Mental health in family medicine最新文献_第9页

Communication and mental health in general practice: physicians' self-perceived learning needs and self-efficacy. 全科医生的沟通与心理健康:医生自我感知的学习需求和自我效能。

Mental health in family medicine Pub Date : 2012-09-01

Tonje L Stensrud, Trond A Mjaaland, Arnstein Finset

{"title":"Communication and mental health in general practice: physicians' self-perceived learning needs and self-efficacy.","authors":"Tonje L Stensrud, Trond A Mjaaland, Arnstein Finset","doi":"","DOIUrl":"","url":null,"abstract":"Background General practitioners (GPs) often see patients presenting with mental health problems, but their training regarding mental health treatment varies. GPs' communication skills are of particular importance in these consultations, and communication skills training of GPs has been found to improve patients' mental health. To tailor a communication skills training by basing it on GPs' learning needs and self-efficacy, thereby maximising learning, we conducted a questionnaire study. Objective To measure GPs' self-perceived needs regarding communication with and treatment of mental health patients. Methods GPs in training for specialist general practice were given a questionnaire on communication and mental health in general practice. The questionnaire measured prevalence, referring practices, self-efficacy and self-perceived learning need regarding mental health treatment and communication skills, as well as interest in attending training. Results A majority of GPs in our sample was interested in training on communication skills and mental health treatment. However, they reported moderate learning needs and high confidence on the different measures. GPs reported highest learning needs regarding specific communication skills and treatment of the most common mental health problems. At the same time, they reported highest self-efficacy in treating the same disorders. They also reported high confidence in communication skills. Conclusion Despite being confident, GPs in this sample recognise the need for specific skills in consultations with patients with mental health problems, but may underestimate the importance of general communication skills. These results are informative when designing training for GPs in communication and mental health. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"201-9"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622912/pdf/MHFM-09-201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701387","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

Psychiatric distress among spouses of National Guard soldiers prior to combat deployment. 国民警卫队士兵配偶在战斗部署前的精神困扰。

Mental health in family medicine Pub Date : 2012-09-01

Christopher R Erbes, Laura A Meis, Melissa A Polusny, Paul A Arbisi

{"title":"Psychiatric distress among spouses of National Guard soldiers prior to combat deployment.","authors":"Christopher R Erbes, Laura A Meis, Melissa A Polusny, Paul A Arbisi","doi":"","DOIUrl":"","url":null,"abstract":"Background The mental health functioning of military spouses and intimate partners prior to the combat deployments of their loved ones is poorly studied. Aims Whereas service members and veterans often receive healthcare directly from the military or the Department of Veterans Affairs, family members may be more likely to present in family care settings. An understanding of mental health problems commonly occurring in this population is therefore important. Method National Guard soldiers and their spouses or cohabitating partners (n = 223 couples) were surveyed about mental health symptoms, social functioning and mental health service utilisation one to two months prior to a combat deployment to Afghanistan. Results Screening rates for partner post-traumatic stress disorder, depression, alcohol problems and social impairment were 2.4, 15.3, 3.7 and 10.7%, respectively, and were significantly higher for partners than soldiers with regards to depression and social impairment. The majority of partners screening positive for psychiatric distress did not report utilising mental health services or military support services (i.e. family readiness groups). Clinical implications are discussed. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"161-9"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622908/pdf/MHFM-09-161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701383","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

The case for change: The Global Mental Health Action Plan 2013-2020. 变革理由:《2013-2020年全球精神卫生行动计划》。

Mental health in family medicine Pub Date : 2012-09-01

Gabriel Ivbijaro

引用次数: 0

Investigating the use of NICE guidelines and IAPT services in the treatment of depression. 调查NICE指南和IAPT服务在抑郁症治疗中的使用情况。

Mental health in family medicine Pub Date : 2012-09-01

Alex Gyani, Neil Pumphrey, Hannah Parker, Roz Shafran, Suzanna Rose

{"title":"Investigating the use of NICE guidelines and IAPT services in the treatment of depression.","authors":"Alex Gyani, Neil Pumphrey, Hannah Parker, Roz Shafran, Suzanna Rose","doi":"","DOIUrl":"","url":null,"abstract":"Background There is evidence that the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health disorders are used to varying degrees in primary care. A lack of access to cognitive-behavioural therapy (CBT) has been found to be a barrier to their implementation. The Improving Access to Psychological Therapies (IAPT) initiative was created in 2007 to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders within the National Health Service in England. Aim This study aims to investigate whether general practitioners (GPs) who have access to IAPT services and use NICE guidelines are more likely to use NICE concordant treatments for depression than those who do not. Depression was chosen as it is the most common mental health problem facing primary care physicians. Method Questionnaires were sent to 830 GPs in southeast England and six GPs were interviewed. The response rate to the questionnaires was 27% (n = 222). Results Ninety-five per cent of GPs were aware of the NICE guidelines for depression, and 76% had read them. Concordance with the guidelines was significantly higher when GPs had access to a local IAPT service or had read the NICE guidelines. Conclusions The interviews revealed favourable views to IAPT services when used, although access to treatments was still a common barrier to the implementation of the NICE guidelines for depression. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"149-60"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622907/pdf/MHFM-09-149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31700925","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

