Simply no time? Barriers to GPs' participation in primary health care research
Simply no time? Barriers to GPs' participation in primary health care research
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DOI：
10.1093/fampra/cmn015
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发表时间：
2008-04-01
期刊：
影响因子：
2.2
通讯作者：
Himmel, Wolfgang
中科院分区：
文献类型：
--
作者：
Hummers-Pradier, Eva;Scheidt-Nave, Christa;Himmel, Wolfgang
背景资料。全科医生的不参与是以实践为基础的研究的一个严重的偏差来源。目的：阐明医生不参与全科医学研究的动机和主观障碍。选择退出涉及电子病历(EPR)的质量评估项目的德国全科医生收到了一份问卷，内容是他们对全科医学研究的态度以及他们对当前项目的具体反对意见。对部分医生进行了访谈。根据不参与的原因和可能的激励因素，对他们的陈述进行了编码和分类。调查回应率为37%(96/263)；21名全科医生完成了额外的定性访谈。几乎所有受访者(88/96)都认为全科研究很重要，但58%的人以前没有参加过研究项目，56%的人将来不会参加。近一半(47/96)的人反对从他们的环境政策报告中提取数据。定性分析揭示了与环境影响报告书收集有关的深层次关切(例如，数据可能被滥用、受到控制或由此导致的计算机问题)。一些全科医生对招募自己的患者参加这项研究表示担忧。一些医生抱怨在研究过程中没有被充分认可为合作伙伴或没有发言权。医生的消极态度、担忧和矛盾情绪应该在招聘战略中得到解决，特别是当需要对EPR进行分析或直接与患者接触时。一些医生出于原则不参与研究，很难说服他们。
Background. Non-participation of general practitioners (GPs) is a serious source of bias for practice-based studies.Objective. To elucidate doctors' motives for non-participation in, and subjective barriers to, general practice research.Methods. German GPs that had opted out of a quality assessment project involving electronic patient records (EPRs) were mailed a questionnaire regarding their attitudes towards general practice research and their specific objections to the current project. A sub-sample of doctors was interviewed. Their statements were coded and classified with regard to the reasons given for non-participation and possible motivating factors.Results. The survey response rate was 37% (96/263); 21 GPs completed an additional qualitative interview. Nearly all respondents (88/96) considered general practice research to be important, but 58% had not previously participated in research projects and 56% would not do so in the future. Nearly half (47/96) were opposed to having data extracted from their EPRs. The qualitative analysis revealed deep concerns related to the collection of EPRs (e.g. potential misuse of data, being subject to control or resulting computer problems). Some GPs expressed concerns about recruiting their own patients for the study. Some doctors complained of not being sufficiently recognized as a partner or not having a voice in the research process.Conclusion. Doctors' negative attitudes, concerns and ambivalent feelings should be addressed in recruitment strategies, especially when the analysis of EPRs or direct patient contact is required. Some doctors do not participate in research out of principle and will be very difficult to convince.