Mental health in family medicine最新文献_第10页

Depression remission after six months of collaborative care management: role of initial severity of depression in outcome. 协作护理管理六个月后抑郁症缓解:抑郁症初始严重程度在结果中的作用。

Mental health in family medicine Pub Date : 2012-06-01

Kurt B Angstman, Pamela Pietruszewski, Norman H Rasmussen, John M Wilkinson, David J Katzelnick

{"title":"Depression remission after six months of collaborative care management: role of initial severity of depression in outcome.","authors":"Kurt B Angstman, Pamela Pietruszewski, Norman H Rasmussen, John M Wilkinson, David J Katzelnick","doi":"","DOIUrl":"","url":null,"abstract":"Aim The impact of initial severity of depression on the rate of remission has not been well studied. The hypothesis for this study was that increased depression severity would have an inverse relationship on clinical remission at six months while in collaborative care management. Participants The study cohort was 1128 primary care patients from a south-eastern Minnesota practice and was a longitudinal retrospective chart review analysis. Results Clinical remission at six months was less likely in the severe depression group at 29.6% compared with 36.9% in the moderately severe group and 45.6% in the moderate depression group (P < 0.001). Multivariate analysis of a sub-group demonstrated that increased initial anxiety symptoms (odds ratio [OR] 0.9645, 95% confidence interval [CI] 0.9345-0.9954, P = 0.0248) and an abnormal screening for bipolar disorder (OR 0.4856, 95% CI 0.2659-0.8868, P = 0.0187) predicted not achieving remission at six months. A patient with severe depression was significantly less likely to achieve remission at six months (OR 0.6040, 95% CI 0.3803-0.9592, P = 0.0327) compared with moderate depression, but not moderately severe depression (P = 0.2324). There was no statistical difference in the adjusted means of the PHQ-9 score for those patients who were in remission at six months. However, in the unremitted patients, the six-month PHQ-9 score was significantly increased by initial depression severity when controlling for all other variables. Conclusion Multivariate analysis in our study demonstrated that patients with severe depression have a decreased OR for remission at six months compared with moderate depression. Also, there was a significant increase in the six-month PHQ-9 score for those unremitted patients in the severe vs. moderate depression groups.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"99-106"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513702/pdf/MHFM-09-099.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31476619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

'Can he have the test for bipolar, doctor? His dad's got it': exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems - a clinical initiative. “他能做躁郁症测试吗，医生?”他的爸爸得到了它:探索全科医生的潜力，与儿童和年轻人一起在初级保健中表现出常见的精神健康问题——一项临床倡议。

Mental health in family medicine Pub Date : 2012-06-01

Jane H Roberts, Paul M Bernard

{"title":"'Can he have the test for bipolar, doctor? His dad's got it': exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems - a clinical initiative.","authors":"Jane H Roberts, Paul M Bernard","doi":"","DOIUrl":"","url":null,"abstract":"Background General practitioners (GPs) play a key role in assessing and managing adult mental health problems, but this input is not seen in their management of child and adolescent mental health. Mental health problems in 5-19-year-olds are common, yet detection rates in primary care are low. The symptoms of most adult diagnoses of mental health problems are present by mid-adolescence, yet the typical time from onset to diagnosis is 5-15 years. The role of general practice in this area has been underexplored. Aim This pilot study explores the potential of GPs to respond to common mental health problems in children and adolescents. Design Children and young people who would have ordinarily been referred to Child and Adolescent Mental Health Services (CAMHS) were seen in a GP setting. In a UK general practice surgery serving a disadvantaged population. Method Children and young people were seen for an initial biopsychosocial assessment and formulation of the presenting concerns. GP-based interventions were offered as appropriate or referred to CAMHS. Results Data from the first 50 children (2-19 years) are presented. Twenty younger children (10 years and under) and 30 older children (11 years and above) were seen. Eighteen referrals were made to CAMHS. GP interventions included watchful waiting, brief behavioural interventions, non-directive counselling, brief cognitive- behavioural therapy (CBT) and liaison with colleagues in education, CAMHS and the voluntary sector. Conclusion This clinical pilot demonstrates that with adequate time, access to supervision and practice support, children and young people experiencing emotional and behavioural problems associated with common mental health issues can be helped in primary care.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"115-23"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513704/pdf/MHFM-09-115.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31476621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Standardised measures of needs, stigma and informal care in schizophrenia using a bottom-up, cross-cultural approach. 采用自下而上的跨文化方法，对精神分裂症患者的需求、耻辱感和非正式护理进行标准化测量。

Mental health in family medicine Pub Date : 2012-06-01

Francisco Torres-Gonzalez, Ariadne Runte-Geidel, Claudio Antonioli, Luciane C Wagner, Dinarte Ballester, Jose Miguel Caldas de Almeida, Emiliano Galende, Benjamín Vicente, Miguel Xavier, Manuel Gómez-Beneyto, Michael B King, Sandra M Saldivia

