家庭醫學科醫師轉介病患予臨床心理師之可能影響因素

The Factors Influencing Family Physicians' Referral of Psychiatric Patients to Clinical Psychologists

張榮哲(Jung-Che Chang) ； 曾珮琪(Pei-Chi Tseng) ； 鐘弘達(Hung-Ta Chung) ； 余馥羽(Fu-Yu Yu) ； 李怡青(I-Ching Lee)

《臨床心理學刊》 6卷2期 (2012/12) Pp. 21-30

https://doi.org/10.6550/ACP.201212_6(2).0003

摘要

目的：精神疾病在基層醫療有高盛行率，而醫師與臨床心理師的合作可提昇精神疾患照護品質。本研究探討家醫科醫師轉介病患給臨床心理師的可能影響因素。方法：採問卷調查法，以描述統計與路徑分析檢驗42名家醫科醫師的自陳資料。結果：受訪醫師對臨床心理師有中等程度的知識，偏正向的態度，自認照顧精神疾患的能力中等，有高度意願照顧精神疾患，亦有高度意願轉介病患予臨床心理師，然而轉介行為偏低。對臨床心理師態度越正面、所處機構資源越不足的家醫科醫師轉介意願越高。轉介意願越高，轉介行為也愈高，尤其在機構資源較高的情況下。此外，自評能力越好、心理師資源越高時，家醫科醫師自陳的轉介行為越高。結論：提升正向態度、增加心理師可得性、改善機構資源，與加強醫師診治精神疾病能力，是增進家醫科醫師與臨床心理師合作的可能方法。

並列摘要

Objective: Mental disorders are highly prevalent in primary care. The collaboration of physicians and clinical psychologists may improve the quality of medical care for psychiatric patients. The purpose of this study is to investigate factors which may influence family physicians' referral to clinical psychologists. Method: Path-analysis and descriptive analysis were performed to examine self-reported data collected through a structured questionnaire from 42 family physicians. Results: The participating physicians had moderate knowledge and a positive attitude toward clinical psychologists. The physicians reported moderate ability to care for psychiatric patients. Although the physicians highly intended to take care of psychiatric patients and to refer patients to clinical psychologists, they seldom made actual referrals. The more the positive attitude toward clinical psychologists and the less the institutional resources, the more intent the physicians reported on referring. In addition to referral intent, the more accessible the psychologists were, the more the physicians evaluated their ability to care for the patients, and the more of both referral intent and institutional resources, the more the physicians made actual referrals. Conclusion: Increasing positive attitude toward clinical psychologists, increasing accessibility of clinical psychologists, increasing institutional resources, and improving physicians' ability in handling psychiatric disorders are possible ways of promoting actual referrals from family physicians to clinical psychologists.