1 Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.
2 Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.
Aust N Z J Psychiatry. 2018 Jun;52(6):561-572. doi: 10.1177/0004867417728806. Epub 2017 Sep 9.
To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population.
A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed.
Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services.
People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.
从精神疾病患者的角度描述他们在 12 个月内使用全科医生服务的情况，以及全科医生在为这一人群提供医疗保健方面所面临的经历、态度和挑战。
采用两阶段设计。第一阶段，在澳大利亚七个地区的公共专门精神卫生服务机构和非政府组织中进行精神病筛查。第二阶段，对筛查出阳性的 1825 名精神病患者进行随机选择进行访谈，访谈内容包括在访谈前的 12 个月内与全科医生联系的频率和原因。还对同意参加的患者的全科医生（1473 人）进行了调查。
几乎所有（90.3%）调查参与者在过去 12 个月内咨询过全科医生，平均 8.9 次，28.8%的就诊者咨询了 12 次或更多次。大多数（83.5%）患者在一个全科医生诊所就诊。大多数（77.6%）全科医生希望参与他们患者的精神卫生保健。尽管 69.1%的医生表示管理他们的患者对他们的诊所没有问题，但五分之一的全科医生报告说，与患者不遵守治疗方案和不按时预约、时间限制以及缺乏来自治疗精神卫生服务的反馈有关的问题。
患有精神病的患者会咨询全科医生，有些患者咨询的频率非常高。大多数澳大利亚全科医生认为，他们有责任审查患者的身心健康。改善全科医生和精神卫生服务之间的沟通，以及更容易获得精神卫生支持，可能有助于全科医生管理他们患者的复杂的心理、身体和社会问题。
