Murphy E, Kinmonth A L, Marteau T
Department of Primary Medical Care, University of Southampton.
Br J Gen Pract. 1992 Jul;42(360):279-83.
Forty three patients with non-insulin dependent diabetes registered at two suburban practices were interviewed at least one year after the introduction of an organized general practice based system of diabetic surveillance and the results compared with data gathered from interviews administered before the introduction of the system. Structured data from the two interviews were compared in relation to the importance which patients attached to diabetes and its medical review, patients' preference for place of future review and the health professionals from whom they wished to receive diabetes care. Patients' ratings of the performance of health professionals on various aspects of care were compared with the ratings given before the introduction of the new service. At the follow-up interviews the reasons behind patients' responses to the structured questions were explored using a qualitative method. The introduction of a general practice based diabetes service was marked by an improvement in attendance for diabetes monitoring (56% before introduction, 98% in the year following introduction). This was associated with an increase in the importance which patients attached to diabetes and its medical review. After experience of diabetes care in general practice, patients remained enthusiastic about general practice involvement and confident in their general practitioners' knowledge about diabetes management. In spite of an improvement in the patients' ratings of hospital doctors' communication skills, they continued to rate general practitioners significantly more highly in these skills (P < 0.01) and in terms of convenience and accessibility (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
在引入基于全科医疗的糖尿病监测系统至少一年后，对在两家郊区诊所登记的43名非胰岛素依赖型糖尿病患者进行了访谈，并将结果与该系统引入前访谈收集的数据进行比较。比较了两次访谈的结构化数据，内容涉及患者对糖尿病及其医学检查的重视程度、患者对未来检查地点的偏好以及他们希望接受糖尿病护理的医疗专业人员。将患者对医疗专业人员在护理各方面表现的评分与新服务引入前给出的评分进行比较。在随访访谈中，采用定性方法探究了患者对结构化问题回答背后的原因。引入基于全科医疗的糖尿病服务的标志是糖尿病监测的就诊率有所提高（引入前为56%，引入后的一年中为98%）。这与患者对糖尿病及其医学检查重视程度的提高相关。在经历了全科医疗中的糖尿病护理后，患者对全科医疗的参与仍充满热情，并对其全科医生的糖尿病管理知识充满信心。尽管患者对医院医生沟通技巧的评分有所提高，但他们在这些技巧方面（P<0.01）以及在便利性和可及性方面（P<0.001）对全科医生的评分仍然显著更高。（摘要截短至250字）
