| Objectives To understand the current situation of spiritual and psychological services provided by family doctors in Shanghai community,and to design special training programs for improving their mental and psychological abilities according to the needs.To explore the macro framework of improving service skills with systematic and holistic thinking,and to build a community mental and psychological service model with the focus on doctors,family doctors and the participation of the whole society.It also provides some Suggestions for exploring the training of public health personnel,the construction of social psychological service system,and the construction of psychiatric medical association.Methods The methods of questionnaire survey,semi-structured interview,mathematical statistics and expert consultation were applied.With 205 family doctors from 6 districts and counties included in the mental and psychological skills training program of the fourth round of public health three-year action plan of Shanghai as the research objects,descriptive analysis and chi-square test were used to analyze the specific training stage data.The design concept of the training is to inspire the students to understand and deal with the community mental health problems with a systematic view,to train the family doctor team to work with individuals,families,medical institutions,schools,social and cultural environment and the whole system,so as to promote the integration and collaboration of different institutions and departments.In addition,Suggestions and strategies for improving community mental and psychological service capacity are explored to provide reference materials for the construction of social psychological service system,the association of specialized mental and psychological doctors,and the cultivation of public health talents in general health.Results 1.Basic information of trainees:The students are mainly young and middle-aged,accounting for 73.2% with people aged 40 and under;Higher educational level,bachelor degree or above accounting for 84.4%;48.8% of the public health staff have non-public health professional background.2.Special training of mental psychology:There were statistically significant differences in training approaches among staff of different positions(P < 0.05),and family doctors were more inclined to continue their studies in specialized hospitals.98.05% said they were very willing to put the training content into practice.90.73% of the students scored more than 80 points in the exam,and the training achieved good results.3.Current Situation of mental and psychological training:48.78% of students reported insufficient policy protection;81.46% believe that the gold content of certificates should be increased;76.59% reported more conflicts between training and work.The training willingness of family doctors and public health doctors is relatively high,among which the family doctor team has a high demand for the diagnosis and treatment of psychosomatic diseases,doctor-patient communication and stress management.4.Mental and psychological service Model and system:The family doctor team reported that the most prominent problems in mental and psychological services were lack of professionals(75.61%),lack of knowledge and technology(65.37%),and need to improve residents’ knowledge(65.85%).90.73% believed that they should be paid for their community mental services,but only 17.56% actually got paid.The most effective measures to improve the motivation of mental and psychological service personnel are to establish reasonable remuneration(93.66%),improve the working environment(74.15%)and provide training opportunities(68.29%).5.Long-term effects of capacity improvement:More family doctors applied their mental and psychological knowledge to interpersonal relationship problems(57.46%)and work problems(58.21%).The improvement of professional competence will,to a certain extent,promote the investment of funds,improve the hardware,software and manpower allocation of community mental health services,and significantly promote the improvement of residents’ mental and psychological knowledge.Conclusions 1.The structure of the family doctor team is relatively reasonable,and the age and educational background constitute a solid foundation for the improvement of service ability;Training should be carried out in combination with the professional background and job requirements of the team design scheme.The family doctor team has a high demand for mental and psychological skills training.Systematic and standardized special training of mental psychology is more popular.2.Capacity improvement should be carried out in combination with the promotion stage of signing up family doctors for mental health services,and strive for active cooperation and support from multiple departments to ensure the comfortable participation of medical staff;The establishment of an appropriate performance evaluation mechanism for community mental and psychological services is conducive to stimulating the enthusiasm of the family doctor team and playing a good role in promoting the construction of the community-level mental health service system.3.Public health personnel and the family doctor is the main force of community spirit psychological service,Shanghai tertiary prevention management mode can be signed with the family doctor service,build fine lines of public health prevention as the article,assist other personnel managing family doctors with mental disorders and community mental health services for the block,how to,the whole society to participate in the community spirit of psychological service mode.The construction of the social psychological service system is not only the treatment of mental and psychological diseases in the health department,but also more general psychological intervention and health promotion,which requires the active cooperation of multiple departments,and more importantly,the complete basic psychological service network and the human resources foundation.4.Public health personnel with non-public health professional background restrict the benign development of community block combination,and it is urgent to cultivate public health personnel.We should build a comprehensive and systematic training system for public health personnel,and give overall consideration to the three stages of public health personnel training,so as to make the linkage between college education,post-graduation education and continuing education smooth,and the trained personnel can quickly adapt to the needs of the society.5.The lack and uneven distribution of mental and psychological human resources are difficult to solve in a short term.Active exploration of the municipal specialized medical association,specialized hospital-community hospital Medical Association,general hospital-specialized hospital medical Association,and "Internet +" cross-regional medical association is an effective way to quickly solve the lack of existing service resources. |
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