Bireckoven Martina B, Niebling Wilhelm, Tinsel Iris
Lehrbereich Allgemeinmedizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwig-Universität Freiburg, Freiburg, Deutschland.
Lehrbereich Allgemeinmedizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwig-Universität Freiburg, Freiburg, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2016 Nov;117:45-55. doi: 10.1016/j.zefq.2016.09.004. Epub 2016 Oct 15.
Depression is a very common disease among the elderly. Various studies demonstrated the need to improve the care for elderly depressed patients. Within the GermanIMPACT trial specifically trained care managers were engaged to cooperate with general practitioners (GPs). This study investigates how GPs evaluate this cooperation and their attitude towards collaborative care.
To explore the perspective of GPs a qualitative study design with semi-structured interviews was chosen. The guideline-based interviews were conducted with GPs from the intervention group, the control group and with GPs who had decided not to participate in the trial. The interviews were audio-taped, fully transcribed and analysed.
Eighteen GPs were interviewed. Almost all GPs from the intervention group appreciated the support by care managers. Advantages they mentioned included their own relief by the committed conversation between patient and care manager, the continuous monitoring of the patients as well as the regular feedback via protocols. GPs who refused to take part in the study expressed different attitudes towards collaborative care.
Due to the general overall positive valuation of care managers as well as their positive attitude towards collaborative care a continuation of the IMPACT program in Germany should be considered. More investigation needs to be done to answer the question how care managers can be integrated in everyday primary care.
抑郁症在老年人中是一种非常常见的疾病。各种研究表明需要改善对老年抑郁症患者的护理。在德国IMPACT试验中，专门培训的护理经理与全科医生（GP）合作。本研究调查了全科医生如何评估这种合作以及他们对协作护理的态度。
为了探究全科医生的观点，选择了采用半结构化访谈的定性研究设计。对来自干预组、对照组的全科医生以及决定不参与试验的全科医生进行了基于指南的访谈。访谈进行了录音、全文转录并分析。
采访了18名全科医生。几乎所有来自干预组的全科医生都赞赏护理经理的支持。他们提到的优点包括患者与护理经理之间的深入交谈使他们自身得到解脱、对患者的持续监测以及通过协议进行的定期反馈。拒绝参与研究的全科医生对协作护理表达了不同的态度。
由于对护理经理的总体积极评价以及他们对协作护理的积极态度，应该考虑在德国继续开展IMPACT项目。需要进行更多调查以回答如何将护理经理纳入日常初级护理的问题。
