School of Psychology and Clinical Language Sciences, University of Reading, Reading.
Institute of Psychology, Health and Society, University of Liverpool, Liverpool.
Br J Gen Pract. 2017 Dec;67(665):e888-e898. doi: 10.3399/bjgp17X693473. Epub 2017 Oct 23.
Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs' perspectives on and experiences of supporting children with these disorders.
To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders.
Twenty semi-structured interviews were conducted with GPs in primary care throughout England.
GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis.
Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services).
GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children's mental health, as well as potential for greater collaboration between primary and specialist services.
焦虑障碍的发病中位年龄为 11 岁,是儿童期最常见的情绪障碍;然而,相当一部分患者并未获得专业支持。在英国,全科医生通常是家庭首先寻求的医疗专业人员,因此他们处于支持患有焦虑障碍的儿童的最佳位置;然而,目前关于全科医生对这些障碍的看法和支持经验的研究甚少。
探讨全科医生在识别、管理和获得儿童(<12 岁)焦虑障碍专科服务方面的经验。
在英格兰的基层医疗保健中,对 20 名全科医生进行了 20 次半结构式访谈。
全科医生在注册患者的种族和社会经济状况、全科医生年龄、性别、职业地位、以前参与研究以及实践规模和地点等方面反映出多样化的群体。采用目的性抽样招募全科医生,直到达到理论饱和。使用恒定性比较方法对数据进行主题分析。
20 次半结构化访谈的数据组织成三个主题:决策制定、责任和情绪反应,以及全科医生感到准备不足的总体主题。这些主题被回顾性分析,以说明它们在基层医疗过程的不同阶段(识别、管理和获得专科服务)的作用。
全科医生感到在管理和支持儿童焦虑障碍方面准备不足,这表明医疗培训需要更加重视儿童的心理健康,并可能需要加强基层和专科服务之间的合作。