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患者希望从医生那里得到什么?对咨询的书面患者议程的内容分析。

What do patients want from doctors? Content analysis of written patient agendas for the consultation.

作者信息

McKinley R K, Middleton J F

机构信息

Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital.

出版信息

Br J Gen Pract. 1999 Oct;49(447):796-800.

Abstract

BACKGROUND

Although much has been written about what patients want when they contact their general practitioner (GP), there are no published data from large cohort studies of what patients expect.

AIM

To describe the expectations of a large group of patients who consulted with their GPs.

METHOD

A GP and a social sciences graduate carried out a content analysis of written agenda forms completed by 819 patients who consulted 46 randomly selected GPs. Inter- and intra-rater reliabilities were confirmed.

RESULTS

A total of 756 (92%) agenda forms were returned. Inter-rater reliability was satisfactory (kappa > 0.6 for all but two main themes). Almost all patients had requests they wished to make of their doctor, 60% had their own ideas about what was wrong, and 38% had considered explanations about why they were unwell. Forty-two per cent and 24% of patients had consulted because they had reached the limit of their anxiety or tolerance respectively. Seven per cent, 4%, and 2% had comments, which were usually negative, to make about previous management, communication with doctors, or time in the consultation.

CONCLUSION

These data demonstrate that most patients come to the consultation with a particular agenda. Failure to address this agenda is likely to adversely affect the outcome of many consultations.

摘要

背景

尽管已有大量关于患者联系全科医生(GP)时需求的文献,但尚无来自大型队列研究中患者期望的公开数据。

目的

描述一大群咨询全科医生的患者的期望。

方法

一名全科医生和一名社会科学专业毕业生对819名咨询46名随机选择的全科医生的患者填写的书面议程表进行了内容分析。确认了评分者间和评分者内的信度。

结果

共收回756份(92%)议程表。评分者间信度令人满意(除两个主要主题外,所有主题的kappa值均>0.6)。几乎所有患者都有想向医生提出的请求,60%的患者对自身问题有自己的看法,38%的患者思考过自己不适的原因。分别有42%和24%的患者咨询是因为他们的焦虑或忍耐达到了极限。7%、4%和2%的患者对之前的治疗、与医生的沟通或咨询时间有意见,且通常为负面意见。

结论

这些数据表明,大多数患者前来咨询时都有特定的议程。未能解决此议程可能会对许多咨询的结果产生不利影响。

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