South Texas Psychiatric Practice-Based Research Network, San Antonio, TX, USA.
J Am Board Fam Med. 2012 Sep-Oct;25(5):669-75. doi: 10.3122/jabfm.2012.05.120050.
To examine the prevalence of difficult psychiatrist-patient interactions of 20 psychiatrists in the South Texas Psychiatric practice-based research network, determine what characteristics were associated with "difficult" patients, and compare findings with previous studies in primary care.
During a 2-month observational study, psychiatrists collected patient information on setting, demographics, diagnoses, and medications and rated the patients using the Difficult Doctor-Patient Relationship Questionnaire, which had previously been used and validated in the primary care setting.
A total of 905 valid data cards were collected. Difficult patients were identified in 15% of the sample. Diagnoses of schizophrenia, alcohol/substance abuse, and personality disorder were associated with difficulty. Psychiatrists least burdened by difficult patients were older and in a solo practice and worked 51 to 55 hours per week.
This cross-sectional study demonstrates that psychiatrists encounter difficult patients at a rate (15%) similar to that of primary care physicians. Mentoring programs and structured treatment interventions for the most difficult patient groups may assist all physicians who treat psychiatric patients, whether in specialty, family medicine, or other primary care settings.
在南德克萨斯精神病学实践为基础的研究网络中，检查 20 位精神科医生与患者互动的困难程度，确定与“困难”患者相关的特征，并与初级保健中的先前研究进行比较。
在为期 2 个月的观察性研究中，精神科医生收集了患者的背景、人口统计学、诊断和用药信息，并使用先前在初级保健环境中使用和验证过的“医生与患者关系困难问卷”对患者进行评分。
共收集了 905 份有效数据卡。在样本中，有 15%的患者被认定为“困难”患者。精神分裂症、酒精/物质滥用和人格障碍的诊断与困难有关。最不受“困难”患者困扰的精神科医生年龄较大，是单人执业，每周工作 51 到 55 小时。
这项横断面研究表明，精神科医生遇到“困难”患者的比例（15%）与初级保健医生相似。针对最困难患者群体的指导计划和结构化治疗干预措施可能会帮助所有治疗精神科患者的医生，无论他们是在专科、家庭医学还是其他初级保健环境中工作。
