Pasarín M Isabel, Fernández de Sanmamed M José, Calafell Joana, Borrell Carme, Rodríguez Dolors, Campasol Salvador, Torné Elvira, Torras M Glòria, Guarga Alex, Plasència Antoni
Agència de Salut Pública de Barcelona, Barcelona, España.
Gac Sanit. 2006 Mar-Apr;20(2):91-9. doi: 10.1157/13087318.
To ascertain why people attend hospital emergency departments (ED) for low complexity health problems.
A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n = 36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation.
Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their self-perception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual's family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making.
The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual.
确定人们因低复杂性健康问题前往医院急诊科（ED）的原因。
进行了一项现象学、互动主义的定性研究。设计了一个理论样本，从加泰罗尼亚（西班牙）选取了一个城市地区和一个农村地区。在每个地区，选择在研究开始前1个月使用过急诊科或初级保健紧急服务的人员（n = 36）。通过8个焦点小组获取数据。进行了解释性内容分析，并通过研究三角法构建了新出现的类别。
出现了五个类别：症状、是否涉及自我诊断、需求感知、对可用医疗服务的认知以及个人的整体背景。症状引发了健康状况不佳的感觉，从而促使人们寻求医疗护理。自我诊断决定了感知到的需求和所寻求的护理类型。人们将自己对需求的自我认知与对可用医疗服务的看法进行了对比。由于这种对比，做出了前往一种或另一种服务机构的决定，但个人的家庭、工作和社会状况也起到了一定作用。与初级保健提供的服务相比，受访者对急诊科提供的服务更为熟悉。时间消耗在决策中也起着重要作用。
自我诊断的存在与否是影响前往急诊科就诊的一个决定性因素。其他影响需求的因素包括对可用医疗服务的认知水平、既往经历以及个人的生活状况。
