.
Ugeskr Laeger. 2010 Jul 5;172(27):2025-9.
The vast majority of patients with mental disorders are treated in general practice. In Denmark, GPs have received a special payment for delivering >>talking therapy<< since 1995. However, it has not been described how this service should be used. Reports from the Danish Psychiatric Society and the Danish College of General Practitioners are paving the way for greater involvement of GPs in psychotherapy. The aim of the study was to investigate how GPs perceive that talking therapy could fit into their day-to-day efforts in the clinic.
This is a qualitative study which is based on interviews with Danish GPs. The analysis was based on interpretative phenomenological analysis.
GPs organized talking therapy very differently and offered it to different extents. The context and conditions differed greatly from those of the secondary health care system, as the treatment was always an extension of a pre-existing doctor-patient relationship. Therapy was only offered if the communication between GP and patient was good beforehand. Talking therapy would not be delivered if the GPs' time conditions did not allow this, and when time was insufficient it was always the emotional area that was forfeited.
The introduction of a psychological thinking to the standardised theoretical curriculum of general practice should be considered. There is a need for research into talking therapy and quality-assured training and supervision of GPs.
绝大多数精神障碍患者在全科医疗中接受治疗。在丹麦,自1995年以来,全科医生因提供“谈话疗法”而获得特殊报酬。然而,尚未描述应如何使用这项服务。丹麦精神病学会和丹麦全科医生学院的报告为全科医生更多地参与心理治疗铺平了道路。本研究的目的是调查全科医生如何看待谈话疗法能够融入他们在诊所的日常工作。
这是一项基于对丹麦全科医生访谈的定性研究。分析基于解释现象学分析。
全科医生组织谈话疗法的方式差异很大,提供的程度也不同。其背景和条件与二级医疗保健系统有很大差异,因为这种治疗始终是现有医患关系的延伸。只有在全科医生与患者事先沟通良好时才会提供治疗。如果全科医生的时间条件不允许,就不会提供谈话疗法,而当时间不足时,总是会放弃情感领域的治疗。
应考虑将心理思维引入全科医疗的标准化理论课程。有必要对谈话疗法以及对全科医生进行质量保证的培训和监督进行研究。