How do General Practitioners experience providing care for their psychotic patients?
BACKGROUND
In primary care, GPs usually provide care for patients with chronic diseases according to professional guidelines. However, such guidelines are not available in the Netherlands for patients with recurring psychoses. It seems that the specific difficulties that GPs experience in providing care for these patients hinder the development and implementation of such guidelines. This study aims to explore the chances and problems GPs meet when providing care for patients susceptible for recurring psychoses, including schizophrenia and related disorders, bipolar disorder, and psychotic depression.


METHODS
A qualitative study of focus group discussions with practising GPs in both town and rural areas. Transcripts from three focus groups with 19 GPs were analysed with the computer program 'Kwalitan'. Theoretical saturation was achieved after these three groups.


RESULTS
Analysis showed that eight categories of factors influenced the GPs' care for psychotic patients: patient presentation (acute vs. chronic phase), emotional impact, expertise, professional attitude, patient related factors, patient's family, practice organization, and collaboration with psychiatric specialists.


CONCLUSIONS
Current primary care for psychotic patients depends very much on personal characteristics of the GP and the quality of local collaboration with the Mental Health Service. A quantitative study among GPs using a questionnaire based on the eight categories mentioned above would determine the extent of the problems and limitations experienced with this type of care. From the results of this quantitative study, new realistic guidelines could be developed to improve the quality of care for psychotic patients.
Oud
Marian J T
MJ
Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands. m.j.t.oud@knmg.nl
Schuling
Jan
J
Slooff
Cees J
CJ
Meyboom-de Jong
Betty
B
D000208:Acute Disease; D000328:Adult; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D002983:Clinical Competence; D005194:Family Practice / Q000379:methods / Q000592:standards*; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008605:Mental Health Services / Q000592:standards* / Q000600:supply & distribution; D008875:Middle Aged; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D011618:Psychotic Disorders / Q000628:therapy*; D012017:Referral and Consultation