呈现佛兰德斯初级保健中心的社会心理问题的流行状况和管理。
Presenting prevalence and management of psychosocial problems in primary care in Flanders.
机构信息
Department of General Practice, KU Leuven, Kapucijnenvoer 33 blok j - bus 7001, 3000 Leuven, Belgium.
出版信息
Arch Public Health. 2015 Mar 9;73(1):10. doi: 10.1186/s13690-015-0061-4. eCollection 2015.
BACKGROUND
Psychosocial problems are widespread but reliable data about management are sparse. An overall view is missing and there is a need for a wider framework to include the data available in health care and welfare practice, databases and research output. The question under scope is: how are psychosocial problems presented and handled in primary care in Flanders?
METHODS
A mixed method was used. Using a 'fishbone diagram' (1) we obtained a basic structure to visualize the main (problem) areas and challenges. A literature study (2) and semi-structured interviews with health care and welfare professionals in primary care (3) were performed. Finally, two interdisciplinary focus groups were organized (4).
RESULTS
In Flanders, there is no tradition of multidisciplinary psychosocial research in primary care causing a lack of integrated data. Data only exist within disciplines without transdisciplinarity. The data are difficult to interpret due to different labeling and registration processes between disciplines and settings. However, we can find some general trends: assistance to patients with psychosocial problems is based on what can be offered, rather than on patient needs; drug treatment remains popular; referral of patients within primary care or to secondary care does not seem to be obvious. Among all disciplines, there is a great need for more collaboration and considerable advantages are to be expected from the growing emergence of multidisciplinary practices; multiculturalism appears to take an increasingly important place within primary care in Flanders and has implications for the care offered; and treatment effectiveness in psychosocial problems seems to be more related to the person of the caregiver than to a specific discipline, theory or type of treatment.
CONCLUSIONS
Based on our results, we strongly advise stimulation and organization of integrated (multidisciplinary) research regarding psychosocial problems in primary care and a more consistent registration by the agencies in primary care.
背景
心理社会问题普遍存在，但管理方面的可靠数据却很少。缺乏整体视角，需要更广泛的框架来纳入医疗保健和福利实践、数据库和研究成果中的数据。本次研究的范围是：在佛兰德斯，初级保健中如何呈现和处理心理社会问题？
方法
采用混合方法。使用“鱼骨图”（1），我们获得了一个基本结构，以可视化主要（问题）领域和挑战。进行了文献研究（2）和初级保健中医疗保健和福利专业人员的半结构化访谈（3）。最后，组织了两个跨学科焦点小组（4）。
结果
在佛兰德斯，初级保健中没有多学科心理社会研究的传统，导致缺乏综合数据。数据仅存在于学科内部，没有跨学科性。由于不同学科和环境之间的标签和注册过程不同，数据难以解释。然而，我们可以发现一些总体趋势：为有心理社会问题的患者提供帮助是基于所能提供的，而不是基于患者的需求；药物治疗仍然很受欢迎；在初级保健或二级保健中，患者的转诊似乎并不明显。在所有学科中，都非常需要更多的合作，并且从多学科实践的不断出现中可以预期会带来相当大的优势；多元文化主义在佛兰德斯的初级保健中似乎占据越来越重要的地位，并对所提供的护理产生影响；心理社会问题的治疗效果似乎与护理人员的个人素质更相关，而不是与特定的学科、理论或治疗类型有关。
结论
根据我们的研究结果，我们强烈建议刺激和组织有关初级保健中心理社会问题的综合（多学科）研究，并由初级保健机构进行更一致的登记。
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