Depression and anxiety disorders are common in primary care. Comorbidities are frequent, and the diagnoses can be difficult. The Mini-International Neuropsychiatric Interview (MINI) can be a support in the clinical examination of patients with complex problems. However, for family practitioners (FPs), time and perceptions about structured interviews can be barriers to the MINI. An inter-professional teamwork process where FPs refer a patient to a therapist for a MINI assessment represents one way in which to address the problem. The results are fed back to the FPs for diagnosis and treatment decisions. The purposes of this study were to explore if the process was feasible for FPs, patients and therapists in Swedish primary care, and to identify factors influencing the process, using the COM-B model. FPs at two primary care centers (PHCC) in Stockholm were offered the opportunity to refer patients to in-house therapists. Semi-structured interviews or focus groups were conducted with 22 patients, 17 FPs and three therapists to capture their experiences and perceptions. Inductive content analysis for each group of participants was followed by triangulation across groups. Finally, the categories obtained were fitted to the components in the COM-B. Therapists at both PHCCs conducted the MINI. The intended process was adopted at one PHCC. At the second PHCC, the responsibilities for the diagnosis and treatment of patients referred were transferred to the therapist. The patients were satisfied, as they appreciated multi-professional examinations. The FPs’ competence in psychiatry, actual access to therapists, beliefs that the referrals saved the FPs time and effort, and established habits influenced whether patients were referred. Existing routines and professional expectations for work content influenced the degree of cooperation between the therapists and the FPs. An inter-professional diagnostic process where FPs refer patients to a therapist for assessment and the results are fed back to the FPs can be feasible. Feasibility depends on access to a therapist, the perceptions of roles and competences among FPs and therapists, and strategies for supporting teamwork.

中文翻译：

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转诊至治疗师以评估初级保健中的精神疾病的可行性–访谈研究

抑郁症和焦虑症在初级保健中很常见。合并症很常见，诊断可能很困难。迷你国际神经精神病学访谈（MINI）可以为患有复杂问题的患者进行临床检查提供支持。但是，对于家庭医生（FP），时间和对结构化访谈的看法可能会成为MINI的障碍。在跨行业的团队合作过程中，FP将患者转介给治疗师进行MINI评估是解决问题的一种方法。将结果反馈给FP，以进行诊断和治疗决策。这项研究的目的是探讨该过程对于瑞典初级保健中的FP，患者和治疗师是否可行，并使用COM-B模型确定影响该过程的因素。斯德哥尔摩两个初级保健中心（PHCC）的FP为他们提供了将患者转诊至内部治疗师的机会。对22位患者，17位FP和3位治疗师进行了半结构式访谈或焦点小组访谈，以了解他们的经验和看法。对每组参与者进行归纳式内容分析，然后进行跨组三角测量。最后，将获得的类别拟合到COM-B中的组件。两个初级保健中心的治疗师都进行了MINI治疗。一个PHCC通过了预期的过程。在第二届PHCC，将转诊患者的诊断和治疗职责移交给治疗师。患者很满意，因为他们赞赏多专业检查。FP在精神病学方面的能力，与治疗师的实际接触，相信转诊节省了FP的时间和精力，并且习惯养成习惯影响了是否转诊患者。现有的例行工作和对工作内容的专业期望影响了治疗师和FP之间的合作程度。在跨行业的诊断过程中，FP将患者转介给治疗师进行评估，然后将结果反馈给FP是可行的。可行性取决于与治疗师的接触，对FP和治疗师之间的角色和能力的了解以及支持团队合作的策略。在跨行业的诊断过程中，FP将患者转介给治疗师进行评估，然后将结果反馈给FP是可行的。可行性取决于与治疗师的接触，对FP和治疗师之间的角色和能力的了解以及支持团队合作的策略。在跨行业的诊断过程中，FP将患者转介给治疗师进行评估，然后将结果反馈给FP是可行的。可行性取决于与治疗师的接触，对FP和治疗师之间的角色和能力的了解以及支持团队合作的策略。