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[患有心理障碍的移民在普通医学咨询中的障碍与实际情况。法国全科医生的定性研究]

[Obstacles and practical perspectives of the consultation in general medicine of migrants with psychological disorders. Qualitative study among French general practitioners].

作者信息

Lerigoleur Marie, Urena-Dores Aurélie, Gérard Bourrel, Jaume Cyril, Minet Mathilde, Million Élodie, Clary Bernard, Oude Engberink Agnès, Lognos Folco Béatrice

机构信息

University of Montpellier Faculty of Medicine Montpellier-Nimes, Montpellier, France.

INSERM-Université de Montpellier IDESP, Montpellier, France.

出版信息

Can J Psychiatry. 2024 Mar;69(3):207-216. doi: 10.1177/07067437231200842. Epub 2023 Sep 24.

Abstract

OBJECTIVE

The aim of this study is to understand the problems of managing psychological disorders in migrant populations, based on the experience of general practitioners.

METHOD

A qualitative study was carried out with general practitioners interviewed in a semi-directive mode. We chose the continuous comparison method and Peirce's pragmatic phenomenological approach to explore the lived experience.

RESULTS

Thirteen interviews revealed four phenomenological categories: (1) Immigration was an experience of mental suffering from beginning to end at the source of psychological disorder migrant population (PDMPs) with the need for specialized follow-up. (2) Inadequate support on arrival, with complicated administrative procedures and insecure societal and environmental conditions, exacerbated the precariousness of migrants, making follow-up difficult. (3) Immigration was a transcultural journey in which the language, attitudes and perceptions of each individual blurred understanding of symptoms and care, and thus professional communication. (4) Unprepared general practitioners found counselling migrants to be difficult, time-consuming and complex. They pointed to the need for a coordinated system with comprehensive multidisciplinary care.Data saturation was reached. Three researchers were brought together.

CONCLUSION

This study highlights the difficulties encountered by general practitioner (GPs) dealing with migrant patients in France. They feel helpless in the face of the nature of the disorders encountered and experience a disparity between the connections that are difficult to establish and those in their usual practice, even when professional experience with this population is acquired. They point to the need for coordinated models of care, financed by public policy.

摘要

目的

本研究旨在基于全科医生的经验,了解移民人群心理障碍管理方面的问题。

方法

采用半指导性访谈方式对全科医生进行定性研究。我们选择持续比较法和皮尔斯的实用现象学方法来探索生活经历。

结果

13次访谈揭示了四个现象学类别:(1)移民从始至终都是心理障碍移民人群(PDMPs)心理痛苦的经历,需要专业随访。(2)抵达时支持不足,行政程序复杂,社会和环境条件不安全,加剧了移民的不稳定状况,使随访变得困难。(3)移民是一段跨文化旅程,每个人的语言、态度和观念模糊了对症状和护理的理解,进而影响了专业沟通。(4)毫无准备的全科医生发现为移民提供咨询既困难、耗时又复杂。他们指出需要一个协调的系统,提供全面的多学科护理。数据达到饱和。三位研究人员进行了汇总。

结论

本研究突出了法国全科医生在诊治移民患者时遇到的困难。面对所遇到疾病的性质,他们感到无助,并且在难以建立的联系与日常诊疗中的联系之间体验到差异,即使获得了针对该人群的专业经验也是如此。他们指出需要由公共政策资助的协调护理模式。

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