Salmon Peter, Peters Sarah, Rogers Anne, Gask Linda, Clifford Rebecca, Iredale Wendy, Dowrick Christopher, Morriss Richard
Division of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK.
Fam Pract. 2007 Jun;24(3):269-75. doi: 10.1093/fampra/cmm015. Epub 2007 May 15.
The level of participation in research by GPs is low internationally. Previous reports of the reasons why practitioners decline opportunities for research participation have tended to recount the barriers that they describe as if they are objective accounts.
By theoretical sampling of practitioners who had declined to participate in a research trial, we sought to interpret the functional significance and interrelationship of the barriers that they reported.
Twenty-three GPs who had declined to participate in a trial of training to manage medically unexplained symptoms were interviewed and their accounts analysed interpretatively.
The practitioners described general practice and research as alien fields. Research lacked intrinsic, clinical or professional value and was linked to evidence-based medicine which they rejected as incompatible with person-centered care. Every doctor described a lack of time for research, but time was an elastic resource that payment could release from the reservoir of their 'own time'.
The findings should inform the design and interpretation of future quantitative surveys to identify how common the attitudes that we report are. Doctors with the attitudes of those whom we interviewed will not be drawn into research by measures predicated on the assumption that it is intrinsically, clinically or professionally valuable. If they cannot be convinced of its utility, value could be conferred by payment for participation.
全科医生参与研究的程度在国际上较低。以往关于从业者拒绝参与研究机会原因的报告往往只是叙述他们所描述的障碍，就好像这些是客观描述一样。
通过对拒绝参与一项研究试验的从业者进行理论抽样，我们试图解读他们所报告的障碍的功能意义及相互关系。
对23名拒绝参与一项关于处理医学上无法解释症状培训试验的全科医生进行访谈，并对他们的叙述进行解释性分析。
这些从业者将全科医疗和研究描述为不同的领域。研究缺乏内在、临床或专业价值，且与循证医学相关联，而他们认为循证医学与以患者为中心的医疗不相容而予以拒绝。每位医生都表示缺乏进行研究的时间，但时间是一种弹性资源，报酬可以从他们“自己的时间”储备中释放出时间。
这些发现应为未来定量调查的设计和解读提供参考，以确定我们所报告的态度有多普遍。持有我们所访谈对象态度的医生不会因基于研究具有内在、临床或专业价值这一假设的措施而参与研究。如果无法让他们相信研究的效用，可以通过支付参与报酬来赋予其价值。
