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担心浪费全科医生的时间成为寻求帮助的障碍:一项基于社区的定性研究。

Worrying about wasting GP time as a barrier to help-seeking: a community-based, qualitative study.

作者信息

Cromme Susanne K, Whitaker Katriina L, Winstanley Kelly, Renzi Cristina, Smith Claire Friedemann, Wardle Jane

出版信息

Br J Gen Pract. 2016 Jul;66(648):e474-82. doi: 10.3399/bjgp16X685621. Epub 2016 May 23.

Abstract

BACKGROUND

Worrying about wasting GP time is frequently cited as a barrier to help-seeking for cancer symptoms.

AIM

To explore the circumstances under which individuals feel that they are wasting GP time.

DESIGN AND SETTING

Community-based, qualitative interview studies that took place in London, the South East and the North West of England.

METHOD

Interviewees (n = 62) were recruited from a sample (n = 2042) of adults aged ≥50 years, who completed a 'health survey' that included a list of cancer 'alarm' symptoms. Individuals who reported symptoms at baseline that were still present at the 3-month follow-up (n = 271), and who had also consented to be contacted (n = 215), constituted the pool of people invited for interview. Analyses focused on accounts of worrying about wasting GP time.

RESULTS

Participants were worried about wasting GP time when time constraints were visible, while dismissive interactions with their GP induced a worry of unnecessary help-seeking. Many felt that symptoms that were not persistent, worsening, or life-threatening did not warrant GP attention. Additionally, patients considered it time-wasting when they perceived attention from nurses or pharmacists to be sufficient, or when appointment structures (for example, 'one issue per visit') were not adhered to. Close relationships with GPs eased worries about time-wasting, while some patients saw GPs as fulfilling a service financed by taxpayers.

CONCLUSION

Worrying about wasting GP time is a complex barrier to help-seeking. GP time and resource scarcity, symptom gravity, appointment etiquette, and previous GP interactions contribute to increasing worries. Friendly GP relationships, economic reasoning, and a focus on the GP's responsibilities as a medical professional reduce this worry.

摘要

背景

担心浪费全科医生的时间常常被认为是阻碍人们因癌症症状寻求帮助的一个因素。

目的

探讨个体认为自己在浪费全科医生时间的情形。

设计与背景

基于社区的定性访谈研究,在英格兰伦敦、东南部和西北部开展。

方法

从年龄≥50岁的成年人样本(n = 2042)中招募受访者(n = 62),这些成年人完成了一项“健康调查”,其中包括一份癌症“警示”症状清单。在基线时报告有症状且在3个月随访时仍存在的个体(n = 271),并且同意被联系的个体(n = 215),构成了受邀参加访谈的人群。分析重点关注关于担心浪费全科医生时间的描述。

结果

当时间限制明显时,参与者担心浪费全科医生的时间,而与全科医生的轻视互动引发了对寻求不必要帮助的担忧。许多人认为症状不持续、不恶化或不危及生命就不值得全科医生关注。此外,患者认为当他们觉得护士或药剂师的关注足够时,或者当预约安排(例如“每次就诊一个问题”)未被遵守时,就是在浪费时间。与全科医生的密切关系减轻了对浪费时间的担忧,而一些患者认为全科医生是在履行由纳税人资助的服务。

结论

担心浪费全科医生的时间是寻求帮助的一个复杂障碍。全科医生的时间和资源稀缺、症状严重程度、预约礼仪以及之前与全科医生的互动都会增加担忧。友好的医患关系、经济考量以及对全科医生作为医疗专业人员职责的关注可以减少这种担忧。

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