政策制定者与全科医生在实施新遗传学方面的紧张关系：扎根理论访谈研究
Tensions between policy makers and general practitioners in implementing new genetics: grounded theory interview study.
作者信息
Kumar S, Gantley M
机构信息
Department of Primary Medical Care, University of Southampton, Southampton SO16 5ST.
出版信息
BMJ. 1999 Nov 27;319(7222):1410-3. doi: 10.1136/bmj.319.7222.1410.
OBJECTIVE
To explore general practitioners' perceptions of their role in implementing genetic technology.
DESIGN
Grounded theory interview study.
SETTING
Primary care.
SUBJECTS
Purposive sample of 30 general practitioners with a further theoretical sample of 14.
RESULTS
Inconsistencies were identified between policy makers' and general practitioners' definitions of general practitioners' role in implementing the new genetics. General practitioners emphasised the need to build on current practice, whereas policy makers focused on transforming practice to include the new specialised roles and skills. Two core themes were identified: genetics in a generalist context, which included appropriate generalist intervention, the ethical dilemmas implicit in the "therapeutic gap," the familial-hereditary distinction in primary care, and the implications for generalist identity, including the potential marginalisation of generalism.
CONCLUSION
New technologies such as genetics that require implementation in general practice should be integrated within existing generalist frameworks.
目的
探讨全科医生对其在实施基因技术中角色的认知。
设计
扎根理论访谈研究。
背景
基层医疗。
研究对象
30名全科医生的目的抽样，另有14名的理论抽样。
结果
政策制定者与全科医生对全科医生在实施新基因技术中角色的定义存在不一致。全科医生强调在当前实践基础上发展的必要性，而政策制定者则专注于改变实践以纳入新的专业角色和技能。确定了两个核心主题：全科背景下的遗传学，包括适当的全科干预、“治疗差距”中隐含的伦理困境、基层医疗中的家族遗传区分以及对全科身份的影响，包括全科医学可能被边缘化。
结论
需要在全科医疗中实施的基因等新技术应整合到现有的全科框架内。
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