van Steenkiste Ben, van der Weijden Trudy, Timmermans Daniëlle, Vaes Jaqueline, Stoffers Jelle, Grol Richard
Department of General Practice, Centre for Quality of Care Research, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Patient Educ Couns. 2004 Nov;55(2):301-7. doi: 10.1016/j.pec.2003.11.005.
The application of cardiovascular guidelines and risk tables may be impeded by many barriers. In the present paper, we explored the role of patients in the feasibility of cardiovascular preventive care in general practice. Patient-related barriers were examined by means of a qualitative study. Fifteen GPs audio-taped one or two consultations on primary cardiovascular preventive care. The tapes were used to guide the subsequent semi-structured in-depth interviews with patients. Twenty-two patients were interviewed. Patients' understanding of prevention of cardiovascular disease (CVD) was often insufficient. The risk table and the multi-factorial approach were difficult to understand. Risk perception was often unrealistic and dichotomous, and mainly based on personal experiences. There was a demand for more information and cholesterol tests. At the patient level, many barriers impede effective prevention of cardiovascular diseases. In particular, the highly individualized high-risk approach needs to be explained to patients. Educational patient materials, intended to support both the GP and the patient, should take into account the ideas, fears and expectations of patients.
心血管指南和风险表的应用可能受到许多障碍的阻碍。在本文中，我们探讨了患者在全科医疗中进行心血管预防保健可行性方面的作用。通过定性研究对与患者相关的障碍进行了调查。15名全科医生录制了一到两次关于原发性心血管预防保健的会诊。这些录音带被用于指导随后对患者进行的半结构化深入访谈。对22名患者进行了访谈。患者对心血管疾病（CVD）预防的理解往往不足。风险表和多因素方法难以理解。风险认知往往不现实且过于简单化，主要基于个人经验。患者对更多信息和胆固醇检测有需求。在患者层面，许多障碍阻碍了心血管疾病的有效预防。特别是，需要向患者解释高度个体化的高风险方法。旨在支持全科医生和患者的教育性患者材料应考虑到患者的想法、恐惧和期望。
