Nonurgent Emergency-Department Care: Analysis of Parent and Primary Physician Perspectives
Nonurgent Emergency-Department Care: Analysis of Parent and Primary Physician Perspectives
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DOI：
10.1542/peds.2010-1723
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发表时间：
2011-02-01
期刊：
影响因子：
8
通讯作者：
Greer, Ann
中科院分区：
文献类型：
--
作者：
Brousseau, David C.;Nimmer, Mark R.;Greer, Ann
目的：为了更好地了解父母的决定，寻求照顾他们的孩子和医生的看法，父母的决定，寻求非紧急急诊科care.Patients和方法：在深度访谈的26名儿童的父母和20名初级保健医生的同一儿童提出非紧急护理在儿童医院急诊科完成。家长帐户的事件之前，紧急部门访问编码和定性分析的主题。通过与初级保健医生的访谈，他们也描述了自己的实践特点，确定了医生对事件和父母决定的评价。父母/医生分析允许的儿童的护理的各个方面的调查，并旨在揭示父母和医生之间的差异believs.RESULTS：父母认为，他们采取适当的行动，和医生批准的父母的决定。出现了四个主要主题：（1）立即保证他们的孩子不受伤害对父母的决定至关重要;（2）初级保健办公室缺乏父母和医生认为可能必要的具体测试和治疗，无论他们是否实际需要;（3）医生和父母对充分沟通和接触的看法存在差异;和（4）非紧急急诊室访问被认为是一个显着的足够的破坏护理的连续性由医生和家长值得任何关注。结论：在评估个别访谈时，无论是父母还是初级保健医生都没有将非紧急急诊科就诊视为一个足够重要的问题，以保证医生护理实践或父母寻求护理行为的任何改变。儿科2011;127：e375-e381
OBJECTIVE: To better understand parental decisions to seek care for their children and physician perceptions of parents' decisions to seek nonurgent emergency-department care.PATIENTS AND METHODS: In-depth interviews of 26 parents of children and 20 primary care physicians of the same children presenting for nonurgent care at a children's hospital emergency department were completed. Parent accounts of events that preceded the emergency-department visit were coded and qualitatively analyzed for themes. Physician evaluations of the accounts of events and parental decisions were ascertained through interviews with primary care physicians, who also described their practice characteristics. The parent/physician analyses allowed for an investigation of all aspects of the child's care and were designed to reveal differences between parent and physician beliefs.RESULTS: Parents believed that they acted appropriately, and physicians approved of parents' decisions. Four main themes emerged: (1) immediate reassurance that their children are safe from harm is critical to parents' decisions; (2) primary care offices lack specific tests and treatments that parents and physicians believe may be necessary, regardless of whether they are actually needed; (3) discrepancies exist between physician and parent perceptions of adequate communication and access; and (4) nonurgent emergency-department visits are not perceived as a significant enough breach in continuity of care by physicians and parents to warrant any concern.CONCLUSIONS: When individual interviews were evaluated, neither parents nor primary care physicians saw nonurgent emergency-department visits as a significant enough problem to warrant any change in physician care practices or parent care-seeking behavior. Pediatrics 2011;127:e375-e381