Psychiatric outpatient consultation for seniors. Perspectives of family physicians, consultants, and patients/family: a descriptive study.

https://arctichealth.org/en/permalink/ahliterature175180
Source
BMC Fam Pract. 2005 Apr 19;6(1):15
Publication Type
Article
Date
Apr-19-2005
Author
Mark J Yaffe
Francois Primeau
Jane McCusker
Martin G Cole
Eric Belzile
Nandini Dendukuri
Michel Elie
Johanne Laplante
Author Affiliation
Department of Family Medicine, McGill University and St. Mary's Hospital Centre, 3830 Lacombe Avenue, Montreal, Qc, H3T 1M5, Canada. mark.yaffe@mcgill.ca
Source
BMC Fam Pract. 2005 Apr 19;6(1):15
Date
Apr-19-2005
Language
English
Publication Type
Article
Keywords
Aged
Attitude of Health Personnel
Geriatric Psychiatry - organization & administration - standards
Hospitals, Community - organization & administration
Humans
Interprofessional Relations
Mentally Ill Persons - psychology
Outpatient Clinics, Hospital - organization & administration - standards
Patient Satisfaction - statistics & numerical data
Physician-Patient Relations
Physicians, Family - psychology
Process Assessment (Health Care)
Quebec
Questionnaires
Referral and Consultation
Abstract
Family practitioners take care of large numbers of seniors with increasingly complex mental health problems. Varying levels of input may be necessary from psychiatric consultants. This study examines patients'/family, family practitioners', and psychiatrists' perceptions of the bi-directional pathway between such primary care doctors and consultants.
An 18 month survey was conducted in an out-patient psychogeriatric clinic of a Montreal university-affiliated community hospital. Cognitively intact seniors referred by family practitioners for assessment completed a satisfaction and expectation survey following their visits with the psychiatric consultants. The latter completed a self-administered process of care questionnaire at the end of the visit, while family doctors responded to a similar survey by telephone after the consultants' reports had been received. Responses of the 3 groups were compared.
101 seniors, referred from 63 family practitioners, met the study entry criteria for assessment by 1 of 3 psychogeriatricians. Both psychiatrists and family doctors agreed that help with management was the most common reason for referral. Family physicians were accepting of care of elderly with mental health problems, but preferred that the psychiatrists assume the initial treatment; the consultants preferred direct return of the patient; and almost 1/2 of patients did not know what to expect from the consultation visit. The rates of discordance in expectations were high when each unique patient-family doctor-psychiatrist triad was examined.
Gaps in expectations exist amongst family doctors, psychiatrists, and patients/family in the shared mental health care of seniors. Goals and anticipated outcomes of psychogeriatric consultation require better definition.
Notes
Cites: J Fam Pract. 1992 Jul;35(1):21-31613471
Cites: Med J Aust. 1992 Jan 20;156(2):108-101736049
Cites: Can J Psychiatry. 1997 Oct;42(8):suppl 12 pp9417365
Cites: J Am Geriatr Soc. 1999 Mar;47(3):269-7610078887
Cites: J Gen Intern Med. 1999 May;14(5):281-610337037
Cites: Int J Geriatr Psychiatry. 1999 Jun;14(6):440-510398353
Cites: Psychiatr Serv. 1999 Sep;50(9):1198-20410478907
Cites: J Clin Psychiatry. 1999;60 Suppl 20:45-5110513859
Cites: Int J Geriatr Psychiatry. 2001 Jun;16(6):553-911424163
Cites: Can J Psychiatry. 2002 Apr;47(2 Suppl 1):iS-viiiS, 1S-103S11989111
Cites: JAMA. 2002 Dec 11;288(22):2836-4512472325
Cites: Can J Psychiatry. 2003 Apr;48(3):145-5312728738
Cites: Gen Hosp Psychiatry. 2003 Jul-Aug;25(4):238-4512850655
Cites: JAMA. 2004 Mar 3;291(9):1081-9114996777
Cites: J Am Geriatr Soc. 1975 Oct;23(10):433-411159263
Cites: N Engl J Med. 1987 Dec 31;317(27):1731-43320750
Cites: J R Coll Gen Pract. 1988 Nov;38(316):487-903256680
Cites: BMJ. 1991 May 18;302(6786):1186-82043816
Cites: Fam Pract. 1996 Feb;13(1):41-518671103
PubMed ID
15840163 View in PubMed
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