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德国全科医生与职业健康医生的合作:如何优化?一项定性研究。

Cooperation between general practitioners and occupational health physicians in Germany: how can it be optimised? A qualitative study.

机构信息

Division of General Practice/Family Medicine, University Hospital Tübingen, Österbergstraße 9, 72074, Tübingen, Germany,

出版信息

Int Arch Occup Environ Health. 2014 Feb;87(2):137-46. doi: 10.1007/s00420-013-0845-1. Epub 2013 Jan 24.

Abstract

PURPOSE

General practitioners (GPs) and occupational health physicians (OPs) have several overlapping work fields, such as important functions in prevention, rehabilitation and reintegration into the workplace. In Germany, however, cooperation between GP and OP is often lacking or suboptimal. In this article, we analysed the suggestions for optimisation of cooperation.

METHODS

Three focus groups were interviewed: GP, OP and medical doctors working in both fields. A qualitative content analysis was performed.

RESULTS

Categories of suggestions could be assigned to five issues: the "Systemic View" concerning the state and/or employer (e.g. the system of remuneration for GPs), "Inter-collegial Contact" (e.g. fostering "friendly exchanges" between both groups), "Medical Education" (e.g. introducing joint quality circles), "Contents of both Specialities" (e.g. necessity of communicating respective contents and competences), and "Patient-centred Care" (e.g. reintegration into workplace after longer periods of illness). The optimisation of cooperation was considered necessary by the OPs, whereas its necessity was sometimes questioned in the GPs' group.

CONCLUSION

In many aspects, the present data agree with results of studies from other countries addressing the cooperation between GPs and OPs and/or other specialists. Many suggestions obtained in this study are practical and could be implemented into daily routine. Future quantitative research is required to better assess the relative weight of the suggestions presented here.

摘要

目的

全科医生(GP)和职业健康医生(OP)有几个重叠的工作领域,例如在预防、康复和重返工作岗位方面发挥重要作用。然而,在德国,GP 和 OP 之间的合作往往缺乏或不理想。在本文中,我们分析了优化合作的建议。

方法

采访了三个焦点小组:GP、OP 和同时在这两个领域工作的医生。进行了定性内容分析。

结果

建议类别可分为五个问题:“系统视角”涉及国家和/或雇主(例如 GP 的薪酬体系)、“院际联系”(例如促进两组之间的“友好交流”)、“医学教育”(例如引入联合质量圈)、“两个专业的内容”(例如有必要沟通各自的内容和能力)和“以患者为中心的护理”(例如在病假较长时间后重返工作岗位)。OP 认为优化合作是必要的,而在 GP 组中,有时会对其必要性提出质疑。

结论

在许多方面,这些数据与来自其他国家的研究结果一致,这些研究涉及 GP 和 OP 之间的合作以及与其他专家的合作。本研究中获得的许多建议都是切实可行的,可以纳入日常工作中。需要进行未来的定量研究,以更好地评估这里提出的建议的相对重要性。

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