Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care
Abstract
:1. The Biopsychosocial Model in Primary Health Care
2. Multidisciplinary Teamwork and Primary Health Care
3. Materials and Methods
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- Do you share your clinic with other GPs?
- ○
- No
- ○
- Yes (How many?) _______
- 2.
- How much has your training in medicine promoted the possibility of a collaboration between medicine and psychology?
- ○
- Not at all
- ○
- A little
- ○
- Moderately
- ○
- A lot
- 3.
- In your opinion, what are the specifics of the intervention of these different professionals:Psychologist
- ○
- Intervention targets
- ○
- Intervention goals
- ○
- Reasons for referral
- Psychotherapist
- ○
- Intervention targets
- ○
- Intervention goals
- ○
- Reasons for referral
- Counselor
- ○
- Intervention targets
- ○
- Intervention goals
- ○
- Reasons for referral
- Psychiatrist
- ○
- Intervention targets
- ○
- Intervention goals
- ○
- Reasons for referral
- 4.
- Have you ever referred patients to a psychologist?
- ○
- No
- ○
- Yes
- 5.
- How often have you referred patients to a psychologist for the following medical areas?
Never | Sometimes | Often | Always | |
Urology | ||||
Cardiology | ||||
Surgery | ||||
Dermatology | ||||
Diabetes care | ||||
Somatic functional syndromes | ||||
Chronic pain | ||||
Endocrinology | ||||
Smoking, alcohol, obesity (lifestyle) | ||||
Geriatrics | ||||
Gynecology | ||||
HIV | ||||
Neurology | ||||
Oncology | ||||
Psychiatry | ||||
Other |
- 6.
- Regarding the patients referred, have you received any feedback from the psychologist?
- ○
- No
- ○
- Yes, by phone
- ○
- Yes, in person
- ○
- Yes, other (please specify)
- 7.
- Do you have a network of psychologists you consider “trustworthy”?
- ○
- No, I do not know who to send patients to
- ○
- Yes, within public facilities
- ○
- Yes, within private organizations
- ○
- Yes, professional psychologists (individual or associated)
- 8.
- How often do you prescribe psychotropic drugs?
- ○
- Never
- ○
- Sometimes
- ○
- Often
- ○
- Always
- 9.
- How often do you meet patients who may benefit from psychological intervention?
- ○
- Never
- ○
- Sometimes
- ○
- Often
- ○
- Always
- 10.
- How often do you refer patients who you consider may benefit from psychological intervention to a psychologist?
- ○
- Never
- ○
- Sometimes
- ○
- Often
- ○
- Always
- 11.
- For what reasons did you not propose psychological intervention to someone who would need it?
- ○
- The distress was contained within the doctor-patient relationship
- ○
- I opted for a pharmacological therapy
- ○
- My proposal could have had a negative impact on the patient (“I’m not crazy!”)
- ○
- Patient could have experienced their problem as diminished
- ○
- Patient could have diminished their trust in me because I had not been able to manage the problem directly
- ○
- Patient might have felt abandoned by me
- ○
- I did not know who to refer them to
- ○
- Patient could not economically afford a psychological consultation
- ○
- Other (please specify)
- 12.
- How often do you receive requests for psychological intervention from your patients?
- ○
- Never
- ○
- Sometimes
- ○
- Often
- ○
- Always
- 13.
- How often do your patients complain about physical disorders whose origin is psychological?
- ○
- Never
- ○
- Sometimes
- ○
- Often
- ○
- Always
- 14.
- Which aspects of the relationship with patients are more difficult to manage for you?
- ○
- Aggressiveness
- ○
- Complaints
- ○
- Mistrust
- ○
- Unwarranted criticism
- ○
- Other (please specify)
- 15.
- If you have the opportunity, would you offer psychological interventions to your patients in your clinic?
- ○
- No
- ○
- Yes, individual psychological sessions conducted by a psychologist
- ○
- Yes, visits jointly conducted by doctor and psychologist
- ○
- Yes, group sessions jointly conducted by doctor and psychologist for patients with similar pathologies
- ○
- Yes, other (please specify)
- 16.
- A collaboration with a psychologist:
- ○
- Would help me to manage patients who show little compliance
- ○
- Would help me to manage patients with hypochondriac/psychosomatic symptoms
- ○
- Would shorten the waiting list
- ○
- Would foster a faster recovery of some patients
- 17.
- How much could the psychologist’s work overlap or hinder the doctor’s work?
- ○
- Not at all
- ○
- A little
- ○
- Moderately
- ○
- A lot
- 18.
