全科医生和执业护士对其管理儿科焦虑问题的看法：一项访谈研究。
GPs' and practice nurses' views on their management of paediatric anxiety problems: an interview study.
机构信息
Department of General Practice, ErasmusMC University Medical Center, PO Box 2040, 3000, CA, Rotterdam, the Netherlands.
Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
出版信息
BMC Prim Care. 2022 Sep 12;23(1):235. doi: 10.1186/s12875-022-01802-y.
BACKGROUND
Anxiety problems are common in both children and adolescents, and many affected children do not receive appropriate treatment. Understaffing of mental healthcare services and long waiting lists form major barriers. In the Netherlands, practice nurses have been introduced into general practice to support general practitioners (GPs) in the management of psychosocial problems. In this study we investigated the views of GPs and practice nurses on their management of paediatric anxiety problems.
METHODS
We performed an exploratory study using semi-structured interviews with 13 GPs and 13 practice nurses in the greater Rotterdam area in 2021. Interviews were transcribed and coded into topics, which were categorized per research question.
RESULTS
In their management of paediatric anxiety problems, both GPs and practice nurses try to explore the case and the needs of affected children and their parents. GPs rarely follow up affected children themselves. They often refer the child, preferably to their practice nurse. Practice nurses regularly initiate follow-up consultations with affected children themselves. Practice nurses reported using a variety of therapeutic techniques, including elements of cognitive behavioural therapy. In more severe cases, practice nurses refer the child to external mental healthcare services. GPs reported being satisfied with their collaboration with practice nurses. Both GPs and practice nurses experience significant barriers in the management of paediatric anxiety problems. Most importantly, long waiting lists for external mental health care were reported to be a major difficulty. Improving cooperation with external mental healthcare providers was reported to be an important facilitator.
CONCLUSIONS
In their management of paediatric anxiety problems, GPs and practice nurses experience major challenges in the cooperation with external mental healthcare providers and in the long waiting lists for these services. GPs and practice nurses believe that thanks to their shared approach more children with anxiety problems can remain treated in general practice. Future research is needed to evaluate the treatment outcomes of the shared efforts of GPs and practice nurses in their management of paediatric anxiety problems.
背景
焦虑问题在儿童和青少年中很常见，许多受影响的儿童得不到适当的治疗。精神保健服务人手不足和长时间的候诊名单是主要障碍。在荷兰，执业护士已被引入全科医生诊所，以支持全科医生管理心理社会问题。在这项研究中，我们调查了全科医生和执业护士对他们管理儿科焦虑问题的看法。
方法
我们于 2021 年在鹿特丹地区进行了一项探索性研究，对 13 名全科医生和 13 名执业护士进行了半结构化访谈。访谈记录被转录并编码为主题，根据研究问题进行分类。
结果
在管理儿科焦虑问题时，全科医生和执业护士都试图探讨病例和受影响儿童及其父母的需求。全科医生很少亲自随访受影响的儿童。他们经常将孩子转介给他们的执业护士。执业护士经常自己为受影响的孩子安排随访咨询。执业护士报告说使用了各种治疗技术，包括认知行为疗法的元素。在更严重的情况下，执业护士将孩子转介给外部精神保健服务。全科医生报告对与执业护士的合作感到满意。全科医生和执业护士在管理儿科焦虑问题方面都面临着重大障碍。最重要的是，外部精神保健服务的长候诊名单被报告为一个主要困难。改善与外部精神保健提供者的合作被认为是一个重要的促进因素。
结论
在管理儿科焦虑问题时，全科医生和执业护士在与外部精神保健提供者的合作以及这些服务的长时间候诊名单方面面临重大挑战。全科医生和执业护士认为，由于他们的共同方法，更多患有焦虑问题的儿童可以在全科医生诊所得到治疗。需要进一步研究来评估全科医生和执业护士在管理儿科焦虑问题方面共同努力的治疗效果。
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