Background Referral of patients from tertiary specialist psychiatric hospitals to primary healthcare settings is a worldwide goal. This is of particular importance in South Africa with its considerable burden of mental disorders and limited resources. However, patients are often reluctant to be referred and studies have shown that patients may prefer a dedicated psychiatric service over an integrated primary healthcare service. Aim This study explored the opinions of patients receiving care at a tertiary psychiatric hospital’s outpatient department (OPD) about referral to a primary healthcare clinic (PHCC). Setting The study was conducted at Weskoppies Psychiatric Hospital OPD. Methods This was a qualitative study based on grounded theory. Participants were recruited through purposive-theoretical sampling. Data were collected by means of individual interviews and mini-essays. Results From the 80 participants, 18 had individual interviews and 62 wrote mini-essays. Thirty-nine participants had previously attended a PHCC, while 41 had not. Perceived advantages of referral to PHCCs included: close proximity to participants’ homes, resulting in saving on travelling time and transport costs, as well as the convenience of receiving psychiatric and other medical treatment at the same healthcare facility. Perceived disadvantages of PHCCs included: unavailability of treatment; lack of doctor-based care; lack of specialised care; loss of established relationships with hospital healthcare workers; mistreatment by PHCC nursing staff; longer waiting times; more stigmatisation. Conclusion The perceived disadvantages of referral from a tertiary psychiatric hospital to a PHCC outweighed the perceived advantages. Nonetheless, participants expressed willingness for such a referral if their concerns were addressed.

中文翻译：

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患者对从三级专科精神病医院转诊到基层医疗机构的意见。

背景 将患者从三级专科精神病医院转诊到初级保健机构是一个全球目标。这在精神障碍和资源有限的南非尤为重要。然而，患者通常不愿被转诊，研究表明，患者可能更喜欢专门的精神科服务，而不是综合的初级保健服务。目的 本研究探讨了在三级精神病医院门诊部 (OPD) 接受护理的患者关于转诊到初级保健诊所 (PHCC) 的意见。设置 该研究在 Weskoppies 精神病医院 OPD 进行。方法 这是一项基于扎根理论的定性研究。参与者是通过有目的的理论抽样招募的。通过个人访谈和小论文收集数据。结果 80 名参与者中，18 人进行了个人访谈，62 人撰写了小论文。39 名参与者之前参加过 PHCC，而 41 名没有参加过。转诊到 PHCC 的感知优势包括：靠近参与者的家，从而节省了旅行时间和交通成本，以及在同一医疗机构接受精神科和其他医疗的便利。PHCC 的公认缺点包括：无法治疗；缺乏以医生为基础的护理；缺乏专业护理；失去与医院医护人员的既定关系；PHCC护理人员的虐待；更长的等待时间；更多的污名化。结论 从三级精神病院转诊到 PHCC 的感知劣势超过了感知优势。尽管如此，如果他们的担忧得到解决，参与者表示愿意进行此类转介。