Dahlöf Linda, Simonsson Anna, Thorn Jörgen, Larsson Maria Eh
1Clinical Psychologist,Primary Health Care,Region Västra Götaland,Sweden.
2Department of Public Health and Community Medicine,Sahlgrenska Academy,University of Gothenburg,Primary Health Care,Region Västra Götaland,Sweden.
Prim Health Care Res Dev. 2014 Oct;15(4):441-51. doi: 10.1017/S1463423613000339. Epub 2013 Aug 30.
In a primary health-care centre (PHCC) situated in a segregated area with low socio-economic status, 'primary care triage' has increased efficiency and accessibility. In the primary-care triage, the nurse sorts the patient to the appropriate PHCC profession according to described symptoms. Aim The aim of this study was to examine the patients' experience of being triaged directly to a psychologist for assessment.
Interviews were conducted with 20 patients and then analysed using qualitative content analysis.
The results show that patients contacting the PHCC for mental health issues often are active agents with their own intent to see a psychologist, not a doctor, as a first-hand choice when contacting the PHCC. Seeking help for mental health issues is described as a sensitive issue that demands building up strength before contacting. The quick access to the preferred health-care professional is appreciated. The nurse was perceived as a caring facilitator rather than a decision maker. It is the patient's wish rather than the symptoms that directs the sorting. The patients' expectations when meeting the psychologist were wide and diverse. The structured assessment sometimes collided and sometimes united with these expectations, yielding different outcome satisfaction. The results could be seen in line with the present goal to increase patients' choice in the health-care system. The improved accessibility to the psychologist seems to meet community expectations. The results also indicate a need for providing more prior information about the assessment and potential outcomes.
在一个位于社会经济地位较低的隔离区域的初级保健中心（PHCC），“初级保健分诊”提高了效率和可及性。在初级保健分诊中，护士根据所描述的症状将患者分诊给合适的PHCC专业人员。目的本研究的目的是调查患者直接被分诊给心理医生进行评估的体验。
对20名患者进行了访谈，然后采用定性内容分析法进行分析。
结果表明，因心理健康问题联系PHCC的患者通常是主动的行动者，他们自己有意在联系PHCC时首选看心理医生，而不是医生。将心理健康问题作为寻求帮助的问题被描述为一个敏感问题，在联系之前需要鼓起勇气。快速获得首选的医疗保健专业人员受到赞赏。护士被视为一个关心他人的促进者，而不是决策者。指导分诊的是患者的意愿，而不是症状。患者见到心理医生时的期望广泛且多样。结构化评估有时与这些期望相冲突，有时又与这些期望一致，产生不同的结果满意度。这些结果与当前在医疗保健系统中增加患者选择的目标一致。改善与心理医生的可及性似乎符合社区期望。结果还表明需要提供更多关于评估和潜在结果的预先信息。
