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. 2005 Mar 2;123(2):72-6.
doi: 10.1590/s1516-31802005000200008. Epub 2005 Jun 8.

The general practitioner and mental health problems: challenges and strategies for medical education

Dinarte Alexandre Ballester  1 , Ana Paula Filippon, Carla Braga, Sérgio Baxter Andreoli
Affiliations

The general practitioner and mental health problems: challenges and strategies for medical education

Dinarte Alexandre Ballester et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context and objective: Within the context of primary health care and mental disorders, our aim was to study the opinions of general practitioners regarding attendance of people with mental health problems.

Design and setting: Qualitative focal group study among primary care services in the cities of Porto Alegre and Parobé, State of Rio Grande do Sul.

Methods: A deliberately selected sample of 41 general practitioners who were working in basic health services met in focal groups. Two videos were presented, which simulated consultations for patients with depression and psychoses. The discussions about the identification and handling of mental health problems were recorded and assessed via content analysis.

Results: The opinions related to the difficulties of diagnosing and treating mental problems, the involvement of relatives in caring for patients, the difficulty of compliance with the treatment, the uncertainty experienced by physicians and the difficulty of referring patients to specialized services.

Conclusions: The general practitioners indicated that they perceived the mental health problems among their clientele, but the diagnosis and treatment of these problems are still seen as a task for specialists. The challenge of continuing education on mental health requires methods of interactive and critical teaching, such as the problem-based approach.

CONTEXTO E OBJETIVO:: No contexto de cuidados primários de saúde e transtornos mentais, o objetivo foi conhecer as opiniões de médicos generalistas sobre o atendimento de pessoas com problemas mentais.

TIPO DE ESTUDO E LOCAL:: Estudo qualitativo, por grupos focais, nos Serviços Básicos de Saúde em Porto Alegre e Parobé, Rio Grande do Sul.

MÉTODOS:: Um grupo de 41 médicos que trabalham em cuidados primários de saúde foi escolhido de modo intencional e reunido em grupos focais. Foram apresentados a eles dois vídeos, que simulavam o atendimento de pacientes com depressão e psicose. Discussões sobre a identificação e o manejo dos problemas mentais foram gravadas e descritas pelo método de análise de conteúdo.

RESULTADOS:: As principais opiniões dos médicos referiram-se às dificuldades para diagnosticar e tratar os problemas mentais, o envolvimento dos familiares no cuidado dos pacientes, a dificuldade de adesão ao tratamento, as incertezas experimentadas pelos médicos e as dificuldades para referenciar os pacientes aos serviços especializados.

CONCLUSÕES:: Os médicos generalistas percebem os problemas mentais na sua clientela, mas consideram que o diagnóstico e tratamento destes problemas é tarefa do especialista. O desafio da educação continuada em saúde mental requer métodos de ensino interativos e críticos, como a abordagem de solução de problemas.

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Conflict of interest statement

Conflict of interest: There is no conflict of interest to be presented by the authors.

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