捷克全科医生在持续躯体症状患者管理中的认知、方法和需求:一项全国性横断面调查的结果。

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Martin Seifert, Antonin Sebela, Tim Olde Hartman
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引用次数: 0

摘要

背景:全科医生(gp)认为持续性躯体症状(PSS)患者令人沮丧且难以管理。患者通常对他们所接受的护理表示不满,并经常感到被污名化,不被认真对待。一些捷克全科医生选择额外的心身教育,重点是更好地理解和管理PSS患者。目的:探讨捷克全科医生的看法,有或没有额外的心身训练,关于PSS患者的护理,他们的信念,管理方法,以及他们的组织和教育需求。方法:对捷克全科医生进行全国性的横断面调查研究,探讨管理PSS患者的经验、观念和需求。采用统计和定性方法对数据进行分析。结果:共有152名全科医生参加了本次调查,其中37名接受了额外的心身训练,115名未接受额外的心身训练,有效率为20.3%。全科医生与负面情绪、与患者的沟通、诊断的不确定性、患者缺乏理解、这些患者产生的工作量、缺乏专业护理以及医疗保健系统的其他问题作斗争。他们呼吁进行更多的心身教育和沟通培训。这应该包括理论解释模型、巴林小组和其他类型的监督或同伴小组。与没有接受额外心身训练的全科医生相比,接受额外心身训练的全科医生对这些患者的护理更有信心和能力(OR = 4.1;95% ci = 1.85-9.11);p结论:全科医生努力照顾PSS患者。接受额外心身教育的全科医生表明他们更有信心和能力。捷克的全科医生呼吁,在照顾PSS患者时,需要更多的时间和报销,需要更多的心身培训,需要更好的专业心身护理,需要更好的跨学科合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perceptions, approaches, and needs of Czech GPs in the management of patients with persistent somatic symptoms: the results of a nationwide cross-sectional survey.

Background: General practitioners (GPs) perceive patients with persistent somatic symptoms (PSS) as frustrating and difficult to manage. Patients commonly express dissatisfaction with the care they receive and often feel stigmatised and not taken seriously. Some Czech GPs use the option of extra psychosomatic education which focuses on better understanding and management of patients with PSS.

Objectives: To explore perceptions of Czech GPs, with and without additional psychosomatic training, regarding the care of patients with PSS, their beliefs, approaches in the management, and their organisational and educational needs.

Methods: A nationwide cross-sectional survey study among Czech GPs exploring experiences, perceptions, and needs in managing patients with PSS was conducted. Statistical and qualitative approaches were performed to analyse the data.

Results: A total of 152 GPs (37 with and 115 without additional psychosomatic training) participated in this survey (response rate 20,3%). GPs struggle with negative emotions, communication with patients, diagnostic uncertainty, patients' lack of understanding, the workload these patients generate, lack of specialized care, and other problems of the healthcare system. They call for more psychosomatic education and communication training. This should include theoretical explanatory models, Balint groups, and other kinds of supervision or peer groups. GPs with additional psychosomatic training feel more confident and competent caring for these patients, compared to GPs without such additional training (OR = 4.1; 95% CI = 1.85-9.11); p < 0.005). Furthermore, they view PSS patients as less burdensome (OR = 4.69; 2.11-10.4; p < 0.001).

Conclusions: GPs struggle with caring for patients with PSS. GPs with additional psychosomatic education indicate that they have more confidence and competence. Czech GPs call for more time and reimbursement when caring for patients with PSS, more psychosomatic training, better availability of specialized psychosomatic care, and better interdisciplinary cooperation.

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