Jones Roger, Ballard Karen
Department of General Practice and Primary Care, King's College, London School of Medicine, London, UK.
Eur J Gastroenterol Hepatol. 2008 Apr;20(4):269-75. doi: 10.1097/MEG.0b013e3282f2a5bd.
Gastro-oesophageal reflux disease (GORD) is a common problem in the community, and many patients do not seek medical attention despite potential morbidity and the availability of effective therapeutic interventions. The factors which determine healthcare seeking in GORD are not well understood.
To examine the symptom experience and health and illness beliefs in people with GORD, who had either been diagnosed with the condition, or were dealing with the symptoms themselves.
A total of 12 focus groups and 65 face-to-face interviews were conducted in the USA, UK, France and Germany, and involved 164 participants, who had either been diagnosed with GORD or were identified as having GORD in the community, using a random digit dialling telephone method. Transcripts of focus groups and interviews were analysed thematically, using a constant comparative approach, to identify key factors associated with healthcare seeking.
Patients' descriptions of GORD symptoms were often vivid, with the use of unexpected imagery and unusual beliefs about causality. We were able to identify four factors associated with healthcare seeking for GORD which were: the characteristics of symptoms (intensity and control), the perceived seriousness of symptoms, interference by symptoms with daily life and views about medicines and the medical profession.
Patients with GORD, using both self care and formal medical care, have a surprising range of ideas about the causes and best treatments of their symptoms. Physicians' awareness of these beliefs, coupled with an understanding of the factors associated with healthcare seeking for GORD, is likely to be important in enhancing clinical management and in patient and public education.
胃食管反流病（GORD）是社区中的常见问题，尽管存在潜在的发病率且有有效的治疗干预措施，但许多患者并未寻求医疗帮助。目前对于决定GORD患者寻求医疗服务的因素尚不清楚。
研究已被诊断患有GORD或正在自行应对相关症状的患者的症状体验以及健康和疾病观念。
在美国、英国、法国和德国共进行了12个焦点小组讨论和65次面对面访谈，涉及164名参与者，这些参与者要么已被诊断患有GORD，要么通过随机数字拨号电话方法在社区中被确定为患有GORD。使用持续比较法对焦点小组讨论和访谈的文字记录进行主题分析，以确定与寻求医疗服务相关的关键因素。
患者对GORD症状的描述通常很生动，会使用意想不到的意象以及对因果关系持有不寻常的观念。我们能够确定与GORD患者寻求医疗服务相关的四个因素，即：症状特征（强度和可控性）、对症状严重性的认知、症状对日常生活的干扰以及对药物和医疗行业的看法。
GORD患者在使用自我护理和正规医疗护理时，对其症状的病因和最佳治疗方法有着令人惊讶的广泛想法。医生了解这些观念，再加上对与GORD患者寻求医疗服务相关因素的理解，可能对加强临床管理以及患者和公众教育具有重要意义。
