Managing mental illness in primary care - General Practitioners' perspective

Chong, Wayne Freeman; Lim, Harold; Yong, Shing Yew Joel

doi:10.5334/ijic.1501

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…We were unable to determine if the sociodemographic profile of the GPs was representative of overall GPs in Singapore, although it was similar to that reported in previous studies conducted among GPs. 50,51 The response rate was just over 50%, thus, responses might not be strongly representative given the low response rate, and the resulting non-response bias may limit the generalisability of the results. However, our response rate of 52% in this mailing study involving GPs was higher than that reported in other similar studies 17,18 and the results are an important first step towards engaging GPs in dementia care.…”

Section: Factor 4: Trainingmentioning

confidence: 99%

General Practitioner’s Attitudes and Confidence in Managing Patients with Dementia in Singapore

Subramaniam

Ong

Abdin

et al. 2018

Ann Acad Med Singap

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The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs’ attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the “GP Attitudes and Competencies Towards Dementia” questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n = 296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed or agreed that early recognition of dementia served the welfare of the patients (n = 385; 96%) and their relatives (n = 387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of the questionnaire revealed 4 factors representing “benefits of early diagnosis and treatment of patients with dementia”, “confidence in dealing with patients and caregiver of dementia", “negative perceptions towards dementia care” and “training needs”. GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical first step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs’ knowledge, confidence and comfort in managing patients with dementia. Key words: Communication, Diagnosis, Management

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Section: Factor 4: Trainingmentioning

confidence: 99%

General Practitioner’s Attitudes and Confidence in Managing Patients with Dementia in Singapore

Subramaniam

Ong

Abdin

et al. 2018

Ann Acad Med Singap

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“…These findings were comparable with the results of previous surveys of GPs in Singapore. 22 23) The proportion of patients with ID constituted 1% to 5% of the overall patient population for most GPs who responded to the survey. This indicates that patients with ID constitute only a minor part of their work, which might make GPs less confident or inexperienced in dealing with these patients over time.…”

Section: Discussionmentioning

confidence: 99%

General Practitioners' Perceptions on Clinical Management and Training Needs regarding the Healthcare of Community-Dwelling People with Intellectual Disability: A Preliminary Survey in Singapore

2017

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BackgroundStudies worldwide indicate that people with intellectual disability have high risks of physical and mental morbidities, and poor quality of health care. This study was aimed at determining general practitioners' perceptions on barriers in clinical assessment and training needs with regard to the healthcare of community-dwelling people with intellectual disability.MethodsA survey questionnaire was developed specifically for the study through focus group discussions and a literature review. The study was conducted as a cross-sectional anonymous survey of private general practitioners practicing in Singapore. The survey contained questions on their experience and training needs in assessing and treating patients with intellectual disability.ResultsForty-nine of the 272 questionnaires sent out were returned. The respondents were predominantly male general practitioners working in “solo” practices. For most general practitioners, the proportion of patients with intellectual disability ranged from 1% to 5%. Nearly 90% of general practitioners identified problems in communicating with such patients as an important barrier that affected the quality of assessment of their health conditions. Other barriers identified were behavioral issues and sensory impairments. Only one-third of the general practitioners were confident that they had sufficient knowledge of physical and mental health conditions related to patients with intellectual disability. Three-fourths of the general practitioners believed that further training in this area would be beneficial.ConclusionAppropriate interventions to address barriers in assessment and management of patients with intellectual disability with further training for general practitioners may improve the standard of healthcare provided to this population group.

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“…Among the GPs who were seeing patients with mental illness, depression (23%) was one of the most common mental illnesses attended to. [6] These findings were admittedly conservative estimates of the local prevalence of depression since studies have indicated that in Asian societies, somatic symptoms of depression may be more salient to patients and could be mistakenly reported merely as symptoms of organic ailments. [7] Studies have shown that treatment adherence and positive treatment outcomes could be predicted by patients' perception of their illness, the severity of their illness, and their expectation that the illness will improve with treatment.…”

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confidence: 99%

Depression Outcome Expectancy in Primary Care in Singapore: Symptom Severity as a Mediating Determinant

Chin

Lim

Yap

et al. 2020

Indian Journal of Psychological Medicine

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Background: Depression has been identified as the most common mental illness in Singapore. To address this growing concern, the current study focused on the population within the primary care setting since depression has been demonstrated to be highly prevalent in these patients. This study examined the possible predictors of outcome expectancy based on illness perception and depression severity. Methods: One hundred and one adult patients with depressive symptoms in primary care were recruited for a cross-sectional study. Positive outcome expectancy was measured using the Depression Change Expectancy Scale, and illness perception was measured using the Illness Perception Questionnaire Mental Health. Depression severity was derived from the Patient Health Questionnaire-9 scores extracted from the participants' medical records. Regression and mediation analyses were applied to explore possible predictors of positive outcome expectancy. Results: Regression analysis demonstrated that symptom severity, and specific dimensions under illness perception (i.e., perception of chronicity, perception of personal control, and perception of treatment control) were the most significant predictors of positive outcome expectancy. Mediation analysis found that symptom severity partially mediated the relationship between perception of chronicity and positive outcome expectancy. Conclusions: Pharmacotherapy, interventions from allied health professionals, and psychotherapeutic interventions (e.g., strategies from positive psychology, solution-focused therapy, and strengths-based cognitive behavioral therapy) that aim to directly alleviate depressive symptoms as well as improve the perceptions of chronicity, personal control, and treatment control could potentially enhance treatment benefits in primary care patients with depression.

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Managing mental illness in primary care - General Practitioners' perspective

Cited by 3 publications

References 5 publications

General Practitioner’s Attitudes and Confidence in Managing Patients with Dementia in Singapore

General Practitioner’s Attitudes and Confidence in Managing Patients with Dementia in Singapore

General Practitioners' Perceptions on Clinical Management and Training Needs regarding the Healthcare of Community-Dwelling People with Intellectual Disability: A Preliminary Survey in Singapore

Depression Outcome Expectancy in Primary Care in Singapore: Symptom Severity as a Mediating Determinant

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