Drennan Vari, Walters Kate, Lenihan Penny, Cohen Shoshanna, Myerson Sybil, Iliffe Steve
Department of Primary Care and Population Sciences, Royal Free and University College London Medical School, University College, London, UK.
Fam Pract. 2007 Oct;24(5):454-60. doi: 10.1093/fampra/cmm034. Epub 2007 Aug 4.
Primary care practitioners are encouraged to identify unmet need in older people, but the best mechanisms for doing this are not known.
To identify common unmet needs, as perceived by older people and professionals, that could be enquired about during routine encounters in primary care.
This was a nominal group technique qualitative study conducted with older people in London and primary care professionals working in the same localities. Subjects were seven nominal groups of 5-12 participants each, four with culturally diverse user groups recruited through local community and voluntary sector resources and three with primary care professionals (GPs and nurses). Group interviews were conducted with two facilitators and one observer recording field notes and were tape-recorded and transcribed for data collection.
Older people and professionals share some ideas about unmet need, but there are important differences. Older people may emphasize their autonomy and right to make choices, while professionals may use epidemiological knowledge to justify their own agendas, which may be considered intrusive. Nominal groups can be useful tools for capturing perspectives of different groups, but prioritization of themes identified by nominal groups may not always be feasible.
Unmet need is a complex concept, with different interpretations according to the perspective taken. Professionals relying on epidemiological knowledge to guide their enquiries about unmet needs in older patients may find that the needs that they identify are not perceived as unmet, or even meetable, by their patients.
鼓励基层医疗从业者识别老年人未被满足的需求，但实现这一目标的最佳机制尚不清楚。
识别老年人和专业人员所认为的常见未被满足的需求，这些需求可在基层医疗的常规诊疗中进行询问。
这是一项采用名义群体技术的定性研究，研究对象为伦敦的老年人以及在同一地区工作的基层医疗专业人员。研究对象分为7个名义群体，每个群体有5至12名参与者，其中4个群体是通过当地社区和志愿部门资源招募的文化背景各异的用户群体，另外3个群体是基层医疗专业人员（全科医生和护士）。由两名主持人和一名观察员进行小组访谈，观察员记录现场笔记，并进行录音和转录以收集数据。
老年人和专业人员在未被满足的需求方面有一些共同的想法，但也存在重要差异。老年人可能强调他们的自主权和做出选择的权利，而专业人员可能会利用流行病学知识来为自己的议程辩护，这可能被认为具有侵扰性。名义群体可以作为获取不同群体观点的有用工具，但对名义群体确定的主题进行优先级排序可能并不总是可行的。
未被满足的需求是一个复杂的概念，根据所采取的视角有不同的解释。依靠流行病学知识来指导对老年患者未被满足需求进行询问的专业人员可能会发现，他们所确定的需求在患者看来并非未被满足，甚至是无法满足的。
