Caring for seriously mentally ill patients. Qualitative study of family physicians experiences.

摘要

OBJECTIVE: To examine family physicians' experiences in caring for patients with serious mental illness and their expectations of a shared mental health care (SMHC) model. DESIGN: Qualitative method of in-depth interviews. SETTING: London, Ont. PARTICIPANTS: Purposive sample of 11 full-time family physicians providing ongoing care for patients with serious mental illness. METHOD: Eleven interviews were conducted to explore family physicians' experiences. All interviews were audiotaped and transcribed verbatim. Analysis was done using a constant comparative approach and was carried out concurrently rather than sequentially. Researchers read all interview transcripts independently before comparing and combining their analyses. Final analysis involved examining all interviews together to discover relationships between and among emerging themes. MAIN FINDINGS: Findings reflected three main themes: what family physicians perceive they bring to care of seriously mentally ill patients (i.e., whole-person approach to care); challenges family physicians face in participating in shared care of these patients (i.e., communication and access issues); and family physicians' expectations of a SMHC model (i.e., guidance and feedback). CONCLUSION: As seriously mentally ill patients are moved out of institutions, the need for an effective and efficient SMHC model becomes imperative. Our findings suggest that family physicians could be an important part of SMHC models but only if systemic barriers are removed and collaborative practice is encouraged.