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Background
Triage involves matching resources to the patient - based on limited information - as quickly as possible. Principles from triage can be applied to the assessment and management of patients with psychological distress.
Objective
This article describes four steps in triage - once significant distress is identified: assessing the severity, looking for indicators that point to a diagnosis, formulating a working diagnosis, and treating the distress.
Discussion
When the presenting symptoms are nonspecific, or the nature of the distress remains unclear, an approach to gathering more information over three visits is described. After this further assessment is completed, options to tailor treatment to the patient are suggested.
Keywords
stress, psychological; triage; mental health; general practice
The concept of triage was developed to enable healthcare workers to do the most good for the most people with the resources available. It means more than identifying which patient the doctor will see next. It involves matching resources to the patient - based on limited information - as quickly as possible.1 This information includes the nature and severity of the patient's problem, knowledge of the available resources, self-knowledge of our own abilities and an assessment of the time available. The process recognises that other patients require attention also. These principles can be usefully applied in family medicine when helping adult patients suffering psychological distress. General practitioners frequently see patients suffering psychological distress.
General practitioners frequently see patients who exhibit distress, or whose suffering is magnified by psychological factors such as worry, grief, resentment, anger or sadness. Patients expect their physician to discuss the psychological and social aspects of their health if relevant to managing their problem.
This article describes a four-step approach to help triage the distressed patient in the general practice setting. Once psychological distress is recognised:
* assess the severity of the distress
* identify indicators suggestive of a diagnosis
* formulate a working diagnosis
* treat the distress by linking the right resources to the right patient.
When the presenting symptoms are nonspecific, or the nature of the distress remains unclear, follow up to gather more information can be arranged.
First, recognise the distress
To effectively treat the distressed patient, the GP must be alert to, and recognise the possibility of, emotional and psychological...