{"title":"Standardised measures of needs, stigma and informal care in schizophrenia using a bottom-up, cross-cultural approach.","authors":"Francisco Torres-Gonzalez, Ariadne Runte-Geidel, Claudio Antonioli, Luciane C Wagner, Dinarte Ballester, Jose Miguel Caldas de Almeida, Emiliano Galende, Benjamín Vicente, Miguel Xavier, Manuel Gómez-Beneyto, Michael B King, Sandra M Saldivia","doi":"","DOIUrl":"","url":null,"abstract":"Background There is a lack of instruments to measure the needs, stigma and informal care of people with schizophrenia that take account of sociocultural variation and patients' and formal and informal carers' opinions and experiences. Aims To develop questionnaires to measure stigma, needs and informal (non-professional) care for people with schizophrenia. Method We undertook the study in seven countries and in English, Spanish and Portuguese. We first held focus group discussions with patients, formal carers (professionals) and informal carers (family and friends) in Spain, the UK, Argentina, Brazil, Chile and Venezuela to elicit the main dimensions of needs, stigma and informal care. We then held nominal group discussions about these dimensions with patients, family members and professionals in Spain, Portugal and the UK, to develop the instruments. Results Three hundred and three people participated in 46 focus groups and results were discussed in three nominal groups, each involving eight participants. Three instruments were developed in this iterative process: needs for care (46 items), stigma (38 items) and informal care (20 items). Conclusions These instruments are based on service users' and carers' views and experiences and have cross-cultural validity. They will have application in assessment of outcomes for people with schizophrenia and their families.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"125-34"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513705/pdf/MHFM-09-125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31476622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longitudinal association of intimate partner violence and depressive symptoms. 亲密伴侣暴力与抑郁症状的纵向联系。

Mental health in family medicine Pub Date : 2012-06-01

Cynthia H Chuang, Amanda L Cattoi, Jennifer S McCall-Hosenfeld, Fabian Camacho, Anne-Marie Dyer, Carol S Weisman

{"title":"Longitudinal association of intimate partner violence and depressive symptoms.","authors":"Cynthia H Chuang, Amanda L Cattoi, Jennifer S McCall-Hosenfeld, Fabian Camacho, Anne-Marie Dyer, Carol S Weisman","doi":"","DOIUrl":"","url":null,"abstract":"Purpose The association between intimate partner violence (IPV) and depression has been well established in cross-sectional research, but how IPV is associated with depressive symptoms over time has not been well studied. Methods Using the Central Pennsylvania Women's Health Study, a population-based longitudinal survey of women aged 18-45 (N = 1,420), we performed a two-step logistic regression analysis. In step 1, the association of recent IPV exposure at baseline with depressive symptoms 2 years later was analysed adjusting for relevant covariates; in step 2, we additionally included positive coping strategies (social support, physical activity) and negative coping strategies (binge drinking/drug use, smoking) in the model. Results Baseline IPV was reported by 4.6 percent of the sample and was independently associated with depressive symptoms 2 years later (adjusted or 1.88, 95% confidence interval [CI] 1.02-3.45). The strongest predictor was depressive symptoms at baseline, which was associated with a fivefold increase in the likelihood of depressive symptoms at 2-year follow-up. Other predictors of future depressive symptoms were IPV at follow-up, older age, lower educational attainment, and lower household income. When we controlled for potential coping strategies in the model (step 2), the relationship between recent IPV and follow-up depressive symptoms was attenuated (adjusted OR 1.50, 95% CI 0.80-2.80). Conclusions Exposure to IPV increases the likelihood of depressive symptoms occurring two years later. Greater social support and binge drinking/drug use attenuates this association, suggesting that interventions focusing on coping mechanisms may serve to reduce the impact of IPV on future depression.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"107-14"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513703/pdf/MHFM-09-107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31476620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring and evaluation of the activities of trainees in the 'training of trainers' workshop at Ibadan, south-west Nigeria. 监测和评价尼日利亚西南部伊巴丹“培训教员”讲习班受训人员的活动。

