PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2019 | 13 | 4 |

Tytuł artykułu

Co-presence of a family doctor and psychologist in the management of patients with psychosocial and somatic symptom disorders

Autorzy

Treść / Zawartość

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Background: Patients often seek out the help of general practitioners for problems that need a holistic, biopsychosocial approach. Having a psychologist present to support the GP in treatment allows for a more complete response to the patient’s distress, which is aided by the integration of the two specialists’ areas of expertise. Aim of the study: The aims of the study were to ensure all patients had direct access to a psychologist during treatment, even if they had not put in a specific request for one, to take care of accidental crises in real time, to reduce spending on inappropriate pharmaceutical prescriptions and diagnostic examinations, and to facilitate health promotion. Material and methods: The experiment took place between January 2014 and December 2015, in Pordenone, Italy. The psychologist was present in the GP practice every Thursday. The psychologist was present to provide consultation for each person who went to the GP practice for treatment. The study also explored the significance of any request, the psychological framework of the observed situations, and included an additional meeting with the psychologist in the GP practice, for individual interviews. Results: Of about 1,300 consultations with both the psychologist and GP present, the majority of the patients accepted the psychologist’s presence favorably. The most frequent source of discomfort for patients related to the grieving process during separation from people to whom the individual has a strong emotional attachment. 30 patients (6 males, 24 females) took part in individual follow-up meetings, 5 abandoned the project, 21 completed the full series of meetings, and 4 were sent to a mental health facility. Because of this holistic approach, spending on medical investigations was reduced by 6%, and the cost of pharmaceutical expenditure decreased by 10%. Conclusions: The joint medico-psychological treatment prevented, even at early stages, the appearance of somatic and psychic symptoms. This study has positively promoted health and well-being and shown that this type of treatment can help to limit expenses for pharmaceutical prescriptions and specialist diagnostic examinations.

Słowa kluczowe

Wydawca

-

Rocznik

Tom

13

Numer

4

Opis fizyczny

p.11-16,fig.,ref.

Twórcy

autor
  • Department of Primary Care, Azienda Per L’assistenza Sanitaria 5, Pordenone, Italy
autor
  • Department of Primary Care, Azienda Per L’assistenza Sanitaria 5, Pordenone, Italy

Bibliografia

  • 1. Balint M. The Doctor, his patient and the illness. London: Pitman Medical Publishing; 1957.
  • 2. NICE – National Institute for Health and Care Excellence, Clinical guideline: generalized anxiety disorder and panic disorder in adults [online] 2011 [cit. 27.10.2019]. Available from: https://www.nice.org.uk/guidance/cg113.
  • 3. Spielmans G, Berman M, Usitalo A. Psychotherapy versus second-generation antidepressants in the treatment of depression: a meta-analysis. J Nerv Ment Dis 2011; 199: 142–149.
  • 4. Jauregui A, Ponte J, Salgueiro M, Unanue S, Donaire C, Gómez M, et al. Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol. BMC family practice 2015; 16(1): 39.
  • 5. Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol 2010; 65(2): 98–109.
  • 6. Miller-Matero LR, Dubaybo F, Ziadni MS, Feit R, Kvamme R, Eshelman A, et al. Embedding a psychologist into primary care increases access to behavioral health services. J Prim Care Community Health 2015; 6(2): 100–104.
  • 7. Derksen J. Primary care psychologists in the netherlands: 30 years of experience. Prof Psychol Res Pr 2009; 40(5): 493–501.
  • 8. Gunn W, Blount A. Primary care mental health: a new frontier for psychology. J Clin Psychol 2009; 65(3): 235–252.
  • 9. Chomienne M, Grenier J, Gaboury I, Hogg W, Ritchie P, Farmanova‐Haynes E. Family doctors and psychologists working together: doctors’ and patients’ perspectives. J Eval Clin Pract 2011; 17(2): 282–287.
  • 10. Solano L. Dal Sintomo alla Persona: Medico e Psicologo insieme per l’assistenza di base. Milano: Franco Angeli Editore; 2011. (In Italian).
  • 11. Falanga R, Pillot L. Un percorso sperimentale di interazione tra Mmg e psicologo. M.D. Medicinae Doctor 2014; 5: 20–22. (In Italian).
  • 12. McDaniel S, deGruy III F. V. An introduction to primary care and psychology. Amer Psychol 2014; 69(4): 325–331.
  • 13. Prins M, Verhaak P, Dineke S, Verheij A. Healthcare utilization in general practice before and after psychological treatment: a follow-up data linkage study in primary care. Scand J Prim Health Care 2014; 32: 117–123.
  • 14. Solano L. Tra mente e corpo: come si costruisce la salute. Milano: Raffaello Cortina Editore; 2013. (In Italian).
  • 15. Clark DM. Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience, Int Rev Psychiatry 2011; 23: 375–384.
  • 16. Unutzer J, Katon WJ, Fan MY, Schoenbaum MC, Lin EH, Della Penna RD, et al. Long-term cost effects of collaborative care for late-life depression. Am J Manag Care 2008; 14(2): 95–100.
  • 17. Solano L, Pirrotta E, Ingravalle V, Fayella P. The family physician and the psychologist in the office together: a response to fragmentation. Ment Health Fam Med 2009; 6(2): 91–98.
  • 18. Falanga R, Pillot L. Co-presence general practitioner and psychologist: a winning solution in primary care. Proceedings of the 21st World Conference of Family Doctors; 2016 Nov 2–6; Rio de Janeiro, Brazil [online] [cit. 27.10.2019]. Available from URL: https://proceedings.science/wonca/trabalhos/co-presencegeneral-practitioner-and-psychologist-a-winning-solution-inprimary-care?lang=en.
  • 19. Khan L, Personage M, Stubbs J. Investing in children’s mental health. A review of evidence on the costs and benefits of increased service provision. Centre for Mental Health Report [online] 2015 [cit. 27.10.2019]. Available from URL: https://www.centreformentalhealth.org.uk/sites/default/files/2018-11/investing_in_childrens_mental_health.pdf.
  • 20. Knapp M, Iemmi V. The economic case for better mental health. In: Davies S, ed. Annual report of the Chief Medical Officer 2013, public mental health priorities: investing in the evidence. London: Department of Health; 2014: 147–156 [online] [cit. 27.10.2019]. Available from URL: http://eprints.lse.ac.uk/59520/.

Typ dokumentu

Bibliografia

Identyfikatory

Identyfikator YADDA

bwmeta1.element.agro-5d325742-3953-45fe-8c73-b39650f77b13
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.