A model to explain visits to the doctor: with specific reference to the case of Israel.
A model to explain visits to the doctor: with specific reference to the case of Israel.
复制标题
解释看医生的模型：具体参考以色列的案例。
DOI：
10.2307/2136838
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发表时间：
1972
影响因子：
5
通讯作者：
A. Antonovsky
中科院分区：
文献类型：
--
作者：
A. Antonovsky
人们什么时候看医生？在一个极端的情况下，在那些有医生的社会里，明显的病理和极度的痛苦会把一个人带到医生那里，只有少数例外（可能精神疾病除外）。在另一个极端，有一小部分就诊是为了预防保健，没有发现任何症状。但是，正如左拉所指出的（1966,1968），“我们发现（医生的工作量）很大一部分与相当小的疾病有关。”另一方面，他指出，有大量的数据表明，有很多疾病，无论是临床还是主观定义，都没有引起医生的注意。左拉的意思是，进入病人状态的可能性是非常广泛和持续的。从临床上讲，一个人可能生病了，却不去看医生；或者一个人可以去看医生，要么没有任何临床状况的特别改变，要么甚至没有医生的任何特别理由。如果个体、社会亚群体或社会之间的访视率差异不能在一定范围内用临床可确定的发病率差异来解释，那么哪些因素可以预测这种差异？本文的目的是提出一个模型。虽然源自以色列的情况，但也应适用于其他社会。
W HEN do people see a doctor? At one extreme, blatant pathology and extreme pain will, with few exceptions, bring one to a doctor in those societies where doctors are available (with the possible exception of mental illness). At the other extreme, a small portion of the visits are accounted for by a preventive health orientation, where no symptoms have been perceived. But, as Zola points out (1966, 1968), "we find that the vast bulk [of a physician's load] is concerned with quite minor disorders." There is, on the other hand, he notes, a great body of data which show that there is much illness, defined as such both clinically and subjectively, which is not brought to the attention of the physician. What Zola is saying, then, is that the potential for entry into patienthood is extraordinarily widespread and continuous. One can be ill, clinically speaking, without going to the doctor; or one can go to the doctor, either without any particular change in one's clinical condition or even without any particular justification from the point of view of the physician. If variations among individuals, social subgroups, or societies in visiting rates cannot be explained, within limits, by variations in clinically-determinable morbidity, what are the factors that can predict such variations? It is the purpose of this paper to present a model which. though derived from the case of Israel, should be applicable to other societies as well.