Gerber Tonia, Hernandez Laura Diaz, Rüegg René, Vetter Dunja, Zeller Andreas
Centre for Primary Health Care, University of Basel, Basel, Switzerland.
Bern University of Applied Sciences, Bern, Switzerland.
BMC Prim Care. 2025 Jan 14;26(1):11. doi: 10.1186/s12875-024-02702-z.
Health or illness and social issues cannot be viewed in isolation. Social problems can influence well-being and disease. General Practitioners (GPs) are requested to offer counselling opportunities to respond to the social issues of their patients adequately. Counselling on non-medical issues in general practice increases GPs' workload. The study aimed to analyse the occurrence of social problems as well as the strengths and weaknesses of existing working agreements between social services and GPs in primary care.
We carried out a cross-sectional online survey between December 2022 and January 2023 among a sample of Swiss GPs from the Sentinella-Network, the uniham-bb-Network and social workers from the SAGES-Network.
Findings come from a sample of 143 GPs (mean age 54 years, 37.8% female) and 41 social workers (mean age 43 years, 75.6% female). GPs face a median of 3 patients with social problems per week (IQR 5.2). They reported encountering patients facing "Finance" issues most frequently, with 78.8% encountering such cases between "more than 3 patients per week" and "1-3 patients per month". "Work" (76.4%) and "Loneliness" (73.7%) were also among the most commonly encountered social problems. When suspecting the problem, GPs more often addressed the issue if it was about "Addiction" (83.2%), "Loneliness" (72.3%), or "Protection" (71.4%). More than half of GPs (56.0%) reported having contact with social workers less than once a month, while approximately half of the social workers reported having contact with GPs 1 to 3 times a month (48.7%). GPs (69.3%) and social workers (76.3%) would like more contact. The most frequently mentioned benefits of an increased collaboration from the GPs' perspective were "improved quality of care (more time for medical issues)" (64.8%) and "improved mental health of patients" (55.6%).
Social problems in general practice are common, but the interprofessional cooperation between GPs and social workers is scarce. However, both parties appear to be in favour of closer interprofessional collaboration and seem to be willing to attempt to improve joint patient care in the future. The integration of social workers into general practice is promising for a comprehensive, interprofessional, and preventative patient approach to providing the best healthcare.
健康或疾病以及社会问题不能孤立看待。社会问题会影响幸福感和疾病。要求全科医生提供咨询机会，以充分应对患者的社会问题。全科医疗中针对非医疗问题的咨询会增加全科医生的工作量。本研究旨在分析社会问题的发生率以及初级保健中社会服务机构与全科医生之间现有工作协议的优缺点。
我们在2022年12月至2023年1月期间，对来自Sentinella网络、uniham-bb网络的瑞士全科医生样本以及SAGES网络的社会工作者进行了横断面在线调查。
研究对象包括143名全科医生（平均年龄54岁，女性占37.8%）和41名社会工作者（平均年龄43岁，女性占75.6%）。全科医生每周面对社会问题患者的中位数为3名（四分位距为5.2）。他们报告称，最常遇到面临“财务”问题的患者，78.8%的人表示每周遇到此类情况的患者“超过3名”至“每月1 - 3名”。“工作”（76.4%）和“孤独”（73.7%）也是最常遇到的社会问题。当怀疑存在问题时，如果问题涉及“成瘾”（83.2%）、“孤独”（72.3%）或“保护”（71.4%），全科医生更常提及该问题。超过一半的全科医生（56.0%）报告与社会工作者每月联系不到一次，而约一半的社会工作者报告每月与全科医生联系1至3次（48.7%）。全科医生（69.3%）和社会工作者（76.3%）希望增加联系。从全科医生的角度来看，增加合作最常提到的好处是“提高护理质量（有更多时间处理医疗问题）”（64.8%）和“改善患者心理健康”（55.6%）。
全科医疗中的社会问题很常见，但全科医生与社会工作者之间的跨专业合作较少。然而，双方似乎都赞成更紧密的跨专业合作，并且似乎愿意在未来尝试改善联合患者护理。将社会工作者纳入全科医疗对于采用全面、跨专业和预防性的患者护理方法以提供最佳医疗保健具有前景。
