[Family doctors and psychiatrists and the patient with depression: the need to re-adjust health care approaches and organisational dynamics]. / Médicos de familia y psiquiatras ante el paciente con depresión: la necesidad de readecuar enfoques asistenciales y dinámicas organizativas.

OBJECTIVES: To find out the perceptions of family doctors (FD) and psychiatrists (PS) on their inter-relationships in the health care of patients with depression. DESIGN: Qualitative methodology. Exploratory design based on FD and PS discussion groups (DG). SETTING: Primary health care centres (PHCC) and mental health centres (MHC) of the Basque Country Health Service in Vizcaya. PARTICIPANTS AND CONTEXT: A total of 29 FD from 20 PHCC, and 13 PS from 11 MHC, distributed according to the socioeconomic level of the reference population. The meetings were arranged and held in the PC research unit. METHODS: An intentional sample to configure 4 DG of FD and 2 of PS, homogenous as regards socioeconomic level, and heterogeneous as regards the centres they came from, work experience and gender. The meetings were recorded and transcribed and a sociological discourse analysis was made. Triangulation between researchers and results comparison with the participants was carried out. RESULTS: The perceptions and attitudes of the FD and PS differed, in their connections with the patient, expectations and health care context. In both cases they perceived the unsuitability of the real patient as regards the prefixed perceptions of the professional. The increase of the problem and its management seemed to be conditioned by a social medium which was uncontrolled, and due to increasing deficiencies in the collaboration between health care levels. CONCLUSIONS: Care of the patient with depression requires diagnostic and treatment approaches centred on the patient and shared by FD and PS.

Médicos de familia y psiquiatras ante el paciente con depresión: la necesidad de readecuar enfoques asistenciales y dinámicas organizativas / Family Doctors and Psychiatrists and the Patient With Depression: the Need to Re-adjust Health Care Approaches and Organisational Dynamics

Objetivos: conocer las percepciones de los médicos de familia (MF) y psiquiatras (PS) acerca de su interrelación en la asistencia a los pacientes con depresión. Diseño: metodología cualitativa. Diseño exploratorio basado en grupos de discusión (GD) de MF y PS. Emplazamiento: centros de salud (CS) de atención primaria (AP) y centros de salud mental (CSM) del Servicio Vasco de Salud-Osakidetza en Bizkaia. Participantes y contextos: un total de 29 MF de 20 CS y 13 PS procedentes de 11 CSM, distribuidos según el nivel socioeconómico de las poblaciones de referencia. La convocatoria y las reuniones se realizaron en la unidad de investigación de AP. Método: muestreo intencional para configurar 4 GD de MF y 2 de PS, homogéneos respecto al nivel socioeconómico, y heterogéneos en cuanto a centros de procedencia, experiencia laboral y sexo. Grabación y transcripción de las reuniones. Análisis sociológico del discurso. Triangulación entre investigadores y contraste de resultados con los participantes. Resultados: las percepciones y actitudes de MF y PS difieren en su vinculación con el paciente, expectativas y contexto asistencial. En ambos casos se percibe inadecuación del paciente real respecto de los esquemas prefijados por el profesional. El aumento del problema y su manejo aparecen condicionados por un medio social que no se controla, y por deficiencias crecientes en la colaboración entre niveles asistenciales. Conclusiones: la atención al paciente con depresión requiere de enfoques diagnósticos y tratamientos centrados en el paciente y compartidos por MF y PS(AU)

Objectives: To find out the perceptions of family doctors (FD) and psychiatrists (PS) on their inter-relationships in the health care of patients with depression. Design: Qualitative methodology. Exploratory design based on FD and PS discussion groups (DG). Setting: Primary health care centres (PHCC) and mental health centres (MHC) of the Basque Country Health Service in Vizcaya. Participants and context: A total of 29 FD from 20 PHCC, and 13 PS from 11 MHC, distributed according to the socioeconomic level of the reference population. The meetings were arranged and held in the PC research unit. Methods: An intentional sample to configure 4 DG of FD and 2 of PS, homogenous as regards socioeconomic level, and heterogeneous as regards the centres they came from, work experience and gender. The meetings were recorded and transcribed and a sociological discourse analysis was made. Triangulation between researchers and results comparison with the participants was carried out. Results: The perceptions and attitudes of the FD and PS differed, in their connections with the patient, expectations and health care context. In both cases they perceived the unsuitability of the real patient as regards the prefixed perceptions of the professional. The increase of the problem and its management seemed to be conditioned by a social medium which was uncontrolled, and due to increasing deficiencies in the collaboration between health care levels. Conclusions: Care of the patient with depression requires diagnostic and treatment approaches centred on the patient and shared by FD and PS(AU)

La red de investigación en actividades preventivas y promoción de la salud: un reto para la atención primaria / The network of research info preventive activities and health promotion: a challenge for primary care

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