Payne F, Shipman C, Dale J
Department of Palliative Care and Policy, Guy's, King's and St Thomas' School of Medicine, Bessemer Road, London SE5.
Fam Pract. 2001 Apr;18(2):156-60. doi: 10.1093/fampra/18.2.156.
The use of the telephone to deliver health care advice has increased considerably in recent years. Little research has been carried out to explore the experience of patients who receive such advice and its acceptability.
The aim of this study is to describe the expectations of patients, or third party callers, who had contacted a GP out-of-hours co-operative and their satisfaction with telephone advice received.
Semi-structured interviews were conducted by telephone 7-10 days after contact with one inner city GP co-operative.
A total of 47 telephone consultations were followed up with an interview. Of these, 23 (48.9%) callers had expected to be offered a home visit when they called. Reasons for wanting a home visit were either to do with the nature of the condition and its perceived severity, problems in being able to attend the primary care centre and the risks of travel, or because of problems in communicating over the telephone. Satisfaction with telephone consultations centred mostly on the doctor being able to provide reassurance and give adequate time to allay concerns. The most common reasons given for dissatisfaction were the caller feeling that the doctor could not make a correct diagnosis without having seen the patient, or the caller being made to feel that they were wasting the doctor's time. Many patients were anxious about their ability to describe symptoms over the telephone, or understand and follow the advice that they received.
There appears to be a need for patients to be better informed about the service they can expect to receive from GP co-operatives. Recent developments such as NHS Direct may have an influence on the telephone consultation rate to GP co-operatives.
近年来，通过电话提供医疗保健建议的方式使用显著增加。但很少有研究探讨接受此类建议的患者的体验及其可接受性。
本研究旨在描述联系过非工作时间全科医生合作机构的患者或第三方来电者的期望，以及他们对所获电话建议的满意度。
在与一家市中心全科医生合作机构联系7至10天后，通过电话进行半结构化访谈。
共对47次电话咨询进行了随访访谈。其中，23名（48.9%）来电者在打电话时期望能得到上门问诊服务。希望上门问诊的原因要么与病情的性质及其严重程度、前往基层医疗中心的困难和出行风险有关，要么是因为电话沟通存在问题。对电话咨询的满意度主要集中在医生能够给予安心并花足够时间消除顾虑。最常见的不满原因是来电者觉得医生在未见到患者的情况下无法做出正确诊断，或者来电者感觉自己在浪费医生的时间。许多患者担心自己在电话中描述症状的能力，或者理解和遵循所获建议的能力。
似乎有必要让患者更好地了解他们从全科医生合作机构可能获得的服务。诸如国民保健服务热线等近期的发展可能会对全科医生合作机构的电话咨询率产生影响。
