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在初级保健咨询中征集更多问题以及简短沟通干预对协助征集问题的效用:一项定性研究。

Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study.

作者信息

Summers Rachael H, Moore Michael, Ekberg Stuart, Chew-Graham Carolyn A, Little Paul, Stevenson Fiona, Brindle Lucy, Leydon Geraldine M

机构信息

Faculty of Health Sciences, University of Southampton, Southampton, UK.

Primary Care and Population Sciences, University of Southampton, Southampton, UK.

出版信息

Patient Educ Couns. 2016 May;99(5):724-32. doi: 10.1016/j.pec.2015.12.005. Epub 2016 Jan 4.

Abstract

OBJECTIVE

To investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation.

METHODS

Eighteen GPs participating in a feasibility randomised controlled trial were interviewed. Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach.

RESULTS

Participants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice. Nevertheless, soliciting ACs in every consultation was not unanimously supported.

CONCLUSION

The prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations.

PRACTICE IMPLICATIONS

Some GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively.

摘要

目的

探讨全科医生(GP)对询问额外问题(AC)的实践看法,以及旨在辅助询问的两种简短干预措施(提示)的可接受性和效用。

方法

对参与一项可行性随机对照试验的18名全科医生进行访谈。访谈采用半结构化并进行录音。使用框架分析法对数据进行分析。

结果

参与者认为询问额外问题对于以下方面很重要:减少多次就诊的需求、早期识别严重疾病以及提高患者和全科医生的满意度。全科医生发现提示易于使用,并且一些人在研究结束后仍继续使用以帮助进行时间管理。其他人指出干预措施与他们的常规做法有相似之处。然而,并非所有人都支持在每次会诊时询问额外问题。

结论

在试验背景下,提示对全科医生来说是可接受的,但对于是否应常规询问额外问题存在分歧。一些全科医生认为该干预措施有助于他们在会诊中提高优先级确定效率。

实践意义

一些全科医生会发现,鼓励在会诊早期询问额外问题的提示能使他们更好地安排优先级,并更有效地管理时间有限的会诊。

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