缺乏初级保健医生与严重精神疾病患者的痛苦增加有关。

Lacking a Primary Care Physician Is Associated With Increased Suffering in Patients With Severe Mental Illness.

作者信息

Olsen Cynthia G, Boltri John M, Amerine Jenna, Clasen Mark E

机构信息

Department of Family Medicine, Wright State University Boonshoft School of Medicine, Wright State Physicians Health Center, 725 University Blvd, Fairborn, OH, 45324, USA.

Department of Family and Community Medicine, Northeast Ohio Medical University, 4209 St. RT.44, P.O. Box 95, Rootstown, OH, 44272, USA.

出版信息

J Prim Prev. 2017 Dec;38(6):583-596. doi: 10.1007/s10935-017-0490-7.

DOI:10.1007/s10935-017-0490-7

PMID:28929367

Abstract

We evaluated the relationship between lack of a primary care physician (PCP) and patients with severe mental illness (SMI), who have poorer health and experience more suffering. Using a blinded retrospective record review of 137 patients with SMI, divided between inpatients (n = 70) and outpatients (n = 67), we compared the two groups to determine if lack of a PCP is associated with increased suffering and worse overall health. We included history of preventive services, having a PCP, and comorbid conditions. Multiple linear regressions determined the relationship between lacking a PCP and lifestyle problems, lack of preventive care, and Burden of Suffering. We found that in SMI patients, lack of a PCP is associated with increased lifestyle problems, lacking preventive care, increased Burden of Suffering and cervical dysplasia. Health policy changes are needed to improve outcomes for patients with SMI by increasing access to PCPs and preventive services.

摘要

我们评估了缺乏初级保健医生（PCP）与患有严重精神疾病（SMI）的患者之间的关系，这类患者健康状况较差且遭受更多痛苦。通过对137例SMI患者进行盲法回顾性病历审查，这些患者分为住院患者（n = 70）和门诊患者（n = 67），我们比较了两组患者，以确定缺乏PCP是否与痛苦增加和整体健康状况恶化有关。我们纳入了预防服务史、是否有PCP以及合并症情况。多元线性回归确定了缺乏PCP与生活方式问题、缺乏预防保健以及痛苦负担之间的关系。我们发现，在SMI患者中，缺乏PCP与生活方式问题增加、缺乏预防保健、痛苦负担增加以及宫颈发育异常有关。需要通过增加获得PCP和预防服务的机会来改变卫生政策，以改善SMI患者的治疗效果。