Social prescribing for individuals with mental health problems: a qualitative study of barriers and enablers experienced by general practitioners.
Social prescribing for individuals with mental health problems: a qualitative study of barriers and enablers experienced by general practitioners.
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DOI：
10.1186/s12875-020-01264-0
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发表时间：
2020-09-21
影响因子：
2.9
通讯作者：
Fancourt D
中科院分区：
文献类型：
--
作者：
Aughterson H;Baxter L;Fancourt D
越来越多的证据表明，社会处方是改善患者心理健康的一种手段。然而，在理解全科医生（GP）在为精神健康问题患者进行社会处方时所面临的障碍和推动因素方面存在差距。本研究采用定性方法，涉及一对一的全科医生从英国各地的采访。COM-B模型被用来阐明障碍和促进因素，理论领域框架和行为改变理论和技术工具被用来确定可以解决这些问题的干预措施。全科医生认识到社会处方在解决他们在患者人群中看到的高水平社会心理需求方面的效用，并表示需要将某些患者问题去医疗化。全科医生被帮助病人的愿望所驱使，因此他们从定期的积极反馈中受益，以加强他们的社会处方推荐的价值。他们还讨论了开发更有力的社会处方证据的重要性，但承认在社区环境中进行严格研究的挑战。全科医生缺乏能力和正规培训，无法有效地与社区团体合作，帮助有精神健康问题的患者。当全科医生可用时，链接工作者在弥合全科医生和社区之间的差距方面具有根本的重要性。在社会处方途径的不同点上，信任关系的形成至关重要，患者需要信任全科医生，以便他们同意去看联系工作人员或参加社区活动，全科医生需要一系列强大的人际交往技能，以获得患者的信任并激励他们。本研究从全科医生的角度阐述了社会处方精神健康问题患者的障碍和推动因素。建议的干预措施包括为全科医生提供更系统的反馈结构，以及围绕社会处方和发展相关人际交往技能进行更正式的培训。这项研究为全科医生和其他实践工作人员，专员，管理人员，提供者和社区团体提供了见解，以帮助设计和提供未来的社会处方服务。
There is growing evidence for the use of social prescribing as a means to improve the mental health of patients. However, there are gaps in understanding the barriers and enablers faced by General Practitioners (GPs) when engaging in social prescribing for patients with mental health problems. This study uses a qualitative approach involving one-to-one interviews with GPs from across the UK. The COM-B model was used to elucidate barriers and enablers, and the Theoretical Domains Framework (TDF) and a Behaviour Change Theory and Techniques tool was used to identify interventions that could address these. GPs recognised the utility of social prescribing in addressing the high levels of psychosocial need they saw in their patient population, and expressed the need to de-medicalise certain patient problems. GPs were driven by a desire to help patients, and so they benefited from regular positive feedback to reinforce the value of their social prescribing referrals. They also discussed the importance of developing more robust evidence on social prescribing, but acknowledged the challenges of conducting rigorous research in community settings. GPs lacked the capacity, and formal training, to effectively engage with community groups for patients with mental health problems. Link workers, when available to GPs, were of fundamental importance in bridging the gap between the GP and community. The formation of trusting relationships was crucial at different points of the social prescribing pathway, with patients needing to trust GPs in order for them to agree to see a link worker or attend a community activity, and GPs requiring a range of strong inter-personal skills in order to gain patients’ trust and motivate them. This study elucidates the barriers and enablers to social prescribing for patients with mental health problems, from the perspectives of GPs. Recommended interventions include a more systematic feedback structure for GPs and more formal training around social prescribing and developing the relevant inter-personal skills. This study provides insight for GPs and other practice staff, commissioners, managers, providers and community groups, to help design and deliver future social prescribing services.
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DOI：
10.1186/1748-5908-6-42
发表时间：
2011-04-23
期刊：
Implementation science : IS
影响因子：
--
作者：
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影响因子：
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影响因子：
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CHERRY, R
DOI：
10.1111/j.1464-0597.2008.00341.x
发表时间：
2008-10-01
影响因子：
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