Fleury Marie-Josée, Bamvita Jean-Marie, Farand Lambert, Tremblay Jacques
Assistant Professor, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Ment Health Fam Med. 2008 Sep;5(3):149-60.
Objective The article assesses variables associated with general practitioners (GPs) taking on patients suffering from common mental disorders (CMD).Method The study is based on a sample of 398 GPs, representative of the 7199 equivalent full-time GPs practising in Quebec, the second-largest province of Canada. GPs were asked to answer a 143-item questionnaire related to their socio-demographic profile, clinical practice, patient characteristics, perceived interprofessional relationships, quality of care, and support strategies for improving continuity of care. Descriptive, bivariate, and multivariate analyses were performed.Results This study demonstrates that the following dimensions are associated with GPs taking on patients with CMD: (1) their interest and knowledge in dealing with such patients; (2) the relative simplicity of treating CMD cases; (3) the quality of, and interest in, mental healthcare collaboration; and (4) the availability of diversified services. The main enabling variable in GPs taking on CMD patients is their interest in mental disorders. Conversely, the principal impeding variable is their positive perception of relationships with psychiatric teams.Conclusions In accordance with current healthcare reforms, this study reinforces the need to promote GP interest and training in mental health care. Increasing GP co-ordination with psycho-social services, along with developing integrated care models including specialised care, is strongly recommended.
目的 本文评估与全科医生(GP)接纳患有常见精神障碍(CMD)患者相关的变量。
方法 该研究基于398名全科医生的样本,这些全科医生代表了在加拿大第二大省魁北克执业的7199名同等全职全科医生。全科医生被要求回答一份包含143个项目的问卷,内容涉及他们的社会人口统计学特征、临床实践、患者特征、感知到的跨专业关系、护理质量以及改善护理连续性的支持策略。进行了描述性、双变量和多变量分析。
结果 本研究表明,以下几个方面与全科医生接纳患有CMD的患者相关:(1)他们在处理此类患者方面的兴趣和知识;(2)治疗CMD病例的相对简易性;(3)精神卫生保健协作的质量和兴趣;(4)多样化服务的可获得性。全科医生接纳CMD患者的主要促进变量是他们对精神障碍的兴趣。相反,主要阻碍变量是他们对与精神科团队关系的积极认知。
结论 根据当前的医疗改革,本研究强化了促进全科医生对精神卫生保健的兴趣和培训的必要性。强烈建议加强全科医生与心理社会服务的协调,并开发包括专科护理在内的综合护理模式。