scholarly journals Competence of general practice nurses caring for patients with mental health problems in the somatic departments

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 822 ◽  
Author(s):  
Ligija Švedienė ◽  
Lina Jankauskienė ◽  
Marija Kušleikaitė ◽  
Artūras Razbadauskas
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Mental Health Problems ◽  
Response Rate ◽  
Health Problems ◽  
Psychiatric Consultation ◽  
Practice Nurses ◽  
Anonymous Questionnaire ◽  
Conflict Situations ◽  
Secondary Health Care

Objective. To investigate competence of general practice nurses caring for patients with mental health problems in the somatic departments. Material and methods. A quantitive study on competence of general practice nurses using an anonymous questionnaire was carried out in Klaipėda secondary health care institution in January–February of 2007. The respondents (128 general practice nurses) were selected from seven departments, in which psychiatric consultation was more frequently recommended. In the working places of nurses, 140 questionnaires were distributed; 135 questionnaires were completed (response rate was 96.4%), among them 7 questionnaires were acknowledged as not valid. Results. About 45.0% of general practice nurses had knowledge how to care for the patients with mental health problems, from 1.6 to 21.9% did not have knowledge, and the rest reported having only moderate knowledge (28.1–64.1%). These findings provided a statistically significant link between the duration of employment and education (r from 0.292 to 0.76; P from <0.05 to <0.01). However, only 30.5% of respondents were able to manage conflicts. Most common undesirable events (60.3%) were runaway from inpatient clinic care, injury followed by runaway (29.4%), and suicide (10.3%). From 18.8% to 28.9% of respondents believed that undesirable events were influenced by an unsuitable environment of the department, the shortage of time and personnel, difficulty in getting a psychiatrist’s consultation. Only 3.1% of respondents thought that these undesirable events might be affected by the lack of competence of personnel. Most of the nurses (form 75.0% to 84.4%) had a positive attitude toward the patients; however, the nursing principles were recognized only by (6.3% to 24.2%) of respondents. Conclusions. Competence of the nurses caring for the patients with mental health problems is not at the level required. This may be associated with insufficient professional skills, conflict situations with the patients, and the lack of acknowledgment of the principles of nursing.

scholarly journals Irish General Practitioner referrals to psychological therapies

2015 ◽  
Vol 33 (2) ◽  
pp. 73-80 ◽  
Author(s):  
V. Cullinan ◽  
A. Veale ◽  
A. Vitale
Keyword(s):  
Mental Health ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Response Rate ◽  
Evidence Base ◽  
Health Problems ◽  
Clinical Psychologist ◽  
Medical Practitioners ◽  
Doctoral Level ◽  
Psychological Therapies

ObjectiveGeneral Medical Practitioners play a crucial role in the detection and referral of mental health problems in primary care. This study describes the referral patterns of Irish General Practitioners (GPs) to psychological therapies and profiles the range of psychological therapies available.MethodA 21-item study-specific questionnaire exploring referral processes to psychological therapies was sent to all GPs listed by the Irish College of General Practitioners in one county in Ireland. A 19-item questionnaire exploring details of psychological therapies offered and referral pathways was sent to members of psychological therapy accrediting bodies in the same county.ResultsOf 97 GP respondents (33% response rate), their estimation of the percentage of their patients who have presenting or underlying mental health issues averaged 22%. When asked to indicate which psychological therapies they consider for referrals, psychiatric referrals was the most frequent referral option (94%), followed by Counsellors (69%), Clinical psychologist (60%) and Psychotherapists (30%). GPs indicated they had some or very little knowledge of specific psychological therapies. Of 129 psychological therapists (45% response rate), self-referral and GP referral were their main referral pathways; 80% worked in private practice; highest qualification level was Undergraduate/Higher Diploma (66%), Master Level (39%) and Doctoral Level (5%).ConclusionGPs refer patients presenting with mental health problems to psychiatrists with significantly lower percentages referring to other types of psychological therapists. Findings demonstrate that there is a need for greater education and information-sharing between GPs and providers of accredited psychological therapies to increase knowledge on specific therapies and their evidence base.

scholarly journals Concurrent opioid dependence and mental health problems: a review of the issues for general practice

2001 ◽  
Vol 24 (4) ◽  
pp. 188 ◽  
Author(s):  
Janice Duffy ◽  
Alex Ask ◽  
Colin Macdougall
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Health Professionals ◽  
Opioid Dependence ◽  
Mental Health Problems ◽  
Health Centre ◽  
Health Problems ◽  
Shared Care ◽  
Liaison Psychiatry ◽  
Care Community

The literature is reviewed on the issue of concurrent opioid dependence and mental health problems within the general practice setting. People with such problems have poorer personal, clinical and social outcomes than people with either mental health or drug and alcohol (D&A) problems alone. Mental health and drug services operate from different policy systems and are generally not co-ordinated with each other, leaving the onus on the patient to move effectively through health systems. The common statement that GPs are ideal health professionals to manage concurrent problems is contrasted with the evident barriers in general practice such as lack of time, knowledge, skills and confidence. Models for managing concurrent problems tend towards shared care. However, these models either have received mixed evidence (eg. consultant-liaison psychiatry) or are amenable to development but remain untested (eg. co-ordinated care, community health centre programs). The Enhanced Primary Care items introduced in 1999/2000 may provide an incentive for GPs to participate in shared care arrangements with other health professionals. However, there is a need for mechanisms to increase the links between GPs and other health services.

scholarly journals Applying Computerized Adaptive Testing to the Four-Dimensional Symptom Questionnaire (4DSQ): A Simulation Study

