Nielsen A C, Stein L I, Talbott J A, Lamb H R, Osser D N, Glazer W M
Hosp Community Psychiatry. 1981 Nov;32(11):767-75. doi: 10.1176/ps.32.11.767.
In recent years, psychiatrists in both the public and private sectors have been insufficiently involved in the treatment of chronic psychiatric illness. Simultaneously, deinstitutionalization has made the treatment of chronic patients more complex. In this paper the authors discuss the use of medical education- specifically the psychiatric residency-to increase the number of psychiatrists involved in the treatment of chronic patients and to improve the quality of treatment. Optimally residency programs should provide intense, long-term contact with chronic patients, supervised by role models committed to the treatment of such patients. Programs should encourage appropriate attitudes, including realistic treatment expectations and understanding of the issues of patient passivity and dependence; convey specialized knowledge related to housing, ethnicity, occupational, social, and legal matters and train residents in treatment skills tailored to patient needs, including the ability to perform functional diagnostic assessments and to collaborate with other mental health professionals.
近年来，公共部门和私营部门的精神科医生对慢性精神疾病的治疗参与度不足。与此同时，非机构化使得慢性病患者的治疗更加复杂。在本文中，作者讨论了利用医学教育——特别是精神科住院医师培训——来增加参与慢性病患者治疗的精神科医生数量，并提高治疗质量。理想的住院医师培训项目应提供与慢性病患者的密切、长期接触，并由致力于此类患者治疗的榜样进行监督。这些项目应鼓励形成适当的态度，包括现实的治疗期望以及对患者被动性和依赖性问题的理解；传授与住房、种族、职业、社会和法律事务相关的专业知识，并针对患者需求对住院医师进行治疗技能培训，包括进行功能性诊断评估以及与其他心理健康专业人员协作的能力。
