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基层医疗保健环境中初级保健儿科医生对心理健康的看法。

Primary care pediatrician perceptions towards mental health within the primary care setting.

机构信息

Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Graduate Medical Education Department, University Hospitals Cleveland Medical Center Rainbow Babies and Children's Hospital, Cleveland, OH, USA.

出版信息

Pediatr Res. 2021 Nov;90(5):950-956. doi: 10.1038/s41390-020-01349-7. Epub 2021 Feb 2.

Abstract

BACKGROUND

Mental health (MH) conditions are highly prevalent, yet only marginal portions of children receive adequate services. Access to specialized mental healthcare is limited and, consequently, pediatricians remain the source of management and care of children with MH disorders. Despite this, research suggests that pediatricians report lack of access to training and support regarding MH care of youth, leading to discomfort with managing the population they are asked to treat. An additional barrier to care that has less research is perceptions regarding MH disorders among pediatricians. This scoping review aims to describe the state of science regarding perceptions and possible stigma towards MH in pediatric primary care.

METHODS

PsychInfo, PubMed Medline, Ovid Medline, CINAHL, and Embase were searched with terms related to stigma, pediatricians, and MH disorders. New research articles were included after review, which addressed stigma in pediatricians treating youth with MH disorders.

RESULTS

Our initial search produced 457 titles, with 23 selected for full-text review, and 8 meeting inclusion criteria, N = 1571 pediatricians.

CONCLUSIONS

While a limited number of studies focus on physician-based perceptions/stigma, and even less data on pediatrician stigma towards MH, more studies are needed to explore how this impacts patient care.

IMPACT

In this scoping review, we sought to shed light on the limitations regarding MH care access, especially with the increasing need for care and not enough MH specialists, adding to an already tremendous burden pediatric primary care providers face daily. We also reviewed barriers to said care within pediatric primary care, including the potential for physician stigma towards MH diagnosis, treatment, and management. This review adds a concise summary of the current limited studies on stigma towards MH within primary care pediatricians and the importance of continued research into how perception and stigma affect patient care. This material is an original project and has not been previously published. This work is not submitted for publication or consideration elsewhere.

摘要

背景

心理健康(MH)问题普遍存在,但只有极少数儿童获得了足够的服务。获得专业心理健康医疗服务的机会有限,因此儿科医生仍然是管理和照顾患有 MH 障碍儿童的来源。尽管如此,研究表明,儿科医生报告称缺乏有关青少年 MH 护理的培训和支持,导致他们对管理自己被要求治疗的人群感到不适。另一个较少研究的护理障碍是儿科医生对 MH 障碍的看法。本范围综述旨在描述有关儿科初级保健中对 MH 的看法和可能的污名的科学现状。

方法

使用与污名、儿科医生和 MH 障碍相关的术语,在 PsychInfo、PubMed Medline、Ovid Medline、CINAHL 和 Embase 中进行了搜索。经过审查后,包括了新的研究文章,这些文章涉及儿科医生在治疗患有 MH 障碍的青少年时的污名问题。

结果

我们最初的搜索产生了 457 个标题,其中 23 个进行了全文审查,8 个符合纳入标准,共有 1571 名儿科医生。

结论

虽然少数研究关注医生的看法/污名问题,而且关于儿科医生对 MH 的污名问题的数据更少,但需要更多的研究来探讨这如何影响患者护理。

影响

在这项范围综述中,我们试图阐明 MH 护理机会的局限性,特别是在对护理的需求不断增加而 MH 专家却不足的情况下,这给儿科初级保健提供者每天已经面临的巨大负担增加了负担。我们还审查了儿科初级保健中护理的障碍,包括儿科医生对 MH 诊断、治疗和管理的潜在污名。这篇综述对目前关于初级保健儿科医生对 MH 的污名的有限研究进行了简明总结,以及继续研究看法和污名如何影响患者护理的重要性。这篇综述是一项原创项目,以前没有发表过。本作品未提交发表或考虑在其他地方发表。

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