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全科医生对常见精神健康障碍管理的看法:继续医学教育的关键作用。

General practitioners' views towards management of common mental health disorders: Τhe critical role of continuing medical education.

机构信息

Lab of Public Health, Medical School, University of Patras, GR-26504, Patras, Greece.

Primary Health Care Centre of Kleitoria, Achaia, Greece.

出版信息

BMC Prim Care. 2023 Mar 4;24(1):63. doi: 10.1186/s12875-023-02017-5.

Abstract

BACKGROUND

The disability burden of common mental health disorders is enormous and should be faced at the first point of contact in the healthcare system. General Practitioners (GPs) are called to recognize, diagnose, and manage patients with mental health disorders, a task which is not always addressed successfully. The study aims at examining the relationship between mental health education of GPs and self-reported opinions on the care they provide to patients with mental disorders in Greece.

METHODS

A questionnaire investigating GPs' viewpoints regarding diagnostic methods, referral rates and overall management of patients with mental disorders, and how these are impacted by their education on mental health, was employed, in a randomly selected sample of 353 GPs in Greece. Suggestions and proposals about improvement of ongoing mental health training, along with organizational reforming were also recorded.

RESULTS

Received Continuing Medical Education (CME) is characterized as insufficient by 56.1% of the GPs. More than half of the GPs participate in clinical tutorials and mental health conferences once per three years or less. The level of educational score on mental health is associated positively with decisiveness on management of patients and increases self-confidence. A percentage of 77.6% states knowledge of the appropriate treatment and 56.1% agree to initiate treatment without referring to a specialist. However, low to moderate self-confidence about diagnosis and treatment is stated by 47.5%. According to GPs, critical points for improving mental health primary care are the liaison psychiatry and high degree of CME.

CONCLUSION

Greek GPs are calling for focused and continuing medical education, in the field of psychiatry, along with essential structural and organizational reforming of the healthcare system, including an efficient liaison psychiatry.

摘要

背景

常见精神健康障碍的残疾负担巨大,应在医疗保健系统的第一接触点加以应对。全科医生(GP)负责识别、诊断和管理精神健康障碍患者,但这项任务并非总能成功完成。本研究旨在考察希腊全科医生的精神健康教育培训与他们对精神障碍患者护理的自我报告意见之间的关系。

方法

采用问卷调查的方式,调查了希腊 353 名 GP 对诊断方法、转诊率和精神障碍患者整体管理的观点,以及他们的精神健康教育对这些方面的影响。还记录了关于改善正在进行的精神健康培训以及组织改革的建议和提案。

结果

56.1%的 GP 认为他们接受的继续医学教育(CME)不足。超过一半的 GP 每三年或更久参加一次临床辅导和精神健康会议。精神健康教育得分水平与管理患者的果断性呈正相关,并提高了自信心。77.6%的人表示了解适当的治疗方法,56.1%的人同意在不转介给专家的情况下开始治疗。然而,47.5%的人对诊断和治疗的自信心较低或中等。根据 GP 的说法,改善初级保健精神卫生的关键点是联络精神病学和高度的 CME。

结论

希腊 GP 呼吁在精神病学领域进行有针对性的继续教育,并对医疗保健系统进行必要的结构性和组织改革,包括有效的联络精神病学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff8/9985274/6851927febe1/12875_2023_2017_Fig1_HTML.jpg

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