Psychology Department, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
Br J Health Psychol. 2011 Nov;16(4):862-79. doi: 10.1111/j.2044-8287.2011.02023.x. Epub 2011 Apr 13.
Provision of unscheduled health care (e.g., emergency department, family doctor consultations, pharmacist) is aided by matching patients with the 'right service, first time'. However, service choice is usually made by patients and carers rather than service providers. The self-regulation model (SRM) posits that people cope in ways consistent with their illness understanding. The SRM was used to examine differences in people's use of primary, secondary, and community health care services according to their illness representation, whilst also examining associations with chronic illness. Research historically treats illness representations at the level of independent components; this research focused on components as sets (profiles).
A general population postal survey obtained usable data from 588 respondents on service usage and illness representation.
Cluster analysis detected three illness representation profiles (participant groups) comprising people who regarded their illness as serious, unambiguous, distressing, and difficult to manage (group 1); chronic and concerning, but believing they understood and could manage it (group 2); short-term, of limited impact or concern but ambiguous in nature (group 3). Overall, group 1 used secondary care more than the other groups. When considering illness chronicity, group 1 showed more use of primary care with non-chronic conditions and secondary care with chronic conditions.
Findings highlighted differences in use of unscheduled services that were related to illness representation profiles. Interventions for moderating service use such as patient information campaigns may need to be tuned towards specific groups of service users to optimize impact.
通过将患者与“合适的服务、首次匹配”，为非计划性的医疗保健（例如，急诊、家庭医生咨询、药剂师）提供便利。然而，服务选择通常是由患者和护理人员而不是服务提供者做出的。自我调节模型（SRM）假设人们会以符合其疾病理解的方式应对。该模型用于根据患者的疾病表现来检查他们对初级、二级和社区卫生保健服务的使用差异，同时还检查与慢性病的关联。历史上，研究将疾病表现视为独立的组成部分；本研究侧重于组件集（即疾病表现组）。
一项基于总体人群的邮寄调查从 588 名应答者处获得了有关服务使用和疾病表现的可用数据。
聚类分析检测到三种疾病表现特征（患者群体），包括将疾病视为严重、明确、痛苦和难以管理的患者（群体 1）；慢性且令人担忧，但认为自己了解并能够管理疾病的患者（群体 2）；短期、影响有限或关注但性质不明确的患者（群体 3）。总体而言，群体 1 比其他群体更多地使用二级护理。在考虑疾病的慢性程度时，群体 1 在非慢性疾病中更多地使用初级护理，而在慢性疾病中更多地使用二级护理。
研究结果突出了与疾病表现特征相关的非计划性服务使用差异。调节服务使用的干预措施，例如患者信息宣传活动，可能需要针对特定的服务使用者群体进行调整，以优化效果。
