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| Title: | 基層醫師對自殺防治的經驗、知識、信心與態度
The Experiences, Knowledge, Confidence, and Attitudes of Suicide Prevention among General Practitioners |
| Authors: | 張家銘
Chia-Ming, Chang |
| Contributors: | 中山醫學大學：醫學研究所;周明智 |
| Keywords: | 基層醫師;自殺防治;憂鬱症;經驗;知識;信心;態度
general practitioner;suicide prevention;depression;experience;knowledge;confidence;attitude |
| Date: | 2003 |
| Issue Date: | 2010-06-07T01:37:15Z (UTC)
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| Abstract: | 自殺防治是世界各國都重視的工作。文獻發現，自殺個案生前多曾求助醫療，且求助基層醫師多於精神科醫師。然而許多研究也發現，基層醫師在自殺防治的經驗與知識、信心上有所不足，也常有許多負面的態度。
本研究的目的，在了解基層醫師對自殺防治的經驗、知識、信心與態度。研究方法為橫斷面之調查，樣本選取採取立意取樣，選取台中縣、市的基層醫師為樣本。利用「基層醫師對自殺防治之經驗、知識、信心與態度問卷」，建立問卷的信效度後，郵寄給台中縣市所有開業的基層醫師(內科、小兒科、一般科與家醫科)(N=819)。
總回收率達34%。結果發現83%的基層醫師，曾經詢問憂鬱相關症狀的問題，但只有50%有討論過關於自殺的議題，69%的基層醫師曾使用過抗憂鬱劑，但只有61%的診所中有進抗憂鬱劑。家庭醫科醫師較非家庭醫學科的醫師，在討論自殺(61% vs 44%)、開立(76% vs 65%)及進用(68% vs 56%) 抗憂鬱劑上皆較有經驗，可是反而較少轉介自殺傾向患者看精神科(56% vs 72%)。家庭醫學科醫師與非家庭醫學科的醫師，皆容易低估憂鬱症在基層照護的盛行率，同樣存有許多錯誤的知識，在信心、態度與參與自殺防治網絡的意願，兩者未達顯著差異。
本研究的結論是基層醫師中，家庭醫學科醫師相較於非家庭醫學科醫師，顯著較有經驗在詢問自殺議題、進用與開立抗憂鬱劑，但較少轉介給精神科醫師。家醫科醫師與非家醫科醫師在自殺防治的相關知識仍顯不足，而其信心、態度與參與自殺防治網絡的意願皆未達顯著差異。本結論建議所有的基層醫師，皆同樣需要接受憂鬱症及抗憂鬱劑的認識、自殺防治的處理等相關課程，以強化處理能力，建構自殺防治網絡。
Suicide prevention is a major task for government around the world. Most of the suicidal subjects had consulted medical professionals before their suicides but most of the physicians were general practitioners (GPs). However, some studies found GPs had insufficient experiences, knowledge, confidences, and negative attitudes of suicide prevention.
This study aimed at assessing the GPs about their experiences, knowledge, confidence, and attitudes to suicide prevention. This is a cross-sectional survey. After establishing its validity and reliability, Suicide Prevention Experiences, Knowledge, Confidence, and Attitude Questionnaires were sent to all the GPs (internal medicine, pediatrics, general medicine, and family medicine) in Taichung city and Taichung county (N=819).
The response rate was 34%. Our results found 83% of GPs had experience in asking depression-related questions with their patients. However, only 51% of GPs had experiences in discussing suicide-related issues. About 79% of GPs had the experience of prescribing antidepressants, but only 61% of GPs had installed antidepressants in their clinics. Family physicians had more experience in discussing suicide (61% vs 44%), prescribing (76% vs 65%) and installing (68% vs 56%) antidepressants than non-family physicians, but few referred suicide risk patients to psychiatrists (56% vs 72%). Both of them had some incorrect knowledge concerning suicide prevention. Their confidence, attitude, and willingness to participate in the suicide prevention network also showed no statistical difference.
Our conclusions are that family physicians significantly had more experience in asking about suicide, prescribing antidepressants but few referred patients to psychiatrists. Family physicians and non-family physicians had similar incorrect knowledge. Their confidence, attitudes, and willingness to participate in the suicide prevention network also showed no difference. We suggested that all the GPs should receive a training program about depression, antidepressants, and suicide prevention to improve their knowledge and capability in the management of depression and suicide. |
| URI: | http://140.128.138.153:8080/handle/310902500/1632 |
| Appears in Collections: | [醫學研究所] 博碩士論文
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