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对初级医疗保健的满意度:精神分裂症患者的观点

Satisfaction with primary care: the perspectives of people with schizophrenia.

作者信息

Lester Helen, Tritter Jonathan Q, England Elizabeth

机构信息

Department of Primary Care and General Practice, Medical School, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

出版信息

Fam Pract. 2003 Oct;20(5):508-13. doi: 10.1093/fampra/cmg502.

Abstract

BACKGROUND

Schizophrenia affects up to 1% of the population in the UK. People with schizophrenia use the National Health Service frequently and over a long period of time. However, their views on satisfaction with primary care are rarely sought.

OBJECTIVES

This study aimed to explore the elements of satisfaction with primary care for people with schizophrenia.

METHOD

A primary care-based study was carried out using semi-structured interviews with 45 patients with schizophrenia receiving shared care with the Northern Birmingham Mental Health Trust between 1999 and 2000.

RESULTS

Five major themes that affect satisfaction emerged from the data: the exceptional potential of the consultation itself; the importance of aspects of the organization of primary care; the construction of the user in the doctor-patient relationship; the influence of stereotypes on GP behaviour; and the importance of hope for recovery.

CONCLUSION

Satisfaction with primary care is multiply mediated. It is also rarely expected or achieved by this group of patients. There is a significant gap between the rhetoric and the reality of user involvement in primary care consultations. Acknowledging the tensions between societal and GP views of schizophrenia as an incurable life sentence and the importance to patients of hope for recovery is likely to lead to greater satisfaction with primary health care for people with schizophrenia.

摘要

背景

精神分裂症影响着英国多达1%的人口。精神分裂症患者长期频繁使用国民医疗服务体系。然而,很少有人征求他们对初级医疗保健满意度的看法。

目的

本研究旨在探讨精神分裂症患者对初级医疗保健满意度的影响因素。

方法

开展了一项基于初级医疗保健的研究,对1999年至2000年间与伯明翰北部心理健康信托基金接受联合护理的45名精神分裂症患者进行了半结构化访谈。

结果

数据中出现了影响满意度的五个主要主题:咨询本身的特殊潜力;初级医疗保健组织方面因素的重要性;医患关系中患者的角色构建;刻板印象对全科医生行为的影响;以及康复希望的重要性。

结论

对初级医疗保健的满意度受到多种因素的调节。这个患者群体也很少有这样的期望或能够实现这种满意度。在初级医疗保健咨询中,患者参与的言辞与现实之间存在显著差距。认识到社会和全科医生将精神分裂症视为一种无法治愈的终身疾病的观点之间的矛盾,以及康复希望对患者的重要性,可能会使精神分裂症患者对初级医疗保健更加满意。

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