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住院医师访问专业精神卫生服务的特征:一项回顾性研究。

Characteristics of resident physicians accessing a specialised mental health service: a retrospective study.

机构信息

Integral Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Catalonia, Spain

Psychiatry, Mental Health and Addiction Research Group, VHIR, CIBERSAM, Barcelona, Catalonia, Spain.

出版信息

BMJ Open. 2021 Dec 2;11(12):e055184. doi: 10.1136/bmjopen-2021-055184.

Abstract

OBJECTIVES

Little is known about resident physicians being treated at physician health programmes around the world despite the fact that it is a highly demanding training period. This study aims to describe the profiles of resident physicians accessing a specialised mental health service in Spain over a 20-year period and to compare them to consultant-grade physicians.

DESIGN

Retrospective observational study.

SETTING

Medical records of the Galatea Care Programme for Sick Physicians.

PARTICIPANTS

1846 physicians registered at the Barcelona Medical Council-Association and admitted to the programme from January 1998 to December 2018.

PRIMARY AND SECONDARY OUTCOME MEASURES

Number of admissions, sociodemographic and clinical variables, including medical specialty, main diagnosis and need of hospitalisation.

RESULTS

Residents accounted for 18.1% (n=335) of the sample and admissions increased over the years. Most residents (n=311; 94.5%) and consultant-grade physicians (n=1391; 92.8%) were self-referred. The most common specialty among residents was family medicine (n=107; 31.9%), followed by internal medicine (n=18; 5.4%), paediatrics (n=14; 4.2%), psychiatry (n=13; 3.9%) and anaesthesiology (n=13; 3.9%). Residents, regardless of year of training, mainly asked for help because of adjustment (n=131; 39.1%), affective (n=77; 23%), anxiety disorders (n=40; 18.8%) and addictions (n=19; 5.7%). There were no significant differences between groups in the main diagnosis and in the variables related to need of hospitalisation. The percentage of residents accessing the programme was higher than in the reference population registered at the Barcelona Medical Council-Association (18.1% vs 7.6%; z=7.2, p<0.001) as was the percentage of family medicine residents (31.9% vs 19.6%; z=5.7, p<0.001).

CONCLUSIONS

Residents are more likely than consultant-grade physicians to seek help when suffering from mental disorders. Local primary prevention actions since the beginning of their training period and having access to a well-known highly reliable programme may partly explain these findings.

摘要

目的

尽管住院医师培训期间的要求很高,但全世界对接受医师健康计划治疗的住院医师知之甚少。本研究旨在描述过去 20 年在西班牙接受专门心理健康服务的住院医师的特征,并将其与顾问级医师进行比较。

设计

回顾性观察性研究。

地点

Galatea 医师健康计划医疗记录。

参与者

1998 年 1 月至 2018 年 12 月期间,巴塞罗那医师委员会协会登记的 1846 名医师参加了该计划。

主要和次要结果测量

入院人数、社会人口学和临床变量,包括医学专业、主要诊断和住院需求。

结果

住院医师占样本的 18.1%(n=335),入院人数逐年增加。大多数住院医师(n=311;94.5%)和顾问级医师(n=1391;92.8%)都是自我推荐的。住院医师中最常见的专业是家庭医学(n=107;31.9%),其次是内科(n=18;5.4%)、儿科(n=14;4.2%)、精神病学(n=13;3.9%)和麻醉学(n=13;3.9%)。无论培训年限如何,住院医师主要因调整(n=131;39.1%)、情感障碍(n=77;23%)、焦虑障碍(n=40;18.8%)和成瘾(n=19;5.7%)寻求帮助。两组在主要诊断和与住院需求相关的变量方面无显著差异。参加该计划的住院医师比例高于巴塞罗那医师委员会协会登记的参考人群(18.1%比 7.6%;z=7.2,p<0.001),家庭医学住院医师的比例也高于参考人群(31.9%比 19.6%;z=5.7,p<0.001)。

结论

与顾问级医师相比,住院医师在患有精神障碍时更有可能寻求帮助。自培训开始以来,当地采取的初级预防行动以及获得知名的、高度可靠的计划可能部分解释了这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32b/8640645/24e21b646241/bmjopen-2021-055184f01.jpg

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