Preston C, Cheater F, Baker R, Hearnshaw H
Eli Lilly National Clinical Audit Centre, Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, UK.
Qual Health Care. 1999 Mar;8(1):16-21. doi: 10.1136/qshc.8.1.16.
To discover the views of patients about their experiences across the interface between primary and secondary health care, including referral from general practitioners, outpatient and inpatient care, discharge, and aftercare.
A qualitative study involving individual and focus group interviews of patients and interviews of carers.
33 patients who had attended at least one outpatient appointment or had been an inpatient between two and four months previously, and eight carers of patients with chronic conditions.
Three acute hospitals and one community health service in Leicestershire.
Common themes in the views of patients and carers towards their experiences of care.
Five themes emerged. The first four were: "getting in" (access to appropriate care), "fitting in" (orientation of care to the patient's requirements), "knowing what's going on" (provision of information), and "continuity" (continuity of staff and coordination and communication among professionals). The fifth theme was "limbo" (difficulty in making progress through the system), which was influenced by failures in care in relation to the other four themes.
The concept of progress is central to patients' views of care. It involves both progress through the healthcare system and progress towards recovery or adjustment to an altered health state. Patients' views on how well they progress through the healthcare system may be an appropriate indicator for monitoring health service performance.
了解患者对其在初级卫生保健与二级卫生保健衔接过程中的经历的看法，包括从全科医生处转诊、门诊和住院治疗、出院及后续护理。
一项定性研究，包括对患者进行个人访谈和焦点小组访谈以及对护理人员进行访谈。
33名患者，他们在之前的两到四个月内至少就诊过一次门诊或住过院，以及8名慢性病患者的护理人员。
莱斯特郡的三家急症医院和一家社区卫生服务机构。
患者和护理人员对其护理经历看法中的共同主题。
出现了五个主题。前四个主题是：“进入”（获得适当护理）、“适应”（根据患者需求调整护理）、“了解情况”（提供信息）和“连续性”（工作人员的连续性以及专业人员之间的协调与沟通）。第五个主题是“困境”（在整个系统中取得进展困难），它受到与其他四个主题相关的护理失误的影响。
进展的概念是患者护理观念的核心。它既包括在医疗系统中的进展，也包括朝着康复或适应健康状态改变的进展。患者对其在医疗系统中进展情况的看法可能是监测卫生服务绩效的一个合适指标。
