md-medicaldata

Authors

 

Mihaela Okuka¹, Biljana Lakić², Maja Račić<sup>3

1</sup>Javna zdravstvena ustanova Dom zdravlja Nevesinje, Republika Srpska, Bosna i Hercegovina
²Javna zdravstvena ustanova Dom zdravlja Banja Luka, Republika Srpska, Bosna i Hercegovina
³Medicinski fakultet Foča Univerziteta u Istočnom Sarajevu, Republika Srpska, Bosna i Hercegovina

 

The paper was received on 12.02.2017. / Accepted on 22.02.2017

 

Correspondence to

Biljana Lakić
Sime Matavulja 4
78000 Banja Luka
Mob. 0038765951255
e-mail: : biljanakd@yahoo.com

 

 

Abstract

 

Background: The physicians in Primary Heath Care (PHC), in addition to diseases based on physical causes, are increasingly faced with mental disorders that occurs as an independent construction or as construction on pre-existing disease. Due to the increase in the number of patients there is a need for educating health professionals to better treatmental illnessin PHC. Objective: The aim of this reaserch was to examine the attitudes of family physicians in Republic of Srpska about psychoterapy. Methods: A cross-sectional study included 190 respondents, the physicians who work in teams of family medicine throughout RepublikaSrpskain the period from May to October 2016. The survey instrument used was a questionnaire consisted of six parts including: demographic data of respondents,knowledge of physicians about the indications for referral to psychotherapy and counseling, the reasons for not sending patients on psychotherapy and counseling, physician attitudes about psychotherapy and counseling, awareness of family doctors about psychotherapy as a method of treatment, and awareness of family doctor education in a psychotherapeutic directions. Results: Respondents were divided into two groups according to age. The average age was 41.01 (SD = 9.62) years, including 29 (15.3%) men and 161 (84.7%) women. Given the level of education and specialization, 26.8% of physiciansare without specialization, 20.5% of the physicians are in residency, 36.3% are specialists in family medicine (PM), 14.7% are specialists with other specialties education in the PM, while the smallest number of respondents (1.6%) is a group of specialists in other branches of medicine. The average number of patients with psychiatric diagnosis per team is 16.26 (4.28), and the average proportion of the patients that are sent for psychotherapy was 8.01 (2.68) Conclusion: The majority of physicians in PHChave opinion that mental illness should be treated also with psychotherapy. Due to fact that only a fifth of physicians is trained in psychotherapy, wish of our doctors is for further education in this field to improve the quality of health care.

 

 

 

Key words:

mental disorders, family physicians, psychotherapy

 

 

Sažetak

 

Uvod: Ljekari u primarnoj zdravstvenoj zaštiti(PZZ) su pored organskih fizičkih bolesti danas sve više suočeni sa mentalnim poremaćajima koji se javljaju kao nezavisni ili kao nadogradnja prethodno postojeće bolesti. Zbog porasta broja oboljelih javlja se i potreba za edukacijom zdravstvenih profesionalaca kako bi se i mentalne bolesti bolje liječile u PZZ. Cilj: Cilj ovog istraživanja je bio da se ispitataju stavovi ljekara porodične medicine u Republici Srpskoj o psihoterapiji. Metode: Studijom presjeka je obuhvaćeno 190 ispitanika, ljekara koji rade u timovima porodične medicine širom Republike Srpske u periodu od maja do oktobra 2016. godine. Kao instrument istraživanja korišten je upitnik koji se sastojao iz šest dijelova i to: demografski podaci ispitanika Znanje ljekara o indikacijama za upućivanje na psihoterapiju I savjetovanje, razlozi neupućivanja pacijenata na psihoterapiju I savjetovanje, stavovi ljekara o psihoterapiji I savjetovanju, informisanost ljekara porodične medicine o psihoterapiji kao metodi liječenja, kao I informisanost ljekara porodične medicine o edukaciji iz nekog psihoterapeutskog pravca. Rezultati: Ispitanici su podijeljeni u dvije grupe u odnosu na starost. Prosječna starost ispitanika je 41,01 (SD=9,62) godina, među kojima je 29 (15,3%) muškaraca i 161 (84,7%) žena. S obzirom na nivo obrazovanja i specijalnosti, 26,8% ispitanika su ljekari bez specijalizacije, 20,5% ispitanika su ljekari na specijalizaciji, 36,3% su specijalisti porodične medicine (PM), 14,7% ispitanika su specijalisti druge specijalnosti sa edukacijom iz PM, dok je najmanji broj ispitanika (1,6%) činila grupa specijalista drugih grana medicine. Prosječan broj pacijenata sa psihijatrijskom dijagnozom u timu je 16,26 (4,28), a prosječan procenat pacijenata koji se upute na psihoterapiju je 8,01 (2,68), Zaključak: Većina ljekara u PZZ smatra da se mentalne bolesti trebaju liječiti i psihoterapijom. S obzirom na samo petinu edukovanih ljekara iz psihoterapije, izražena je želja naših ljekara za ovakvom vrstom edukacije kako bi se unaprijedio kvalitet zdravstvene zaštite.

