Stafford Victoria, Greenhalgh Susan, Davidson Ian
NHS Bolton, Elective Orthopaedic Dept., Bolton One, Moor Lane, Bolton BL3 5BN, United Kingdom.
Department of Health Professions, Manchester Metropolitan University, Hathersage Road, Manchester M13 0JA, United Kingdom.
Physiotherapy. 2014 Mar;100(1):66-72. doi: 10.1016/j.physio.2013.08.001. Epub 2013 Nov 14.
To explore why patients with simple mechanical back pain seek urgent care.
Qualitative Exploratory Inquiry based on the principles of Grounded Theory.
Urgent Care.
Data collection by semi-structured interview.
Eleven patients presenting to urgent care (Accident and emergency, Walk-in Centre and Out of hours service) with back pain.
The study identified eight key motivators of patients with mechanical back pain seeking urgent care: (1) GP access, (2) Pain, (3) Function, (4) Something being different, (5) Something being wrong, (6) Desire for investigation, (7) Third Party Influence and (8) Repeat visits.
This study provides some evidence to support the notion that patients are willing to use primary care services for the treatment of Simple Mechanical Back Pain but that access is frequently limited and untimely. The study concludes that inappropriate attendances at urgent care facilities are frequently a human response to perception of pain severity which is reinforced by functional loss, uncertainty, the need to provide care for others and the encouragement of others. While it is asserted that there is a clear need for mass education in this area, it is also speculated that attendance at urgent care may occur to overtly escalate the need for assistance and illustrate to sceptical significant others the severity of the condition.
探讨单纯机械性背痛患者寻求紧急护理的原因。
基于扎根理论原则的定性探索性研究。
紧急护理机构。
通过半结构化访谈收集数据。
11名因背痛前往紧急护理机构(事故与急诊部、随到随诊中心及非工作时间服务机构)就诊的患者。
该研究确定了机械性背痛患者寻求紧急护理的八个关键动机:(1)看全科医生的机会,(2)疼痛,(3)功能,(4)感觉异样,(5)感觉不适,(6)渴望检查,(7)第三方影响,(8)多次就诊。
本研究提供了一些证据支持以下观点:患者愿意利用初级保健服务治疗单纯机械性背痛,但就诊机会往往有限且不及时。该研究得出结论,在紧急护理机构不适当就诊往往是人们对疼痛严重程度的一种反应,功能丧失、不确定性、照顾他人的需要以及他人的鼓励会强化这种反应。虽然有人断言在这一领域显然需要进行大众教育,但也有人推测,前往紧急护理机构就诊可能是为了公然增加获得援助的需求,并向持怀疑态度的重要他人表明病情的严重性。