Wehr Lisa M, Vanderlip Erik R, Gibbons Patrick H, Fiedorowicz Jess G
J Grad Med Educ. 2017 Apr;9(2):237-240. doi: 10.4300/JGME-D-16-00351.1.
Patients with psychiatric disorders have higher rates of chronic medical conditions and decreased life expectancy. Integrating medical and psychiatric care is likely to improve health outcomes for these patients.
This study examined what proportion of psychiatry residents viewed psychiatry as a primary care specialty, how important they felt it was to provide primary care to patients, and how this perception altered self-reported comfort and practice patterns in providing screening and treatment for select general medical conditions.
An online survey was sent to current psychiatry residents of US residency programs.
A total of 268 residents from 40 programs completed the survey (25% response rate), with 55% (147 of 265) of respondents considering psychiatry to be a primary care specialty. Residents who held this opinion gave higher ratings for the importance of providing preventive counseling and reported counseling a higher percentage of patients on a variety of topics. They also reported screening more patients for several medical conditions. Residents who considered psychiatry to be primary care did not report greater comfort with treating these conditions, with the exception of dyslipidemia. The most commonly cited barrier to integrating primary care services was lack of time.
Residents' perceptions of psychiatry as a primary care field appears to be associated with a higher reported likelihood of counseling about, and screening for, medical conditions in their patients.
患有精神疾病的患者慢性疾病发生率较高，预期寿命缩短。整合医疗和精神科护理可能会改善这些患者的健康状况。
本研究调查了精神科住院医师中将精神科视为初级保健专业的比例、他们认为为患者提供初级保健的重要性，以及这种认知如何改变他们在为特定一般医疗状况提供筛查和治疗时自我报告的舒适度和实践模式。
向美国住院医师培训项目的现任精神科住院医师发送了一份在线调查问卷。
来自40个项目的268名住院医师完成了调查（回复率为25%），55%（共265名，其中147名）的受访者认为精神科是初级保健专业。持此观点的住院医师对提供预防性咨询的重要性给予了更高评分，并报告就各种主题为更高比例的患者提供咨询。他们还报告为更多患者进行了几种医疗状况的筛查。认为精神科是初级保健专业的住院医师在治疗这些状况时，除血脂异常外，并未报告更高的舒适度。整合初级保健服务最常被提及的障碍是时间不足。
住院医师将精神科视为初级保健领域的认知似乎与报告中为患者提供医疗状况咨询和筛查的可能性较高有关。
