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马来西亚关于公共医疗服务提供者对家庭医学专科医生期望的全国性调查——对623条书面评论的定性分析

A nationwide survey on the expectation of public healthcare providers on family medicine specialists in Malaysia-a qualitative analysis of 623 written comments.

作者信息

Chew Boon-How, Cheong Ai-Theng, Ismail Mastura, Hamzah Zuhra, A-Rashid Mohd-Radzniwan, Md-Yasin Mazapuspavina, Ali Norsiah

机构信息

Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

Health Clinic Seremban 2, Ministry of Health, Seremban, Negeri Sembilan, Malaysia.

出版信息

BMJ Open. 2014 Jun 11;4(6):e004645. doi: 10.1136/bmjopen-2013-004645.

Abstract

OBJECTIVE

To examine the expectation of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.

DESIGN

Cross-sectional study.

SETTING

This study is part of a larger national study on the perception of the Malaysian public healthcare professionals on FMSs.

PARTICIPANTS

PHCPs from three categories of health facilities, namely hospitals, health clinics and health offices.

MAIN OUTCOME MEASURES

Qualitative analysis of written comments of respondents' expectation of FMSs.

RESULTS

The participants' response rate was 58% (780/1345) with an almost equal proportion from each public healthcare facility. We identified 21 subthemes for the 623 expectation comments. The six emerging themes are (1) need for more FMSs, (2) clinical roles and functions of FMSs, (3) administrative roles of FMSs, (4) contribution to community and public health, (5) attributes improvement and (6) research and audits. FMSs were expected to give attention to clinical duty. Delivering this responsibility with competence included having the latest medical knowledge in their own and others' medical disciplines, practising evidence-based medicine in prehospital and posthospital care, better supervision of staff and doctors under their care, fostering effective teamwork, communicating more often with hospital specialists and making appropriate referral. Expectations ranged from definite and strong for more FMSs at the health clinics to low expectation for FMSs' involvement in research; to mal-expectation on FMSs' involvement in community and public health programmes.

CONCLUSIONS

There were some remarkable differences in expectations on FMSs from the three different PHCPs. These ranged from being clinically competent and administratively available for patients and staff at the health clinics, to mal-expectations on FMSs to engage in public health affairs. Relevant parties, including FMSs themselves, could take appropriate self-improvement initiatives to enhance public practice of family medicine and patient care.

TRIAL REGISTRATION NUMBER NMRR ID

08-12-1167.

摘要

目的

调查在公共卫生诊所与家庭医学专科医生(FMS)密切合作的公共医疗服务提供者/专业人员(PHCP)的期望。

设计

横断面研究。

背景

本研究是一项关于马来西亚公共医疗专业人员对FMS认知的大型全国性研究的一部分。

参与者

来自三类卫生机构的PHCP,即医院、卫生诊所和卫生办公室。

主要观察指标

对受访者对FMS期望的书面评论进行定性分析。

结果

参与者的回复率为58%(780/1345),每个公共医疗设施的比例几乎相等。我们从623条期望评论中确定了21个副主题。六个新出现的主题是:(1)需要更多的FMS;(2)FMS的临床角色和功能;(3)FMS的行政角色;(4)对社区和公共卫生的贡献;(5)属性改进;(6)研究和审计。FMS应关注临床职责。胜任地履行这一职责包括在自己和其他医学学科拥有最新的医学知识,在院前和院后护理中实施循证医学,更好地监督其护理下的工作人员和医生,促进有效的团队合作,更频繁地与医院专科医生沟通并进行适当转诊。期望范围从对卫生诊所增加更多FMS的明确而强烈的期望,到对FMS参与研究的低期望;再到对FMS参与社区和公共卫生项目的错误期望。

结论

来自三种不同PHCP对FMS的期望存在一些显著差异。这些期望范围从在卫生诊所对患者和工作人员具备临床能力和行政可用性,到对FMS参与公共卫生事务的错误期望。包括FMS自身在内的相关各方可以采取适当的自我改进措施,以加强家庭医学的公共实践和患者护理。

试验注册号

NMRR ID:08 - 12 - 1167。

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