Oyama Oliver, Burg Mary Ann, Fraser Kathryn, Kosch Shae Graham
University of South Florida/Morton Plant Mease Family Medicine Residency Program, Clearwater, FL 33755, USA.
Fam Med. 2012 Nov-Dec;44(10):704-11.
Family physicians are trained to assess mental health symptoms and provide some mental health interventions to their patients. Because of obstacles to referring patients to mental health specialists, many family physicians independently provide outpatient mental health treatment such as brief office counseling. Questions exist regarding physicians' interest in, perceived competence with, and their actual practice of brief office counseling in family medicine.
Surveys were administered to physicians at 11 family medicine residency programs in Florida.
Physicians regularly evaluate, diagnose, and treat patients with mild to moderate mental health disorders. Physicians prefer to evaluate patients themselves but refer patients who require counseling to specialists. However, physicians often provide brief office counseling themselves. Physicians believe they have the knowledge and skills to competently and effectively provide brief office counseling to their patients. They also believe that patients are receptive to and prefer to receive brief office counseling from their family physician rather than from a mental health specialist.
Physicians are willing and feel competent to identify and treat patients with mental disorders in the family medicine outpatient setting, including the provision of brief office counseling. Further research is needed to understand what effective mental health interventions can efficiently be taught to family physicians. Having family physicians treat mental health disorders may lead to greater patient satisfaction, improved chronic care management, and a positive impact on quality of care.
家庭医生接受过评估心理健康症状并为患者提供一些心理健康干预措施的培训。由于将患者转诊至心理健康专家存在障碍,许多家庭医生会独立提供门诊心理健康治疗,如简短的诊室咨询。关于家庭医生对简短诊室咨询的兴趣、感知到的能力以及他们的实际做法,仍存在一些问题。
对佛罗里达州11个家庭医学住院医师培训项目的医生进行了调查。
医生会定期对患有轻至中度心理健康障碍的患者进行评估、诊断和治疗。医生更倾向于自己对患者进行评估,但会将需要咨询的患者转诊给专家。然而,医生自己也经常提供简短的诊室咨询。医生认为他们具备知识和技能,能够胜任并有效地为患者提供简短的诊室咨询。他们还认为患者愿意接受并更倾向于从家庭医生而非心理健康专家那里接受简短的诊室咨询。
医生愿意且认为有能力在家庭医学门诊环境中识别和治疗患有精神障碍的患者,包括提供简短的诊室咨询。需要进一步研究以了解哪些有效的心理健康干预措施可以有效地传授给家庭医生。让家庭医生治疗心理健康障碍可能会提高患者满意度,改善慢性病管理,并对医疗质量产生积极影响。