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全科医生为抑郁症患者提供生活方式建议的经验:一项定性焦点小组研究。

General practitioners' experiences of providing lifestyle advice to patients with depression: A qualitative focus group study.

作者信息

Astaire Emma, Jennings Laura, Khundakar Martina, Silverio Sergio A, Flynn Angela C

机构信息

School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom.

Pharmacy Department, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom.

出版信息

PLoS One. 2024 Mar 11;19(3):e0299934. doi: 10.1371/journal.pone.0299934. eCollection 2024.

Abstract

OBJECTIVE

Depression is an increasingly common mental health disorder in the UK, managed predominantly in the community by GPs. Emerging evidence suggests lifestyle medicine is a key component in the management of depression. We aimed to explore GPs' experiences, attitudes, and challenges to providing lifestyle advice to patients with depression.

METHOD

Focus groups were conducted virtually with UK GPs (May-July 2022). A topic guide facilitated the discussion and included questions on experiences, current practices, competence, challenges, and service provision. Data were analysed using template analysis.

RESULTS

'Supporting Effective Conversations'; 'Willing, but Blocked from Establishing Relational Care'; 'Working Towards Patient Empowerment'; and 'Control Over the Prognosis' were all elements of how individualised lifestyle advice was key to the management of depression. Establishing a doctor-patient relationship by building trust and rapport was fundamental to having effective conversations about lifestyle behaviours. Empowering patients to make positive lifestyle changes required tailoring advice using a patient-centred approach. Confidence varied across participants, depending on education, experience, type of patient, and severity of depression.

CONCLUSIONS

GPs play an important role in managing depression using lifestyle medicine and a patient-centred approach. Organisational and educational changes are necessary to facilitate GPs in providing optimal care to patients with depression.

摘要

目的

抑郁症在英国是一种日益常见的心理健康障碍,主要由全科医生在社区进行管理。新出现的证据表明,生活方式医学是抑郁症管理的关键组成部分。我们旨在探讨全科医生在为抑郁症患者提供生活方式建议方面的经验、态度和挑战。

方法

于2022年5月至7月与英国全科医生进行了虚拟焦点小组访谈。一份主题指南推动了讨论,其中包括关于经验、当前做法、能力、挑战和服务提供的问题。使用模板分析法对数据进行了分析。

结果

“支持有效的对话”;“愿意,但无法建立关系性护理”;“努力实现患者赋权”;以及“对预后的控制”都是个性化生活方式建议如何成为抑郁症管理关键的要素。通过建立信任和融洽关系来建立医患关系,对于就生活方式行为进行有效对话至关重要。使用以患者为中心的方法量身定制建议,才能使患者有能力做出积极的生活方式改变。不同参与者的信心各不相同,这取决于教育程度、经验、患者类型和抑郁症的严重程度。

结论

全科医生在使用生活方式医学和以患者为中心的方法管理抑郁症方面发挥着重要作用。需要进行组织和教育变革,以帮助全科医生为抑郁症患者提供最佳护理。

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