Meeting the needs of primary care physicians: A guide to content for programs on depression

被引:8
|
作者
Williams, JW
Bhogte, M
Flinn, JF
机构
[1] S Texas Vet Hlth Care Syst, San Antonio, TX USA
[2] Univ Texas, Hlth Sci Ctr, San Antonio, TX USA
[3] Baylor Coll Med, Houston, TX 77030 USA
来源
关键词
primary health care; depressive disorders; education; medical; physician's practice patterns; attitude of health personnel;
D O I
10.2190/6KC4-HB1M-0XD3-W5EF
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: The purpose of this article is to identify literature-based content for the design of educational programs on depression for practicing primary care physicians. Methods: A MEDLINE search was conducted of English-language medical literature published from 1982 through July 1997 for studies describing primary care physicians' knowledge, skills, practice patterns, and perceived barriers related to care of depressed patients. Studies focusing exclusively on residency training and those describing physician practices outside North America were excluded. Of 377 articles identified, forty met inclusion and exclusion criteria. Results: Recommendations for educational content were identified from the literature review. For recognition, educators should prioritize communication skills and strategies for the use of depression questionnaires. For diagnosis, practice interpreting symptoms in the medically ill, strategies for efficient diagnosis, and systematic approaches to assessing suicide risk should be emphasized. For treatment, greater attention to the therapeutic alliance, staged therapy, and strategies for improving medication adherence are indicated. Conclusions: There is a moderately well developed literature describing self-perceived and observed gaps in the current care for depression in primary care. Addressing the entire list of needs would take more time than practicing physicians are likely to have. An important challenge for educators is to design flexible programs based on individualized needs assessment or, when not possible, to prioritize the most generalizable needs.
引用
收藏
页码:123 / 136
页数:14
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