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在初级保健中为精神状态稳定的精神病患者提供持续护理:患者的偏好和观点。

Continuing care for mentally stable psychiatric patients in primary care: patients' preferences and views.

作者信息

Agyapong Vincent I O

机构信息

Department of Psychiatry, The Trinity College, University of Dublin, Dublin, Ireland.

出版信息

Int J Family Med. 2012;2012:575381. doi: 10.1155/2012/575381. Epub 2012 Jul 11.

Abstract

Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.

摘要

目的。调查精神病患者在从初级保健机构病情稳定后继续接受精神卫生保健时,相对于专科精神科服务机构,他们对就诊机构的偏好。方法。对都柏林一家社区精神卫生中心连续就诊的150名精神病门诊患者进行调查,并要求他们填写一份旨在评估研究目标的半结构化问卷。结果。145名患者完成了问卷,回复率为97%。98名患者(68%)即使在治疗稳定后仍倾向于前往专科精神科服务机构就诊。这类患者给出的常见理由是担心全科医生(GP)提供的精神科护理质量不合格(67名患者,68.4%)。29名患者(20%)更愿意前往全科医生处接受持续的精神卫生保健。这些患者给出的理由包括对全科医生的信任、全科医生为精神疾病提供与精神科医生相同水平的护理(18名患者,占62%),以及全科医生能同时管理精神和身体健康的优势(13名患者,占45%)。结论。大多数就诊于专科精神科服务机构的患者即使病情稳定,也更倾向于继续在专科精神科服务机构就诊,而非初级保健机构,多数原因围绕着对全科医生精神科护理不足的担忧。

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