Aulagnier M, Gourheux J C, Paraponaris A, Garnier J P, Villani P, Verger P
Observatoire régional de la santé PACA, 23, rue Stanislas-Torrents, 13006 Marseille, France.
Ann Readapt Med Phys. 2004 Apr;47(3):98-104. doi: 10.1016/j.annrmp.2003.11.004.
This article presents a study on General Practitioners' (GPs) knowledge, attitudes and practice towards disabled patients.
A sample of 600 private general practitioners practising in Southeastern France was selected in 2002 with a random sampling approach stratified according to age, sex, and size of the urban unit.
A standardised questionnaire was used to collect data by telephone. Results are presented as percentages. Comparisons used Pearson's chi2 test.
Ninety percent of the GPs reported that they had to provide social assistance to their disabled patients (protecting their rights, administrative assistance, family counselor, etc.) as well as coordinating care by various other professionals. GPs frequently reported the presence of barriers that compromised the health care of disabled patients: lack of information (62.8%), time (50.2%), co-ordination between health professionals (37.7%), and training (37.7%), as well as communication problems (20.7%) and the need for assistance in clinical examinations (16.2%). More than 25% of the GPs suggested breast cancer screening (27.6%), contraceptive prevention (29.5%) or hepatitis B vaccination (29,3%) less often to their disabled than non disabled patients and 25.8% reported they had not evaluated the patients' dependency levels.
This study suggests that GPs face several barriers in caring for disabled persons. A lack of knowledge may explain inappropriate care for this population. GPs need more support and guidance in dealing with disabled patients, and coordination with other health professionals must be encouraged.
本文介绍了一项关于全科医生(GPs)对残疾患者的知识、态度和实践的研究。
2002年,采用随机抽样方法,根据年龄、性别和城市单位规模进行分层,选取了600名在法国东南部执业的私人全科医生作为样本。
使用标准化问卷通过电话收集数据。结果以百分比表示。比较采用Pearson卡方检验。
90%的全科医生报告称,他们必须为残疾患者提供社会援助(保护其权利、行政援助、家庭咨询等),并协调其他各类专业人员的护理工作。全科医生经常报告存在影响残疾患者医疗保健的障碍:信息不足(62.8%)、时间(50.2%)、卫生专业人员之间的协调(37.7%)、培训(37.7%),以及沟通问题(20.7%)和临床检查中需要协助(16.2%)。超过25%的全科医生建议为残疾患者进行乳腺癌筛查(27.6%)、避孕预防(29.5%)或乙肝疫苗接种(29.3%)的频率低于非残疾患者,25.8%的医生报告称他们未评估患者的依赖程度。
本研究表明,全科医生在照顾残疾人方面面临若干障碍。知识的缺乏可能解释了对这一人群的不适当护理。全科医生在处理残疾患者时需要更多的支持和指导,并且必须鼓励与其他卫生专业人员进行协调。