Reassured or fobbed off? Perspectives on infertility consultations in primary care: a qualitative study
Reassured or fobbed off? Perspectives on infertility consultations in primary care: a qualitative study
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DOI：
10.3399/bjgp12x649133
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发表时间：
2012-06-01
影响因子：
5.9
通讯作者：
Ziebland, Sue
中科院分区：
文献类型：
--
作者：
Hinton, Lisa;Kurinczuk, Jenny J.;Ziebland, Sue
背景：在英国，9%的夫妇受到不孕症的影响。大多数夫妇因为担心自己的生育能力而去看家庭医生，他们最终会怀孕，但也有少数夫妇不会。治疗通常发生在二级护理中，但全科医生在开始调查、转介和在整个治疗过程中提供支持方面可以发挥宝贵的作用。目的：通过探索女性和男性不孕不育治疗的初级保健经验，并与全科医生参照组讨论结果，探索实践经验，从而为临床实践提供信息。设计和地点：定性患者访谈和全科医生焦点小组研究。访谈在英格兰和苏格兰的病人家中进行；焦点小组在全国会议上举行。方法：对27名女性和11名男性进行深入访谈研究。我们寻找了一个最大变异样本，并将访谈记录下来进行主题分析。与全科医生的焦点小组讨论结果，以引出他们的观点。结果：他们被认真对待的感觉对患者非常重要。一些人觉得他们的担忧没有得到认真对待，或者他们的全科医生似乎对不孕不育没有很好的了解。全科医生的焦点小组强调了方案在管理不孕不育患者方面的作用，以及全科医生在沟通安抚和承诺方面面临的困难。结论：全科医生说的和做的简单的事情，比如在第一次会诊时描述“行动计划”，可能会对表明他们认真对待生育问题产生真正的不同。
Background:Infertility affects 9% of couples in the UK. Most couples who visit their GP because they are worried about their fertility will ultimately conceive, but a few will not. Treatment usually happens in secondary care, but GPs can have an invaluable role in starting investigations, referring, and giving support throughout treatment and beyond.Aim:To inform clinical practice by exploring primary care experiences of infertility treatment among females and males, and discussing findings with a reference group of GPs to explore practice experience.Design and setting:A qualitative patient interview and GP focus group study. Interviews were conducted in patients homes in England and Scotland; the focus group was held at a national conference.Method:An in-depth interview study was conducted with 27 females and 11 males. A maximum variation sample was sought and interviews were transcribed for thematic analysis. Results were discussed with a focus group of GPs to elicit their views.Results:Feeling that they were being taken seriously was very important to patients. Some felt that their concerns were not taken seriously, or that their GP did not appear to be well informed about infertility. The focus group of GPs highlighted the role of protocols in their management of patients who are infertile, as well as the difficulty GPs faced in communicating both reassurance and engagement.Conclusion:Simple things that GPs say and do, such as describing the 'action plan' at the first consultation, could make a real difference to demonstrating that they are taking the fertility problem seriously.