Link B, Levav I, Cohen A
Soc Sci Med. 1982;16(15):1413-20. doi: 10.1016/0277-9536(82)90136-8.
General practitioners are important to the delivery of mental health care because they perform three important functions, as an identifier, as a referral agent and as a caregiver. This study investigates the importance of the attitudes G.P.s hold on their performance of two of these functions, screening and referring. Relying on items developed in previous investigations, four measures of attitudinal dimensions are developed using factor analysis: Belief in Psychogenesis, Psychiatric Fatalism, Referral Reluctance and G.P. as Caregiver. These attitude dimensions are then related to the functions of screening and referral. Three major findings emerge from the results. First, the attitudinal dimensions uncovered are empirically distinct, suggesting that no single pro-to-anti psychiatry is present. Second, attitudes play a role in the screening of cases. A G.P. is more likely to identify cases if he believes in the psychogenesis of physical disorders, and is not concerned that identification and referral will lead to negative consequences for the patient. Third and finally, attitudes do not play a strong role in the referral of cases once they have been identified as such. The findings are presented and interpreted by referring to the sensitive position G.P.s occupy between the public and the psychiatrist.
全科医生对于提供心理健康护理至关重要,因为他们履行三项重要职能,即作为识别者、转诊代理人和护理者。本研究调查了全科医生对其履行其中两项职能(筛查和转诊)的态度的重要性。依靠先前调查中开发的项目,使用因子分析开发了四项态度维度测量指标:对心理病因的信念、精神科宿命论、转诊不情愿以及全科医生作为护理者。然后将这些态度维度与筛查和转诊职能联系起来。结果得出了三个主要发现。首先,所发现的态度维度在实证上是不同的,这表明不存在单一的支持或反对精神病学的观点。其次,态度在病例筛查中起作用。如果全科医生相信身体疾病的心理病因,并且不担心识别和转诊会给患者带来负面后果,那么他更有可能识别病例。第三也是最后一点,一旦病例被识别出来,态度在病例转诊中并不起重要作用。通过参考全科医生在公众和精神科医生之间所占据的敏感位置来呈现和解释这些发现。