Family Medicine, Boston University School of Medicine, Boston, MA, USA Community Health Sciences, Boston University School of Public Health, Boston, MA, USA Health Policy and Management, Boston University School of Public Health, Boston, MA, USA.
J Intellect Disabil Res. 2013 Nov;57(11):1058-67. doi: 10.1111/j.1365-2788.2012.01606.x. Epub 2012 Sep 14.
People with intellectual disabilities (ID) receive primary care in community-based practices and are encouraged to participate in the physician-patient relationship. However, the nature of this participation is not known.
Qualitative data were analysed to obtain perspectives from patients and providers regarding clinic visits. Patient participants were recruited from community organisations, while physician participants were recruited from emails and phone calls to local and regional practices and a national and regional list serve. Analysis methods derived from grounded theory were used.
Twenty-seven women with ID and 22 family physicians were interviewed. Themes important to both groups included time, how the support worker should be used in the encounter and the nature of the physician-patient relationship. Patients expressed frustration at how little time they spent with their physician, and wished that physicians would speak directly to them instead of to their support worker. Physicians felt that patients with ID took too much time, and said that they preferred communicating with the support worker. The interviews also revealed unconscious biases about people with ID.
Patient participation is encouraged for people with ID, but is limited because of both physician and patient factors. Greater awareness of these factors may improve care for patients with ID.
智障人士（ID）在社区实践中接受初级保健，并被鼓励参与医患关系。然而，这种参与的性质尚不清楚。
对定性数据进行分析，以从患者和提供者的角度了解就诊情况。患者参与者是从社区组织招募的，而医生参与者是从当地和地区的实践以及全国和地区的列表中通过电子邮件和电话招募的。使用了源自扎根理论的分析方法。
对 27 名智障女性和 22 名家庭医生进行了访谈。对两组都很重要的主题包括时间、支持人员在就诊中应如何使用以及医患关系的性质。患者对他们与医生在一起的时间太少感到不满，并希望医生直接与他们交谈，而不是与他们的支持人员交谈。医生认为 ID 患者花费的时间太多，并表示他们更喜欢与支持人员沟通。访谈还揭示了对 ID 患者的无意识偏见。
鼓励 ID 患者参与，但由于医生和患者的因素，这种参与受到限制。更多地了解这些因素可能会改善 ID 患者的护理。