- Is there a psychologist in your clinic?
- ○
- No
- ○
- Yes
- 19.
- If a psychologist is present in your clinic, how long has the partnership lasted?
- ○
- 0–5 months
- ○
- 6–12 months
- ○
- >12 months
- 20.
- If a psychologist is present in your clinic, how often are they present in a week?
- ○
- Depends on the number of appointments arranged
- ○
- Twice a week
- ○
- >3 times a week
- 21.
- How did the collaboration start?
- ○
- On the initiative of the psychologist
- ○
- On my own initiative to reduce the costs of the clinic
- ○
- On my own initiative to offer an additional service to patients
- ○
- There was an explicit request from patients
- ○
- Other (please specify)
- 22.
- What kind of cooperation is there between you and the psychologist in your clinic?
- ○
- None, s/he is a consultant to whom patients go spontaneously without my referral
- ○
- Referral for psychosomatic/functional disorders
- ○
- Referral for anxiety and depression disorders
- ○
- Referral for adapting to living with a chronic illness
- ○
- Other (please specify)
- 23.
- Response date to this survey:
- 24.
- Gender:
- ○
- Male
- ○
- Female
- 25.
- Year of birth:
- 26.
- Year of graduation:
- 27.
- Year of specialization (specify which one):
- 28.
- Other specialties or masters (specify which one):
- 29.
- In the past, have you worked as a doctor in other public or private organizations?
- ○
- No
- ○
- Yes, in a hospital
- ○
- Yes, in a residence for elderly
- ○
- Yes, in a family counseling center
- ○
- Yes, in a hospice
- ○
- Yes, other (please specify)
- 30.
- Indicate the year in which you started your practice as a general practitioner:
- 31.
- Number of patients assisted:
- 32.
- Health district to which you belong:
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Thematic Areas | Examples of Questions | Answer Options |
---|---|---|
Degree | Year Type and year Type and year No, hospital, family counseling center, hospice, retirement home, other | |
Education and career information | First specialization | |
Other specialization | ||
Previous medical activity in other services | ||
Patients’ medical conditions and need for psychological interventions | How often do you meet patients who could benefit from psychological intervention? | Never, sometimes, often, always |
Beliefs and attitudes towards mental health professionals | In your opinion, what are the goals of the intervention of these different professionals: psychologist, psychotherapist, counselor and psychiatrist? | Open-ended |
Attitudes towards the psychologist | If you had the opportunity, would you offer your patients a psychological intervention in your clinic? | No, yes |
In case you answered “yes” to the previous question, which psychological intervention would you offer? | Visit jointly conducted by doctor and psychologist, individual psychological/psychotherapy sessions, group posttherapy, other | |
How much could the psychologist/psychotherapist’s work overlap and hinder the doctor’s work? | Not at all, a little, moderately, a lot | |
Features of collaborations with psychologists | How often did you refer patients to a psychologist/psychotherapist with symptoms concerning the following medical areas? (urology, cardiology, dermatology, etc.) | Never, sometimes, often, always |
As for patients you referred to a psychologist/psychotherapist, did you have feedback by the psychologist/psychotherapist? How? | No, yes; by phone, in person, other |
Professionals | Intervention Targets | Intervention Goals | Reasons for Referral |
---|---|---|---|
Psychiatrist | Severe psychic symptoms (major depression, psychosis) | Diagnosis and psychopharmacological treatment | To heal and manage severe psychological symptoms |
Psychologist | Psychic and functional symptoms | Diagnosis, treatment, and psychological support | To heal and manage mild psychological symptoms |
Psychotherapist | Psychic and functional symptoms | Diagnosis, treatment, and psychological support | To heal and manage mild psychological symptoms |
Counselor | Existential and relational difficulties | Personal skills empowerment, promotion of an active role toward their own problems | To help in managing specific life issues |
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Negri, A.; Zamin, C.; Parisi, G.; Paladino, A.; Andreoli, G. Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care. Healthcare 2021, 9, 613. https://doi.org/10.3390/healthcare9050613
Negri A, Zamin C, Parisi G, Paladino A, Andreoli G. Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care. Healthcare. 2021; 9(5):613. https://doi.org/10.3390/healthcare9050613
Chicago/Turabian StyleNegri, Attà, Claudia Zamin, Giulia Parisi, Anna Paladino, and Giovanbattista Andreoli. 2021. "Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care" Healthcare 9, no. 5: 613. https://doi.org/10.3390/healthcare9050613