2017 ◽  
Vol 4 (1) ◽  
pp. e7 ◽  
Author(s):  
Tessa Magnée ◽  
Derek P de Beurs ◽  
Berend Terluin ◽  
Peter F Verhaak
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Simulation Study ◽  
Computerized Adaptive Testing ◽  
Mental Health Problems ◽  
Adaptive Testing ◽  
Health Problems ◽  
Measurement Precision ◽  
Stopping Rule ◽  
Symptom Questionnaire

Background Efficient screening questionnaires are useful in general practice. Computerized adaptive testing (CAT) is a method to improve the efficiency of questionnaires, as only the items that are particularly informative for a certain responder are dynamically selected. Objective The objective of this study was to test whether CAT could improve the efficiency of the Four-Dimensional Symptom Questionnaire (4DSQ), a frequently used self-report questionnaire designed to assess common psychosocial problems in general practice. Methods A simulation study was conducted using a sample of Dutch patients visiting a general practitioner (GP) with psychological problems (n=379). Responders completed a paper-and-pencil version of the 50-item 4DSQ and a psychometric evaluation was performed to check if the data agreed with item response theory (IRT) assumptions. Next, a CAT simulation was performed for each of the four 4DSQ scales (distress, depression, anxiety, and somatization), based on the given responses as if they had been collected through CAT. The following two stopping rules were applied for the administration of items: (1) stop if measurement precision is below a predefined level, or (2) stop if more than half of the items of the subscale are administered. Results In general, the items of each of the four scales agreed with IRT assumptions. Application of the first stopping rule reduced the length of the questionnaire by 38% (from 50 to 31 items on average). When the second stopping rule was also applied, the total number of items could be reduced by 56% (from 50 to 22 items on average). Conclusions CAT seems useful for improving the efficiency of the 4DSQ by 56% without losing a considerable amount of measurement precision. The CAT version of the 4DSQ may be useful as part of an online assessment to investigate the severity of mental health problems of patients visiting a GP. This simulation study is the first step needed for the development a CAT version of the 4DSQ. A CAT version of the 4DSQ could be of high value for Dutch GPs since increasing numbers of patients with mental health problems are visiting the general practice. In further research, the results of a real-time CAT should be compared with the results of the administration of the full scale.

scholarly journals Mental health problems and the presentation of minor illnesses: Data from a 30-year follow-up in general practice

2008 ◽  
Vol 14 (sup1) ◽  
pp. 38-43 ◽  
Author(s):  
Tim Olde Hartman ◽  
Eric van Rijswijk ◽  
Hiske van Ravesteijn ◽  
Lieke Hassink-Franke ◽  
Hans Bor ◽  
...  
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Mental Health Problems ◽  
Health Problems

Investigation of the frequency of alcohol related problems in Józsefváros, Budapest. Data and conclusions of three surveys undertaken among doctors and out-patients

2012 ◽  
Vol 153 (32) ◽  
pp. 1263-1280
Author(s):  
Miklós Péter Kalapos
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Response Rate ◽  
Family Physicians ◽  
Health Problems ◽  
Alcohol Problem ◽  
Physical And Mental Health ◽  
Suicidal Ideas ◽  
Alcohol Related Problems ◽  
Cage Test

The role of permanent alcohol consumption in the development of diseases is well-known. Aims: To study the occurence of alcohol related problems among patients of a municipal pulmonology out-patient clinic as well as in the family practice of three physicians. In addition, a survey was performed among physicians of a municipal health service and also among family practitioners working in the same district by investigating health problems, habits and professional careers of physicians, and their addictive problems, their attitude toward addict patients and their opinion upon chemical dependency. Methods: CAGE-test was used to examine the presence of alcohol problem and a questionnaire was constructed for the study undertaken among physicians. Results: The response rate was 60.18% and 32.98% among patients who visited the pulmonology out-patient clinic and their family physician, respectively. Among those who responded to the test, as many as 6.02% and 4.82% of the cases would need a further medical examination to make clear whether alcohol related health problem was present or not, whilst 9.77% and 11.67% of the patients proved to be alcohol dependent, respectively. The response rate in the survey among physicians was 41.28%. As stated, physicians not only screen the patients for alcohol and drug dependence, but also refer them to a specialist. The general experience seems to oppose this statement. The majority of health professionals considered chemical dependence as a chronic disease, whereas a kind of moral judgment of the problem was also seen, particularly among family physicians. If they had the opportunity to choose whom to treat: an alcoholic or a drug dependent patient, the majority of them would treat patients brought under the first category. The CAGE test revealed alcohol problem in three family physicians, but none in specialists. Nearly all physicians consumed coffee, but the majority of them were non-smokers. As the risk for committing suicide is higher among physicians than in the general population, physicians were interviewed in this regard, too. Three physicians in the sample reported an attempt of suicide, and eleven physicians had suicidal ideas in the past. Although the majority of physicians were satisfied with their physical and mental health, several of them had serious health problems or were treated with depression. At the same time, the majority of physicians were unsatisfied with their financial and professional respect, and had the opinion that a career is unlikely to depend on the professional knowledge. Discussion: Although the relatively low rate of physicians answering the questions did not make it possible to reveal the interrelationships among different variables, the study was able to direct the attention to the risk existing among physicians to commit suicide or use chemical substances. A proposal is made to establish an effective, but discreet and easy way to acquire psychiatric-addictological support. To avoid mental health problems among professionals working in psychiatry, organization of groups headed by someone not belonging to the same institute would be warmly encouraged. Parallel to these, the requirements and the conditions of making a career have to be made clear. On the basis of these surveys, as well as literature data, a continuous test examination of alcohol problem is recommended in the practice of family physicians as well as in the out-patient clinic of such disciplines like pulmonology and gastroenterology. Orv. Hetil., 2012, 153, 1263–1280.

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