Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
Bioethics Centre, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Complement Ther Clin Pract. 2020 May;39:101114. doi: 10.1016/j.ctcp.2020.101114. Epub 2020 Feb 3.
Mental health presents a significant burden of disease and a large, and increasing, number of patients are self-selecting forms of CAM, including acupuncture, as an adjunct, or standalone treatment for the management of their mental health. General practitioners (GPs) play an important role in integrated care management of primary mental health, and in most cases act as the primary provider and access point for further services. However, the interaction and collaboration between GPs and acupuncturists in relation to shared mental health care has not been investigated. This research explores interprofessional communication between GPs and acupuncturists in New Zealand concerning mental health care. The aim of this research was to understand the barriers to communication, and to facilitate collaboration between the two participant groups.
The project utilised a mixed methods multiphase design, with both qualitative and quantitative inquiry, and involving the convergence of data and analyses. A nationwide survey of 400 GPs and 250 acupuncturists was conducted. Univariate data was analysed using descriptive statistics, which included frequencies and percentages for categorical data. This was followed by individual semi-structured interviews of 13 purposively sampled acupuncturists, and 14 GPs which was analysed using thematic analysis. This design consisted of three distinct phases: quantitative, qualitative, implementation and reflection.
Both provider groups acknowledged the complexities of working within mental health care, and supported the development of specific mental health competencies in light of the recognition of the limitations surrounding current mental health care. The unfamiliarity of acupuncture's evidence-base to both provider groups was an identified barrier, yet both groups acknowledged that while practice is informed by the evidence, there are many other factors that also inform clinical practice.
This study is the first in New Zealand to seek quantitative data and qualitative views regarding alignment about mental health management approaches and the use of acupuncture. This has the potential of improving healthcare outcomes through better inter professional communication and by contributing to better trans-cultural understandings on healthcare issues. The results of this research, whilst looking at the communication model between acupuncture and primary health care, will have easily generalizable findings for other necessary interprofessional communication strategies. This is the first time that the role and potential of the relatively untapped resource base of acupuncture within the health sector has been investigated within a New Zealand context.
心理健康带来了巨大的疾病负担，越来越多的患者选择补充和替代医学（CAM），包括针灸，作为管理其心理健康的辅助或独立治疗方法。全科医生（GP）在初级心理健康综合管理中发挥着重要作用，并且在大多数情况下，他们是提供服务和获取进一步服务的主要提供者和接入点。然而，GP 和针灸师之间在共同的心理健康护理方面的相互作用和协作尚未得到研究。本研究探讨了新西兰全科医生和针灸师在心理健康护理方面的跨专业交流。本研究的目的是了解沟通障碍，并促进两个参与者群体之间的合作。
该项目采用混合方法多阶段设计，包括定性和定量研究，并涉及数据和分析的融合。对全国 400 名全科医生和 250 名针灸师进行了调查。使用描述性统计对单变量数据进行分析，包括分类数据的频率和百分比。之后对 13 名有针对性抽样的针灸师和 14 名全科医生进行了个人半结构式访谈，采用主题分析进行分析。该设计包括三个不同的阶段：定量、定性、实施和反思。
两个提供者群体都承认在心理健康护理工作中的复杂性，并支持根据当前心理健康护理的局限性，制定特定的心理健康能力。针灸的证据基础对两个提供者群体都不熟悉，这是一个被识别出的障碍，但两个群体都承认，虽然实践是基于证据的，但还有许多其他因素也会影响临床实践。
这项研究是新西兰首次寻求关于心理健康管理方法和针灸应用的一致性的定量数据和定性观点。这有可能通过更好的跨专业沟通来改善医疗保健结果，并对医疗保健问题有更好的跨文化理解。虽然这项研究着眼于针灸与初级保健之间的沟通模式，但它将为其他必要的跨专业沟通策略提供易于推广的发现。这是首次在新西兰背景下研究相对未开发的针灸资源在卫生部门中的作用和潜力。