 

 

Ključne reči:

mentalne bolesti, ljekari porodične medicine, psihoterapija

 

 

References

 

1. Health Canada. A Report on Mental Illnesses in Canada [Internet]. Canada PHAO,editor. Health San Francisco. Government of Canada; 2002.
2. Klinički vodiči za primarnu zdravstvenu zaštititu. Vodič za anksiozne poremaćaje. Ministarstvo zdravlja i socijalne zaštite Republike Srpske, 2004. str.5-31.
3. Svetska zdravstvena organizacija. Izvještaj o svetskom zdravlju za 2001.-mentalno zdravlje-novo razumevanje, nova nada. Ženeva: SZO, prevod Instituta za mentalno zdravlje u Beogradu, 2003.
4. Republička stručna komisija za izradu i implementaciju vodiča dobre kliničke prakse. Nacionalni vodič dobre kliničke prakse za dijagnostikovanje i lečenje depresije. Ministarstvo zdravlja Republike Srbije. Agencija za akreditaciju zdravstvenih ustanova Srbije, Beograd 2012.str.11-55.
5. 5.Klinički vodiči za primarnu zdravstvenu zaštititu. Depresija. Ministarstvo zdravlja i socijalne zaštite Republike Srpske, 2004.str.5-43.
6. Moffitt TE, Caspi A, Taylor A, Kokaua J, Milne BJ, Polanczyk G, et al. How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychol Med. 2010; 40:125–9.
7. Beutler LE. Making science matter in clinical practice: Redefining psychotherapy. Clinical Psychology: Science and Practice. 2009;16:301–317. doi:10.1111/j.1468-2850.2009.01168.x.
8. Luborsky L, Singer B. Comparative studies of psychotherapies: is it true that „verybody has won and all must have prizes”? Proceedings of the Annual Meeting of the American Psychopathology Association. 1976;(64):3–22.
9. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR, Salomon RM, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of general psychiatry. 2005;409–16.               
10. Keller MB, McCullough JP, Klein DN, Arnow B, Dunner DL, Gelenberg AJ, et al. A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med 2000;342:1462-1470.
11. McDermut W, Miller IW, Brown RA. The efficacy of group psychotherapy for depression: a meta-analysis and review of the empirical research. Clin Psychol-Sci Pract. 2001;8:98–116. doi: 10.1093/clipsy.8.1.98.
12. Coffey SF, Banducci AN, Vinci C. Common questions about cognitive behavior therapy for psychiatric disorders. Am Fam Physician. 2015 Nov 1;92(9):807-812.
13. Wittchen HU1, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79.
14. Kennard BD, Clarkse GN, Weersing VR, Asarnow JR, Shamseddeen W, Porta G, et al. Effective components of TORDIA cognitive-behavioral therapy for adolescent depression: preliminary findings. J Consult Clin Psychol. 2009; 77:1033–41.
15. Swanson J. Family physicians’ approach to psychotherapy and counseling. Perceptions and practices. Can Fam Physician. 1994;40:53–8.
16. Canadian Community Health Survey CCHS. Statistics Canada. 2003.
17. Primary Health Care (PHC) Indicators chartbook. Canadian Health Institute for Health Information, 2007.
18. Canada S. Canadian Community Health Survey: Mental Health, 2012.
19. Friedli K, King MB, Lloyd M, Horder J. Randomised controlled assessment of non-directive psychotherapy versus routine general-practitioner care. Lancet. 1997;350(9092):1662–5.
20. Ward E, King M, Lloyd M, Bower P, Sibbald B, Farrelly S, et al. Randomised controlled trial of non-directive counselling, cognitive- behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness. BMJ 2000;321(7273):1383–8.
21. Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005;55(513):305–12.
22. Skakic O, i sar. Radna sposobnost mentalno oboljelih osoba u uslovima društveno-ekonomske krize. Med Pregl 2011; LXIV (1-2): 41-45.
23. Cuijpers P, Van Straten A, Andersen G. The contribution of active medication tocombined treatments of psychotherapy and pharmacotherapy for adult depression:a meta-analysis. Acta Psychiatr Scandinaavtica. 2010;121:415–23.
24. Hartley D,  Korsen N,  Bird D, Agger M.  Management of Patients With Depression by Rural Primary Care Practitioners .Arch Fam Med. 1998;7:139-145..

UDK: 615.851:614.25
616.89-085.851
COBISS.SR-ID 239037964

PDFOkuka M. et al MD-Medical Data 2017;9(2): 107-112