BackgroundHow GPs understand mental health problems determines their treatment choices; however, measures describing GPs' thinking about such problems are not currently available.
AimTo develop a measure of the complexity of GP explanations of common mental health problems and to pilot its reliability and validity.
Design of studyA qualitative development of the measure, followed by inter-rater reliability and validation pilot studies.
SettingGeneral practices in North London.
Older people with psychological morbidity generally first present to health services in primary care, where they are increasingly seen by primary care nurses. In order to evaluate primary care nurses' identification of psychological morbidity, 190 older patients attending eight practice nurses completed the General Health Questionnaire (GHQ) and the practice nurses made an assessment as to the presence or absence of psychological problems. The practice nurses identified only 26% of probable cases of psychological morbidity identified by the GHQ. Their threshold for identification was high, rating only 12% of patients as experiencing psychological problems compared to 29% probable cases identified by the GHQ, and their accuracy was low (kappa for agreement between GHQ and nurse ratings = 0.23). Likelihood of identification depended on length and type of visit. The findings suggest that it may be unrealistic to expect practice nurses, without additional training and reorganisation of their work, to identify more than a minority of older patients with psychological morbidity in the course of their routine work.
triage scenarios, pre-and post-training knowledge and preparedness were assessed in 5 IAPA staff members and 12 Bachelor's in Social Work students. Participants used a 3-tier triage system (emergent, urgent, non-urgent) to assign a triage level for each scenario.Findings: Paired t-test analysis showed significant differences (P<0.05) in overall pre-and post-test scores. The protocol categories of Fever, Diarrhea, General Danger Signs, and Opportunistic Infections showed the most significant differences (P<0.05) while the protocol category of Cough showed no significant difference (P>.05). 94.1% of trainees felt equally or more prepared posttraining vs. pre-training.Interpretation: Recommendations were made to provide continued yearly CLHIV trainings. Future research looks to recruit more coordinators and assess the protocol's impact on control and treatment groups. Future direction of The UTHAVI Project include expanding the healthcare network to physicians of different specialties. Following the completion of the online triage database, trainings on how to use the technology will be conducted and triaging patients will be studied through the website.
Source of Funding:Center for World Health at UCLA.Abstract #: 2.038_HHR
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