Primary healthcare practitioners' screening practices and attitudes towards women survivors of child abuse. 初级保健从业人员对虐待儿童的妇女幸存者的筛查做法和态度。

Mental health in family medicine Pub Date : 2012-09-01

Adeline Lee, Jan Coles, Stuart Lee, Jayashri Kulkarni

{"title":"Primary healthcare practitioners' screening practices and attitudes towards women survivors of child abuse.","authors":"Adeline Lee, Jan Coles, Stuart Lee, Jayashri Kulkarni","doi":"","DOIUrl":"","url":null,"abstract":"Background Child abuse survivors have an increased risk of developing various mental illnesses in adulthood, which may lead survivors to access primary healthcare services, in particular primary care mental health services. Aim To determine the frequency with which different primary care mental health practitioners encounter child abuse survivors in their practice and differences in their views about routine screening, level of importance, confidence and comfort in screening and supporting survivors, a cross-sectional study was conducted with 186 practitioners. Method The sample consisted of general practitioners (13.9%), psychologists (67.9%) and other professions such as psychiatrists, social workers, counsellors, psychotherapists, mental health nurses and other specific mental health practitioners (18.2%). Results Over 91% of practitioners reported that child abuse was a healthcare issue and was a problem for women in their practice. However, only 51.4% believed that women should be routinely screened for child abuse experiences. Significant differences among practitioner groups were found in aspects of screening and responding to survivors. General practitioners were significantly less likely to screen routinely and reported lower levels of confidence and comfort in conducting screening of survivors when compared with psychologists and other practitioners. The majority of practitioners saw it as psychologists' role to routinely screen; however, 57-82% of practitioners within each group reported that they would benefit from further training in areas relating to asking about and supporting survivors. Conclusion Findings highlighted further education as a potential area of need to enhance the knowledge and capacity of different practitioner groups in responding to women survivors of child abuse. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"181-9"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622910/pdf/MHFM-09-181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701385","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

Predictors of metabolic parameter monitoring in adolescents on antipsychotics in a primary care setting. 在初级保健设置抗精神病药物的青少年代谢参数监测的预测因素。

Mental health in family medicine Pub Date : 2012-09-01

Sameer R Ghate, Christina A Porucznik, Qayyim Said, Mia Hashibe, Elizabeth Joy, Diana I Brixner

{"title":"Predictors of metabolic parameter monitoring in adolescents on antipsychotics in a primary care setting.","authors":"Sameer R Ghate, Christina A Porucznik, Qayyim Said, Mia Hashibe, Elizabeth Joy, Diana I Brixner","doi":"","DOIUrl":"","url":null,"abstract":"Objective To assess the frequency and predictors of regular monitoring of metabolic parameters as recommended by the American Diabetes Association (ADA)/American Psychiatric Association (APA) guidelines in adolescents receiving antipsychotics compared with an untreated comparison group in a primary care setting. Method A retrospective cohort study was conducted using an electronic medical record database in the USA from January 2004 to July 2009. The exposure group consisted of adolescents with a first prescription for second-generation antipsychotics (SGAs). The comparison group, without antipsychotics, was matched (3:1) to the exposed. Baseline and follow-up metabolic measurements were assessed and patients were categorised as being regularly monitored based on recommendations by the ADA/APA guidelines. Multivariate logistic regression was conducted to assess the predictors of regular monitoring, adjusting for demographic characteristics, baseline medications and medical conditions. Results The frequency of regular monitoring of body mass index (BMI), blood pressure, total cholesterol and fasting blood glucose, as recommended by ADA/APA guidelines among antipsychotic users (25, 55, 2.4 and 1.7%) was low but significantly higher compared with the matched comparison group (9.5, 37.4, 0.8 and 0.7%, respectively) (P < 0.05). Overall, antipsychotic treatment was associated with 1.5- to 4.26-fold increase in the likelihood of metabolic monitoring compared with the comparison group (P < 0.05). Other predictors included oral antidiabetic use for BMI monitoring and dyslipidaemia for blood pressure, total cholesterol and fasting blood glucose. Conclusion The majority of adolescents on antipsychotics were under-monitored for BMI, lipids and glucose levels. Antipsychotic users with pre-existing and newly diagnosed metabolic conditions were more likely to be regularly monitored for metabolic parameters. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"137-48"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622906/pdf/MHFM-09-137.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31700924","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

Kabuki syndrome: diagnostic and treatment considerations. 歌舞伎综合征：诊断和治疗注意事项。

Mental health in family medicine Pub Date : 2012-09-01

Bethany D Kasdon, Judith E Fox

引用次数: 0

The feasibility and effectiveness of mindfulness-based cognitive therapy for mixed diagnosis patients in primary care: a pilot study. 基于正念的认知疗法对初级保健中混合诊断患者的可行性和有效性:一项试点研究。

Mental health in family medicine Pub Date : 2012-09-01

Sholto R Radford, Rebecca Susan Crane, Catrin Eames, Eluned Gold, Gareth Wyn Owens

