Quality in general practice consultations; a qualitative study of the views of patients living in an area of high socio-economic deprivation in Scotland.
Quality in general practice consultations; a qualitative study of the views of patients living in an area of high socio-economic deprivation in Scotland.
复制标题
一般实践咨询中的质量；对生活在苏格兰高度社会经济贫困地区的患者观点的定性研究。
DOI：
10.1186/1471-2296-8-22
复制
发表时间：
2007-04-19
影响因子：
2.9
通讯作者：
Bikker AP
中科院分区：
文献类型：
--
作者：
Mercer SW;Cawston PG;Bikker AP
健康和医疗保健服务的不平等是国际上和英国的一个重要政策问题，与社会经济贫困密切相关，而在苏格兰，这种贫困主要集中在格拉斯哥及其周边地区。患者对贫困地区初级保健的看法没有详细记录。在本研究中，我们探讨了生活在高度贫困地区的患者对全科医疗咨询质量的看法。定性焦点小组研究以苏格兰格拉斯哥一个大型外围住宅区的社会经济高度贫困地区为背景。进行了 11 个焦点小组； 8 个与当地社区团体合作，3 个与其他当地居民合作。共有 72 名患者参加。使用扎根理论来分析数据。患者对全科医生咨询质量的看法包括两个广泛且相互关联的主题： (1) 全科医生的能力，以及 (2) 全科医生的同理心或“关怀”。通常会假设患者有能力，但这一假设受到许多因素的影响，特别是患者之前是否（直接或间接与亲密的家庭成员）在该医生那里经历过“成功”的结果。 “关怀”与患者感觉 (a) 被医生倾听并能够交谈有关； (b) 作为个人受到医生的重视 (c) 医生了解“大局”，以及 (d) 医生的解释清晰易懂。护理的关系连续性（能够看同一位全科医生并拥有良好的关系）以及有足够的咨询时间与咨询质量的看法密切相关。来自贫困地区的患者需要全面的全科医生，他们了解这些地区的生活现实，并且值得他们信任，认为他们既能干又真正有爱心。如果没有这一点，他们可能会认为医生在社交上疏远且情感上冷漠。关系的连续性、同理心和充足的协商时间是实现这一目标的关键因素。
Inequality in health and health care services is an important policy issue internationally as well as in the UK, and is closely linked to socio-economic deprivation, which in Scotland is concentrated in and around Glasgow. Patients views on primary care in deprived areas are not well documented. In the present study we explore the views of patients living in a high deprivation area on the quality of consultations in general practice. Qualitative focus group study set in an area of high socio-economic deprivation in a large peripheral housing estate in Glasgow, Scotland. 11 focus groups were conducted; 8 with local community groups and 3 with other local residents. In total 72 patients took part. Grounded theory was used to analyse the data. Patients' perceptions of the quality of the consultation with GPs consisted of two broad, inter-relating themes; (1) the GPs' competence, and (2) the GPs empathy or ' caring'. Competence was often assumed but many factors coloured this assumption, in particular whether patients had experienced (directly or indirectly with a close family member) 'successful' outcomes with that doctor previously or not. 'Caring' related to patients feeling (a) listened to by the doctor and being able to talk; (b) valued as an individual by the doctor (c) that the doctor understood 'the bigger picture', and (d) the doctors' explanations were clear and understandable. Relational continuity of care (being able to see the same GP and having a good relationship), and having sufficient time in the consultation were closely linked with perceptions of consultation quality. Patients from deprived areas want holistic GPs who understand the realities of life in such areas and whom they can trust as both competent and genuinely caring. Without this, they may judge doctors as socially distant and emotionally detached. Relational continuity, empathy and sufficient time in consultations are key factors in achieving this.
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影响因子：
2.2
作者：
Mercer, SW;McConnachie, A;Watt, GCM
通讯作者：
Watt, GCM
影响因子：
105.7
作者：
Mackay, D;Sutton, M;Watt, G
通讯作者：
Watt, G
影响因子：
2.1
作者：
ARBORELIUS E;BREMBERG S
通讯作者：
BREMBERG S
影响因子：
168.9
作者：
HART, JT
通讯作者：
HART, JT
影响因子：
5.4
作者：
Barry, CA;Stevenson, FA;Bradley, CP
通讯作者：
Bradley, CP