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[奥地利医学培训条例修正案允许儿童和青少年精神科医生在患者达到法定成年年龄后继续提供护理:关于专业态度和临床实践的定性研究]

[The amendment to Austria's medical training regulation permitting continued care by child and adolescent psychiatrists after reaching legal adulthood: a qualitative study on professional attitudes and clinical practice].

作者信息

Neumann Matthias, Dörfler Sylvia, Holzinger Anita, Steiner-Hofbauer Verena

机构信息

Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.

Research Unit for Curriculum Development, Medical University of Vienna, Waehringer Gürtel 18-20, 1090, Wien, Österreich.

出版信息

Neuropsychiatr. 2025 May 30. doi: 10.1007/s40211-025-00527-5.

Abstract

BACKGROUND

Adolescents with mental health conditions need stable care structures during their transition to adulthood. The traditionally mandated transfer from child and adolescent psychiatry to adult psychiatric care at the age of 18 does not satisfy this need. A new amendment to the medical training regulations (Ärztinnen/Ärzte-Ausbildungsordnung), effective May 15, 2024, now officially allows child and adolescent psychiatrists (CAPs) in Austria to continue treatment after their patients reach legal adulthood. This study is the first to analyze CAPs' assessments of the amendment and aims to document initial effects on care provision.

METHODOLOGY

Semi-structured interviews were conducted with 16 child and adolescent psychiatrists (CAPs) working in various settings. Data analysis was performed using Reflexive Thematic Analysis.

RESULTS

The study shows that the amendment was introduced unexpectedly for many CAPs, with some private practitioners expressing frustration over the lack of preparation time. Despite this, the reform was largely welcomed and even considered overdue by some. However, given the high patient load, many CAPs still allocate their limited resources to minors, leaving the amendment's impact minimal. In the inpatient sector, persistent shortages of beds have also hindered any substantial changes.

CONCLUSIONS

While the amendment receives substantive approval from the interviewed CAPs, existing resource constraints in both inpatient and outpatient sectors prevent the realization of its potential. The improvements in psychiatric care for transition-age patients intended by the amendment will likely not materialize without capacity expansion.

摘要

背景

患有精神健康问题的青少年在向成年过渡期间需要稳定的护理结构。传统上规定在18岁时从儿童和青少年精神病学转至成人精神病护理,无法满足这一需求。医学培训条例(《医生培训条例》)的一项新修正案于2024年5月15日生效,现在正式允许奥地利的儿童和青少年精神病医生(CAPs)在其患者达到法定成年年龄后继续进行治疗。本研究首次分析了CAPs对该修正案的评估,并旨在记录其对护理提供的初步影响。

方法

对16名在不同环境中工作的儿童和青少年精神病医生(CAPs)进行了半结构化访谈。使用反思性主题分析法进行数据分析。

结果

研究表明,许多CAPs对该修正案的出台感到意外,一些私人执业医生对缺乏准备时间表示沮丧。尽管如此,这项改革在很大程度上受到欢迎,甚至一些人认为早就该进行了。然而,鉴于患者负荷高,许多CAPs仍将其有限的资源分配给未成年人,使得该修正案的影响微乎其微。在住院部门,床位持续短缺也阻碍了任何实质性的改变。

结论

虽然该修正案得到了受访CAPs的实质性认可,但住院和门诊部门现有的资源限制阻碍了其潜力的实现。如果不扩大容量,该修正案旨在改善对过渡年龄患者的精神病护理可能无法实现。

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