综合医院非精神科医生对精神卫生工作转移态度的影响因素分析

Analysis of Influencing Factors for Attitude Shifting to Mental Health Work among Non-psychiatric Doctors in General Hospitals

目的 了解广州市综合医院非精神科医生对精神卫生工作转移态度及其相关影响因素,为改善服务和政策制定提供参考依据。方法 2012年12月～2013年4月,采用现况调查,对广州市三级甲等综合医院的1363名非精神科医生进行问卷调查。结果 在对精神卫生工作转移的态度上,941人（69.6%）持赞成态度。影响调查对象对精神卫生工作转移态度的因素包括：工作时间8～10小时/天（β=0.404,P=0.006）;对综合医院开展精神卫生工作最大的影响因素为医务人员的执业资格（β=-1.345,P=0.016）;认为患有躯体疾病合并心理精神问题的患者所占比例小于10%（β=-0.452,P=0.014）;预计未来综合医院开展精神卫生工作最大的制约因素为实施费用/时间（β=-0.596,P=0.021）;对目前工作中处理心理精神障碍准备好了（β=1.436,P〈0.001）和稍有准备（β=0.694,P〈0.001）。在对精神卫生工作转移态度上,持赞成态度的可能性最高（71.0%）,其次是中立（25.5%）,最后是反对（3.5%）。结论 加强综合医院非精神科医生对开展精神卫生工作的支持以及对精神心理障碍的诊疗,完善相关政策法制以及开展针对性教育培训是当务之急。

Objective：To investigate the attitude towards task - shifting of mental health among non - psychiat- ric physicians of general hospitals in Guangzhou and to provide evidence for continuing education model and health policy making. Methods：A cross -sectional study was implemented among 1363 participants of 17 general hospi- tals from December 2012 to April 2013 in Guangzhou. Results： Among 1363 participants, there were 941 （69.6%） approved the concept of mental health task shift. Factors of attitude to the concept of mental health task shift include work 8 - 10 h/day （/3 =0. 404, P=0. 006）, practice qualification （β = - 1. 345, P =0.016）, less than 10% physical diseases combined with psychological or mental problems in clinical work（β = -0. 452, P = 0.014）, demand of training cost/time（β = -0. 596, P =0. 021 ）, get ready （β = 1. 436, P 〈0. 001 ） and have little preparation （β = 0. 694, P 〈 0. 001 ） preparation for treating mental disorders at present work （recognition and treatment）. The possibility of participants＇ attitude toward task - shifting mental health is positive the highest （71.0%）, followed by neutral （25.5%） and negative （3.5%）. Conclusions：Strengthening non - psychiatric physicians＇ support for mental health task shift with respect to policy and legal levels in general hospitals, improving their recognition and preparation of mental disorders, as well as developing targeted training and courses are the highest priority.