Arthritis Research UK Primary Care Centre, Keele University, Keele ST5 5BG, UK.
BMC Fam Pract. 2013 Dec 20;14:195. doi: 10.1186/1471-2296-14-195.
Osteoarthritis (OA) is a common cause of disability and consultation with a GP. However research suggests the majority of sufferers choose not to consult their GP regarding their symptoms. Understanding the reasons for consulting is central to optimising patient outcomes. This review aims to summarise existing literature to identify what influences patients with OA to consult their GP.
Due to the diversity of both qualitative and quantitative research that has addressed this research question a narrative review of literature has been conducted, backed up by a systematic literature search.
Nineteen papers were identified describing influences on consulting behaviour in patients with likely OA. Health beliefs, such as perceiving OA as an inevitable part of older age about which nothing can be done, in addition to perceiving a negative attitude of the GP, are disincentives to consulting. Severity of pain and disruption of daily activities are important influences towards consultation. Social issues such as the availability of support networks are also likely to be influential. Evidence is lacking about the impact of multi-morbidity on consulting behaviour.
Pain and disruption of activities appear to push towards consulting and negative attitudes regarding OA (from either the patient or GP) appear to be disincentives to consulting. Findings are limited by estimates of consultation frequency and research involving observation of consultations may improve understanding of these issues. Specifically, further research may address how pain and disrupted function are addressed and if negative attitudes are evident in the consultation.
骨关节炎（OA）是导致残疾和咨询全科医生的常见原因。然而，研究表明，大多数患者选择不就其症状咨询全科医生。了解咨询的原因是优化患者结局的核心。本综述旨在总结现有文献，以确定哪些因素影响 OA 患者咨询全科医生。
由于针对这一研究问题的定性和定量研究存在多样性，因此进行了文献的叙述性综述，并辅以系统的文献搜索。
确定了 19 篇描述了可能患有 OA 的患者咨询行为影响因素的论文。健康信念，如将 OA 视为老年不可避免的一部分，对此无能为力，以及对全科医生的负面态度，是不咨询的诱因。疼痛的严重程度和日常生活活动的中断是重要的咨询影响因素。社会问题，如支持网络的可用性，也可能具有影响力。关于多病共存对咨询行为的影响证据不足。
疼痛和活动的中断似乎促使患者咨询，而对 OA 的负面态度（来自患者或全科医生）似乎是不咨询的诱因。研究结果受到咨询频率估计的限制，涉及观察咨询的研究可能会增进对这些问题的理解。具体来说，进一步的研究可能会解决疼痛和功能障碍如何得到解决，以及在咨询中是否存在负面态度等问题。