{"title":"The feasibility and effectiveness of mindfulness-based cognitive therapy for mixed diagnosis patients in primary care: a pilot study.","authors":"Sholto R Radford, Rebecca Susan Crane, Catrin Eames, Eluned Gold, Gareth Wyn Owens","doi":"","DOIUrl":"","url":null,"abstract":"Background Mindfulness-based cognitive therapy (MBCT) is an intervention developed for the prevention of recurrent depression which is now being applied to widening numbers of clinical populations. Despite evidence for its effectiveness in preventing relapse in depression, less is known about its efficacy within routine clinical practice for groups of patients with more varied mental health problems, despite this being a potentially promising context for its application. Aims This pilot study aimed to investigate whether MBCT would be feasible and effective when delivered in a primary care context for patients who are vulnerable to recurrent depression and anxiety. Results Attrition from the programme was low and both attendance and engagement with home practices (during and after the intervention) were comparable with or higher than those observed in the existing literature. Improvements in self-reported depression, anxiety, rumination, self-compassion and well-being were evident over the 8-week programme and at 6-month post intervention follow-up. Conclusions Despite limitations in terms of sample size and the absence of a control group, the results demonstrate that the promising research results of MBCT for depression are transferable from a research to a practice setting, and demonstrate that it may be an effective and feasible intervention when delivered in a primary care setting for a range of mental health problems. ","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 3","pages":"191-200"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622911/pdf/MHFM-09-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31701386","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

Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec. 在魁北克改革的背景下，全科医生和精神保健专业人员之间的合作。

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

Marie-Josée Fleury, Armelle Imboua, Denise Aubé, Lambert Farand

{"title":"Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec.","authors":"Marie-Josée Fleury, Armelle Imboua, Denise Aubé, Lambert Farand","doi":"","DOIUrl":"","url":null,"abstract":"Background In the context of the high prevalence and impact of mental disorders worldwide, and less than optimal utilisation of services and adequacy of care, strengthening primary mental healthcare should be a leading priority. This article assesses the state of collaboration among general practitioners (GPs), psychiatrists and psychosocial mental healthcare professionals, factors that enable and hinder shared care, and GPs' perceptions of best practices in the management of mental disorders. A collaboration model is also developed. Methods The study employs a mixed-method approach, with emphasis on qualitative investigation. Drawing from a previous survey representative of the Quebec GP population, 60 GPs were selected for further investigation. Results Globally, GPs managed mental healthcare patients in solo practice in parallel or sequential follow-up with mental healthcare professionals. GPs cited psychologists and psychiatrists as their main partners. Numerous hindering factors associated with shared care were found: lack of resources (either professionals or services); long waiting times; lack of training, time and incentives for collaboration; and inappropriate GP payment modes. The ideal practice model includes GPs working in multidisciplinary group practice in their own settings. GPs recommended expanding psychosocial services and shared care to increase overall access and quality of care for these patients. Conclusion As increasing attention is devoted worldwide to the development of optimal integrated primary care, this article contributes to the discussion on mental healthcare service planning. A culture of collaboration has to be encouraged as comprehensive services and continuity of care are key recovery factors of patients with mental disorders.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"77-90"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513700/pdf/MHFM-09-077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31475108","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

Evaluation of collaborative models of care in the management of patients with depression: protocol and progress. 评估抑郁症患者管理中的合作护理模式：方案和进展。

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

Hossein Haji Ali Afzali, Jonathan Karnon, Jodi Gray, Justin Beilby

{"title":"Evaluation of collaborative models of care in the management of patients with depression: protocol and progress.","authors":"Hossein Haji Ali Afzali, Jonathan Karnon, Jodi Gray, Justin Beilby","doi":"","DOIUrl":"","url":null,"abstract":"Introduction Depression is highly prevalent and has a considerable impact on the quality of life of affected individuals, and on healthcare resources. Evidence indicates that collaborative care models can improve patient outcomes within a primary care setting. The Primary Care Services Improvement Project (PCSIP) aims to investigate the costs and outcomes of different models of care for the management of patients with depression. These models have been defined based on the level of involvement of practice nurses in management processes within the primary care setting in Australia. This paper describes our study protocol and its progress. Methods PCSIP is an observational study that will link retrospective data from a range of sources to estimate costs and intermediate outcomes (such as relapse rate) over a 3-year time horizon. The main sources of primary data include the medical records of patients held at participating practices and Medicare Australia. Initial report We recruited 15 practices from a metropolitan area and allocated them to three models of care. Two hundred and sixty-one patients agreed to participate. Appropriate regression-based analyses will be used to evaluate the association between different models of care and patient-level outcomes while controlling for several covariates such as age and gender. Discussion/conclusions This project will generate the knowledge required to promote investment in the most cost-effective initiatives, and to ensure that waste of resources due to the implementation of comparatively inefficient interventions is minimised. Given the scarcity of resources, the increasing costs of providing healthcare and the increasing prevalence of chronic diseases, such research is essential.","PeriodicalId":89603,"journal":{"name":"Mental health in family medicine","volume":"9 2","pages":"91-7"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513701/pdf/MHFM-09-091.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31475109","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