Davidson Sandra K, Schattner Peter L
Department of General Practice, Monash University, East Bentleigh, VIC.
Med J Aust. 2003 Sep 15;179(6):302-5. doi: 10.5694/j.1326-5377.2003.tb05552.x.
To explore doctors' perceptions of the acceptable limits to self-treatment and to identify barriers to doctors seeking appropriate healthcare.
Self-completion, postal survey using three hypothetical case vignettes.
896 Australian doctors randomly selected from the Health Insurance Commission database and stratified by sex, discipline (general practitioner or specialist) and location (urban or rural). Data were collected between May and July 2001.
Doctors' self-reported attitudes on illness behaviour and choice of medical care in response to case vignettes.
358 (40%) doctors returned questionnaires. More participants believed it was acceptable to self-treat acute conditions (315/351; 90%) than to self-treat chronic conditions (88/350; 25%). Nine per cent (30/351) of participants believed it was acceptable to self-prescribe psychotropic medication. A greater proportion of GPs (206/230; 90%) than specialists (101/121; 83%) believed doctors are reluctant to attend another doctor, especially if the problem is psychological. Women and GPs were significantly less likely to report that it was easy to find a satisfactory treating doctor (women, 58/140 [41%]; men, 128/211 [61%]; GPs, 106/231 [46%]; specialists, 80/120 [67%]). Being a specialist was predictive of seeking appropriate healthcare for all three vignettes.
Doctors have varying opinions regarding the acceptability of self-treating chronic conditions, and perceive considerable barriers to seeking appropriate medical care. Strategies are needed to challenge the culture of self-reliance.
探讨医生对自我治疗可接受限度的看法,并确定医生寻求适当医疗保健的障碍。
使用三个假设病例 vignettes 进行自我填写的邮政调查。
从健康保险委员会数据库中随机抽取 896 名澳大利亚医生,并按性别、学科(全科医生或专科医生)和地点(城市或农村)进行分层。数据收集于 2001 年 5 月至 7 月之间。
医生针对病例 vignettes 自我报告的疾病行为态度和医疗选择。
358 名(40%)医生返回了问卷。更多参与者认为自我治疗急性疾病(315/351;90%)比自我治疗慢性疾病(88/350;25%)更可接受。9%(30/351)的参与者认为自我开精神药物是可接受的。全科医生(206/230;90%)比专科医生(101/121;83%)中更大比例的人认为医生不愿去看另一位医生,尤其是如果问题是心理方面的。女性和全科医生报告说很难找到满意的治疗医生的可能性显著更低(女性,58/140[41%];男性,128/211[61%];全科医生,106/231[46%];专科医生,80/120[67%])。成为专科医生对于所有三个 vignettes 来说都是寻求适当医疗保健的预测因素。
医生对自我治疗慢性疾病的可接受性有不同看法,并认为在寻求适当医疗护理方面存在相当大的障碍。需要采取策略来挑战自力更生的文化。