Seligman Hilary K, Grossman Melanie D, Bera Nathalie, Stewart Anita L
Division of General Internal Medicine, San Francisco General Hospital, Box 1364, University of California, San Francisco, CA 94143, USA.
Prev Chronic Dis. 2009 Jan;6(1):A18. Epub 2008 Dec 15.
Primary care providers have limited time for physical activity counseling. They can optimize counseling time by referring patients to community resources for more comprehensive support. To facilitate referrals, resource guides (lists of community opportunities with descriptive information) are often created but seldom used. We elicited the detailed opinions of providers about how to make resource guides more useful for them.
We asked a convenience sample of health care providers open-ended questions about resource guide usefulness. Providers included 7 physicians, 6 physical/occupational therapists, 5 registered nurses, and 2 nurse practitioners practicing in diverse settings. We identified key themes using grounded theory methodology.
All participants thought resource guides were potentially useful, particularly providers who worked in communities that were socioeconomically or culturally different from their own. Perceived benefits included providing easy access to information, facilitating specific activity recommendations, and reminding health care providers about the scope of available opportunities. Participants cautioned that resource guides were not a substitute for individual recommendations or provider counseling. They said resource guide usefulness was limited by inconvenience, frustration with outdated entries, and discomfort referring patients to programs without personal experience of program quality. Providers offered suggestions for useful information to include in the resource guides.
Resource guides may offer a critical link between clinical services and community resources. Integrating guides with existing clinical systems, incorporating mechanisms for frequent updating, and providing multiple copies will help address provider concerns. Web-based resource guides may help achieve these goals.
基层医疗服务提供者用于进行体育活动咨询的时间有限。他们可以通过将患者转介至社区资源以获得更全面的支持来优化咨询时间。为便于转介,通常会创建资源指南(包含描述性信息的社区机会列表),但很少被使用。我们征集了医疗服务提供者对于如何使资源指南对他们更有用的详细意见。
我们向一个方便抽样的医疗服务提供者群体询问了关于资源指南实用性的开放式问题。这些提供者包括7名医生、6名物理治疗师/职业治疗师、5名注册护士以及2名在不同环境中执业的执业护士。我们采用扎根理论方法确定了关键主题。
所有参与者都认为资源指南可能有用,尤其是那些在社会经济或文化背景与自己所在社区不同的社区工作的提供者。其感知到的益处包括便于获取信息、促进具体的活动建议以及提醒医疗服务提供者注意现有机会的范围。参与者提醒说,资源指南不能替代个人建议或提供者咨询。他们表示,资源指南的实用性受到不便之处、对过时条目的不满以及在没有亲身了解项目质量的情况下将患者转介至项目的不适感的限制。提供者们就资源指南中应包含的有用信息提出了建议。
资源指南可能是临床服务与社区资源之间的关键纽带。将指南与现有临床系统整合、纳入频繁更新的机制并提供多份副本将有助于解决提供者的担忧。基于网络的资源指南可能有助于实现这些目标。