What happens when doctors are patients? Qualitative study of GPs
What happens when doctors are patients? Qualitative study of GPs
复制标题
DOI：
10.3399/bjgp09x472872
复制
发表时间：
2009-11-01
影响因子：
5.9
通讯作者：
Scott, Jenny
中科院分区：
文献类型：
--
作者：
Fox, Fiona;Harris, Michael;Scott, Jenny
背景：目前关于医生不适经历的证据仅限于质量较差的数据。目的调查全科医生的重大疾病经历，以及这如何影响他们自己随后的实践。研究设计采用解释性现象学分析进行定性研究，对经历过重大疾病的全科医生进行半结构化访谈。在英格兰西部设立两个初级保健信托机构。方法共招募17名全科医生进行半结构化访谈，采用解释现象学分析方法进行分析。“谁在乎医生生病了？”体现了人们对医学作为一种“关怀职业”和一种“系统”的看法之间的紧张关系。“作为一名医患”涵盖了经历重大疾病的医生所经历的角色模糊。“治疗医患”这一类别揭示了协商共享医疗服务的脆弱性。“对实践的影响”强调了个人疾病可以告知全科医生作为病人的理解和他们自己的咨询风格的方式。结论挑战全科医生的疾病免疫文化可能需要个人和组织层面的干预。医生的培训和发展应包括考虑个人健康问题的机会，以及如何在作为病人和治疗医患时处理角色模糊。需要制定关于作为医生和治疗病人的指导方针，全科医生需要方便地获得职业卫生服务。
BackgroundCurrent evidence about the experiences of doctors who are unwell is limited to poor quality data.AimTo investigate GPs' experiences of significant illness, and how this affects their own subsequent practice.Design of studyQualitative study using interpretative phenomenological analysis to conduct and analyse semi-structured interviews with GPs who have experienced significant illness.SettingTwo primary care trusts in the West of England.MethodA total of 17 GPs were recruited to take part in semi-structured interviews which were conducted and analysed using interpretative phenomenological analysisResultsFour main categories emerged from the data. The category, 'Who cares when doctors are ill?' embodies the tension between perceptions of medicine as a 'caring profession' and as a 'system'. 'Being a doctor-patient' covers the role ambiguity experienced by doctors who experience significant illness. The category 'Treating doctor-patients' reveals the fragility of negotiating shared medical care. 'Impact on practice' highlights ways in which personal illness can inform GPs' understanding of being a patient and their own consultation style.ConclusionChallenging the culture of immunity to illness among GPs may require interventions at both individual and organisational levels. Training and development of doctors should include opportunities to consider personal health issues as well as how to cope with role ambiguity when being a patient and when treating doctor-patients. Guidelines about being and treating doctor-patients need to be developed, and GPs need easy access to an occupational health service.