Study To The Status Quo And Countermeasures Of Psychosomatic Disease Service Skills Of A General Medical Team In A District Of Shanghai

Objective:The purpose of this project is to study the current situation of cognition and coping ability of community general medical team on psychosomatic diseases,analyze the influencing factors,and combine with the evaluation of relevant training effect,so as to provide empirical basis for the construction of psychosomatic disease cognition and coping ability of community general medical team,and put forward reasonable development strategies and suggestions.Method:Based on literature review,questionnaire survey and expert consultation,this study investigated 375 untrained and 71 trained general practitioners in a district of Shanghai in 2018 through a self-designed questionnaire on cognition and coping ability of psychosomatic diseases.The survey includes five parts: general information,basic concepts,clinical cognition,clinical coping,and training framework.The main research content is the investigation on the current situation of untrained subjects.Combined with the training effect evaluation of the trained objects,the multiple linear regression model is used to analyze the influencing factors.Comparing 375 untrained subjects with 71 post-training subjects,the total score of post-training subjects> untrained subjects;the clinical cognition scores and clinical response scores of post-training subjects were higher than those of untrained.Results:This study included 375 untrained members of community general medical team,and the total scoresaccording to the scope of practice were mental health physicians > public health physicians > general practitioners of western medicine > general practitioners of traditional Chinese medicine > nurses(P<0.01).The standardized scores of the four modules of the questionnaire were analyzed and compared,the basic concepts > clinical response > clinical cognition > training framework(P<0.01);the score comparison between team subjects(general practitioners,public health physicians,nurses),there were statistically significant differences in total score,basic concept,clinical cognition and clinical response,all of them were ranked according to their scores and all were public health physicians > general practitioners > nurses(P<0.05).The comparison of traditional Chinese medicine and western medicine of general practitioners,the total score and clinical cognition of western medicine general practitioners > traditional Chinese medicine general practitioners(P<0.05).From the comparison of the pass rates of general practitioners in various modules,the basic concept > clinical cognition > clinical response > training framework(P<0.05).Comparing 375 untrained subjects with 71 post-training subjects,the total score of post-training subjects> untrained subjects;the clinical cognition scores(P<0.05);and clinical response scores of post-training subjects were higher than those of untrained(P<0.05).The single factor regression analysis of all objects suggested that the scope of practice and training were the factors affecting the total score,and the multivariate regression analysis indicated that only the scope of practice was the influencing factor of the total score.The single factor regression analysis of general practitioners suggested that working years,scope of practice and training framework were the factors that influenced the total score,and multivariate regression analysis suggested that the scope of practice and training framework were the factors that affected the total score.Conclusions:"General Practitioners",the main body in the community general medical team have lower cognition and coping ability on psychosomatic diseases than "mental health physicians" and "public health physicians",and clinical cognition and coping ability is the main part of the deficiency,which indicates the key point of continuing education and training in the future.The overall level of general practitioners of Western medicine is higher than that of general practitioners of Traditional Chinese medicine,suggesting that Traditional Chinese medicine lacks knowledge of modern psychosomatic medicine,and the training can be integrated and improved in the knowledge of Traditional Chinese and Western medicine.The main influencing factors are the scope of practice and training,it is suggested that the focus should be different for the training objects in different scopes of practice,and the knowledge should be refined.Training is an effective means to improve the psychosomatic disease cognition and coping ability of community general medical teams.It is suggested to improve the psychosomatic disease diagnosis and treatment level of general practitioners through strengthening training,combining Chinese and Western medicine,broadening horizons and policy guidance.The innovation of this study is to integrate general practice and psychosomatic medicine,and focus on both general practitioners of Western medicine and general practitioners of Traditional Chinese medicine..