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[全科医生和精神科医生诊治的抑郁症患者的观点]

[Views of patients diagnosed with depression and cared for by general practitioners and psychiatrists].

作者信息

Calderón Gómez Carlos, Retolaza Balsategui Ander, Payo Gordon Janire, Bacigalupe De La Hera Amaia, Zallo Atxutegi Eskarne, Mosquera Metcalfe Isabel

机构信息

Servicio Vasco de Salud, Centro de Salud de Alza-Donostia. Osakidetza, Donostia, Gipuzkoa, España.

出版信息

Aten Primaria. 2012 Oct;44(10):595-602. doi: 10.1016/j.aprim.2012.02.009. Epub 2012 May 8.

Abstract

OBJECTIVES

To explore the experiences of patients treated for depression either by general practitioners (GPs) or psychiatrists (Ps) with the aim of identifying improvement strategies.

DESIGN

Health services research-oriented qualitative methodology. Exploratory design. PARTICIPANTS AND CONTEXTS: A total of 31 patients diagnosed with depression receiving pharmacological treatment for at least one year, belonging to 20 Health Centres and 8 Mental Health Centres of the Basque Health Service-Osakidetza in Bizkaia, and grouped according to the type of professional (GPs/Ps) and socioeconomic level.

METHOD

Information generation by means of 5 discussion groups and 2 in-depth interviews carried out in 2009 and 2010. Recording and transcription with previous confidentiality agreement and informed consent. Sociological discourse analysis. Technique triangulation and agreement among researchers.

RESULTS

Patients' experiences of depression are associated with their social contexts and their previous experience outside and inside the health services. These components also appear in perceptions on quality of care, with different expectations related to GPs and Ps. Deficiencies in time and psychotherapy are mentioned in general. Collaboration between both professionals does not spontaneously emerge as a patient priority.

CONCLUSIONS

Patient assessments provide dimensions of individual and contextual components in the diagnosis and treatment of depression. These dimensions should be taken into account in the identification of needs and the design of strategies shared by GPs and Psychiatrists to improve care.

摘要

目的

探讨由全科医生(GPs)或精神科医生(Ps)治疗的抑郁症患者的经历,以确定改善策略。

设计

以卫生服务研究为导向的定性方法。探索性设计。参与者与背景:共有31名被诊断为抑郁症且接受药物治疗至少一年的患者,他们来自比斯开省巴斯克卫生服务机构奥萨基德扎的20个健康中心和8个心理健康中心,并根据专业类型(全科医生/精神科医生)和社会经济水平进行分组。

方法

通过2009年和2010年开展的5个讨论组和2次深入访谈来收集信息。在签署保密协议和获得知情同意后进行记录和转录。进行社会学话语分析。研究人员之间采用技术三角互证法并达成共识。

结果

患者的抑郁症经历与他们的社会背景以及他们在卫生服务机构内外的既往经历相关。这些因素也体现在对医疗质量的认知中,对全科医生和精神科医生有着不同的期望。普遍提到时间和心理治疗方面的不足。这两类专业人员之间的协作并非患者优先考虑的自发事项。

结论

患者评估为抑郁症的诊断和治疗提供了个体和背景因素的维度。在确定需求以及全科医生和精神科医生共同设计改善护理的策略时,应考虑这些维度。

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