Mental health in family medicine Pub Date : 2012-01-01

Victor Makanjuola, Victor Doku, Rachel Jenkins, Oye Gureje

{"title":"Monitoring and evaluation of the activities of trainees in the 'training of trainers' workshop at Ibadan, south-west Nigeria.","authors":"Victor Makanjuola, Victor Doku, Rachel Jenkins, Oye Gureje","doi":"","DOIUrl":"","url":null,"abstract":"Background Like most low- and middle-income countries, Nigeria has a huge treatment gap for mental disorders. The World Health Organization has proposed the integration of mental health care into primary health service delivery as one of the ways to bridge this treatment gap. Studies have shown an immediate positive impact of mental health training for primary care workers. We evaluated the impact of training on the tutors of primary care workers approximately 12 months after the training.Method An intensive five-day training workshop for college teachers of mental health in community health officer (CHO) training institutions in south-west Nigeria was conducted in January 2009. Four of the 24 participants were randomly selected for evaluation of the impact of training on their activities approximately 12 months after the workshop. Qualitative methods were used, namely in-depth interviews, direct observation of classroom teaching by the participants and focus group discussion with their students.Results The participants interviewed reported a positive impact of the 'training of trainers' (TOT) workshop on their mental health course teaching. Direct observation of four participants revealed that three of them exhibited a high fidelity with the TOT course material and imbibed the teaching techniques advocated. The tutors' students also reported an improvement in the quality of their mental health classes.Conclusion The training had an overall positive impact on the activities of the trainees approximately one year after the workshop.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487609/pdf/MHFM-09-025.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental health in primary care for adolescent parents. 青少年父母初级保健中的心理健康。

Mental health in family medicine Pub Date : 2012-01-01

Dayna Leplatte, Katherine Lisa Rosenblum, Emily Stanton, Nicole Miller, Maria Muzik

{"title":"Mental health in primary care for adolescent parents.","authors":"Dayna Leplatte, Katherine Lisa Rosenblum, Emily Stanton, Nicole Miller, Maria Muzik","doi":"","DOIUrl":"","url":null,"abstract":"Mental health care is important for everyone, especially teenagers. However, seeking mental health services may be challenging for teenagers, particularly when they are also parents. Offering mental health care in a safe, attractive and easily accessible manner, such as primary care, increases the chances that teenage parents will receive help. Comprehensive care models need to be established to address the many needs that at-risk young mothers and their children face. There are a number of programmes available to teenage mothers that either address healthcare and psychosocial needs or focus primarily on improvements in parenting skills; yet an integrated model that delivers medical, psychiatric and psychosocial care and facilitates positive parenting skills seems to be missing. Through a university-community partnership we have recently developed a model curriculum - the Mom Power (MP) group programme - at the University of Michigan which aims to close this gap in service delivery. We elaborate on core elements and key features of this 10-week group intervention programme for high-risk teenage mothers and their children, and present preliminary outcomes data. Analyses on the first 24 MP group graduates suggest that despite ongoing life trauma during the intervention period, teenage mothers show improvements in depression and post-traumatic stress disorder symptoms post intervention, and also self-rate as less guilty and shameful regarding their parenting skills after programme completion. Although preliminary, due to design and statistical limitations, these results show promise regarding feasibility and effectiveness of this integrated approach for teenage mothers with young children delivered through primary care.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487608/pdf/MHFM-09-039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of a one-week intensive 'training of trainers' workshop for community health workers in south-west Nigeria. 在尼日利亚西南部为社区卫生工作者举办的为期一周的强化“培训师培训”讲习班的影响。

Mental health in family medicine Pub Date : 2012-01-01

Victor Makanjuola, Victor Doku, Rachel Jenkins, Oye Gureje

{"title":"Impact of a one-week intensive 'training of trainers' workshop for community health workers in south-west Nigeria.","authors":"Victor Makanjuola, Victor Doku, Rachel Jenkins, Oye Gureje","doi":"","DOIUrl":"","url":null,"abstract":"Background There is a huge unmet need for mental health services in low- and middle-in-come countries such as Nigeria. It has been suggested that one way of bridging the service gap is to plan for the effective integration of mental health services into primary care. We present the impact of a one-week training workshop on attitudes to and knowledge of mental health issues among the tutors of community health workers.Method An intensive one-week training workshop was organised for 24 trainers of community health officers from eight Nigerian states. The package was designed for the training of primary care workers in low-income countries by one of the authors (RJ). Participants completed a questionnaire designed to assess knowledge of and attitudes to mental health issues before and on completion of the training.Results There were 24 participants with a mean age of 47 years (SD ± 4.89). Eighteen (75%) of the participants were female. The overall assessment of knowledge of mental health issues increased from a mean score of 60.4% before training to a mean score of 73.7% after the training (t-test = 4.48, P = 0.001).Conclusion We reported a significant improvement in the knowledge and attitudes of tutors of community health workers following an intensive one-week training workshop. This, we believe, should improve the quality of pre-service mental health training for community health workers and hopefully impact on mental health service delivery at the primary healthcare level.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"33-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487605/pdf/MHFM-09-033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postpartum depressive symptoms: the B-vitamin link. 产后抑郁症状：与b族维生素有关。

Mental health in family medicine Pub Date : 2012-01-01

Christelle H Blunden, Hazel M Inskip, Sian M Robinson, Cyrus Cooper, Keith M Godfrey, Tony R Kendrick

