OBJECTIVE:To identify reasons why rural general practitioners (GPs) treat a large proportion of patients with a primary psychiatric diagnosis in general beds of their local hospitals, and the barriers encountered when providing this treatment. DESIGN:A postal questionnaire was developed and distributed to a sample of rural GPs, asking about the treatment of patients with an acute mental illness in their local hospital. RESULTS:The majority of GPs agreed that they treat the acutely mentally ill in general beds of their local hospital due to lack of availability of, and inability to gain access to, mental health beds in the larger centres; and also to enable ongoing family involvement and continuity of care. Distance factors were identified as least significant. Barriers to providing care to this group of patients included a perceived lack of support by consultant psychiatrists, confidentiality issues, lack of community mental health workers to provide assistance, aggression levels of patients, inappropriate local hospital setting, and lack of confidence of GPs and general hospital nursing staff. CONCLUSION:Addressing these barriers is necessary if rural Australians are to receive a quality of care that is equal to that received by those located in metropolitan Australia. Continuing research in this area is crucial.

译文

目的:查明农村全科医生(GPs)在其当地医院的普通病床中治疗大部分患有原发性精神病诊断的患者的原因,以及提供这种治疗时遇到的障碍。
设计:开发了一份邮政调查表,并将其分发给农村全科医生的样本,询问在当地医院治疗患有急性精神疾病的患者的情况。
结果:大多数全科医生都同意,由于在较大的中心缺乏精神病床,并且无法获得精神病床,他们在当地医院的普通病床中治疗严重的精神疾病;并使家庭不断参与并获得连续护理。距离因素被确定为最不重要的。向此类患者提供护理的障碍包括:咨询精神病医生缺乏支持,机密性问题,缺乏社区精神卫生工作者提供援助,患者的攻击性,当地医院的环境不适当以及全科医生和普通医生的信心不足医院护理人员。
结论:如果要使澳大利亚农村人口获得与澳大利亚大都市居民相同的医疗质量,则必须解决这些障碍。在这一领域的持续研究至关重要。

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