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一个教学项目能否改善全科医生对老年抑郁症的管理?

Does a teaching programme improve general practitioners' management of depression in the elderly?

作者信息

Butler R, Collins E, Katona C, Orrell M

机构信息

St. Charles Hospital, London, UK.

出版信息

J Affect Disord. 1997 Dec;46(3):303-8. doi: 10.1016/s0165-0327(97)00154-7.

Abstract

General Practitioners have a central role to play in the management of depression in their older patients. However, studies suggest that GPs tend to underdiagnose and undermanage depression in this age group. Continuing Medical Education is an important part of helping GPs keep up to date and improve their practice. We set out to see what effect a half a day postgraduate training course had on the views and knowledge of a group of local GPs on the management of depression in the elderly. Twenty-one general practitioners attended the course and of these fifteen completed a questionnaire with clinical vignettes before and six weeks after the course. Analysis of the questionnaire and vignette data showed significant improvements in a number of areas: in particular, GPs' knowledge about antidepressant treatment increased, as did their preference for cognitive behavioural therapy out of a range of psychological treatments. This study indicates that a teaching package on depression in the elderly can improve general practitioner's management knowledge. It also suggests that old age psychiatrists can play an important part in the education of their GP colleagues. Nevertheless, further studies are needed to ensure that educational programmes make an effective impact on the underdiagnosis and undertreatment of depression in the elderly.

摘要

全科医生在老年患者抑郁症的管理中起着核心作用。然而,研究表明,全科医生往往对这个年龄组的抑郁症诊断不足且管理不力。继续医学教育是帮助全科医生跟上最新知识并改善其医疗实践的重要组成部分。我们着手研究半天的研究生培训课程对一组当地全科医生在老年抑郁症管理方面的观点和知识有何影响。21名全科医生参加了该课程,其中15人在课程前和课程六周后完成了一份包含临床病例的问卷。对问卷和病例数据的分析显示,在多个方面有显著改善:特别是,全科医生对抗抑郁治疗的知识有所增加,他们在一系列心理治疗方法中对认知行为疗法的偏好也有所增加。这项研究表明,一个关于老年抑郁症的教学包可以提高全科医生的管理知识。它还表明老年精神科医生可以在对其全科医生同事的教育中发挥重要作用。然而,需要进一步研究以确保教育项目能对老年抑郁症的诊断不足和治疗不足产生有效影响。

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