{"title":"Postpartum depressive symptoms: the B-vitamin link.","authors":"Christelle H Blunden, Hazel M Inskip, Sian M Robinson, Cyrus Cooper, Keith M Godfrey, Tony R Kendrick","doi":"","DOIUrl":"","url":null,"abstract":"Objective This study examined longitudinal relationships between maternal red-cell folate status and dietary intakes of vitamins B(6), B(12) and folate before and during pregnancy and subsequent postpartum depressive symptoms.Study design and setting Within a cohort study of women aged 20-34 years (the Southampton Women's Survey) dietary data were obtained before pregnancy and at 11 and 34 weeks' gestation. Red-cell folate was measured before pregnancy and at 11 weeks' gestation. We derived relative risks of postpartum depressive symptoms using an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 13 administered from 6 months to 1 year postpartum.Results No significant differences were found between those with postpartum depressive symptoms (n = 905) and those without (n = 1951) in relation to red-cell folate concentration or dietary intake of folate, vitamin B(12) and vitamin B(6), before or during pregnancy. A prior history of mental illness (relative risk (RR) 1.83; 95% confidence interval (CI) 1.53-2.19) was associated with postpartum depressive symptoms, and women who breastfed until 6 months were less likely to experience postpartum depressive symptoms (RR 0.68; 95% CI 0.55-0.84).Conclusion This study suggests that folate status and dietary folate, B(6) and B(12) intakes before and during pregnancy are not associated with postpartum depressive symptoms. A history of mental illness, however, was a strong risk factor.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487611/pdf/MHFM-09-005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integration of mental health into primary care in Sri Lanka. 将精神卫生纳入斯里兰卡的初级保健。

Mental health in family medicine Pub Date : 2012-01-01

Rachel Jenkins, Jayan Mendis, Sherva Cooray, Marius Cooray

{"title":"Integration of mental health into primary care in Sri Lanka.","authors":"Rachel Jenkins, Jayan Mendis, Sherva Cooray, Marius Cooray","doi":"","DOIUrl":"","url":null,"abstract":"Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic \"train the trainers\" programme to integrate mental health into primary care in Sri Lanka's public health system and private sector.Methods A 40 hour training programme was delivered to curriculum and teaching materials were adapted for Sri Lanka, and delivered to 45 psychiatrists, 110 medical officers of mental health and 95 registered medical practitioners, through five courses, each in a different region (Colombo, Kandy, Jaffna, Galle and Batticola). Participants were selected by the senior psychiatrist of each region, on the basis of ability to conduct subsequent roll out of the training. The course was very interactive, with discussions, role plays and small group work, as well as brief theory sessions.Results Qualitative participant feedback was encouraging about the value of the course in improving patient assessments and treatments, and in providing a valuable package for roll out to others. Systematic improvement was achieved between pre- and post-test scores of participants at all training sites. The participants had not had prior experience in such interactive teaching methods, but were able to learn these new techniques relatively quickly.Conclusions The programme has been conducted in collaboration with the Sri Lankan National Institute of Mental Health and the Ministry of Health, and this partnership has helped to ensure that the training is tailored to Sri Lanka and has the chance of long term sustainability.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487606/pdf/MHFM-09-015.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refugees' perspectives on barriers to communication about trauma histories in primary care. 难民对初级保健中创伤史沟通障碍的看法。

Mental health in family medicine Pub Date : 2012-01-01

Patricia Shannon, Maureen O'Dougherty, Erin Mehta

{"title":"Refugees' perspectives on barriers to communication about trauma histories in primary care.","authors":"Patricia Shannon, Maureen O'Dougherty, Erin Mehta","doi":"","DOIUrl":"","url":null,"abstract":"Objective This study explores refugees' perspectives regarding the nature of communication barriers that impede the exploration of trauma histories in primary care.Method Brief interviews were conducted with 53 refugee patients in a suburban primary care clinic in the Midwest USA. Participants were asked if they or their doctors had initiated conversations about the impact of political conflict in their home countries. Qualitative data analysis was guided by grounded theory. Peer debriefings of refugee healthcare professionals were incorporated into the analysis.Results Two-thirds of refugee patients reported that they never shared how they were affected by political conflict with their doctors and that their doctors never asked them about it. Most refugees stated that they would like to learn more about the impact of trauma on their health and to discuss their experiences with their doctors.Conclusion Refugees are hesitant to initiate conversations with physicians due to cultural norms requiring deference to the doctor's authority. They also lack knowledge about how trauma affects health. Physicians should be educated to inquire directly about trauma histories with refugee patients. Refugees can benefit from education about the effects of trauma on health and about the collaborative nature of the doctor-patient relationship.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 1","pages":"47-55"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487607/pdf/MHFM-09-047.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40202190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0